CIDRAP: Growing Drug Shortages Due To COVID-19

FDA infographic


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The potential knock-on effects from the COVID-19 (or any other severe) pandemic extend far beyond the obvious morbidity and mortality from the virus, the economic impacts of shutdowns, and even the potential collapse of some healthcare delivery systems. 

Depending upon the severity and the duration of a pandemic, global supply chains of essential goods could come under intense pressure, and regional shortages of food, drugs, and hundreds of other items could be expected.  

Lest you think that these sort of shortages are unlikely, yesterday the FAO released the following warning:

FAO Director-General urges G20 to ensure that food value chains are not disrupted during COVID-19 pandemic

Global and national markets must continue to be a transparent, stable and reliable source of food supply 

We've looked at supply chain issues during a pandemic many times over the past dozen years, including in 2018's  Supply Chain Of Fools (Revisited), where I wrote:

But it isn't just gloves, gowns, and masks that will be in short supply.

IV bags, tubing, oxygen tubes, needles and syringes, and nearly all of our pharmaceutical drugs (including antibiotics & antivirals) . . . essentially everything needed to run a hospital or pharmacy . . . is either made overseas or is dependent on raw materials from other countries.

          and . . .

Collateral damage, not the infection itself, could prove to be the biggest killer during the next pandemic.

The inability to get routine or emergency medical treatment, or maintenance drugs (insulin, B/P or heart meds, antibiotics, etc.), or perhaps even sufficient food or potable water, could claim more lives than the virus.

Whether COVID-19 lasts long enough, and is severe enough, to cause the worst of these types of disruptions is far from certain - but if not COVID-19 - another pandemic surely will. Our JIT (Just In Time) inventory delivery system, while streamlined and economical, isn't built to handle major disruptions.

This week CIDRAP, which has long examined the cascading impacts of a severe pandemic upon society (see Pandemic Influenza, Electricity & The Coal Supply Chain), released preliminary findings of an 18-month study of essential drug shortages during a severe pandemic.

CIDRAP Finds Supply Chain Risks Availability of Critical Drugs During COVID-19 Pandemic

The Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota announced today preliminary findings from its Resilient Drug Supply Project to address shortages of life-saving drugs in the U.S.

The Resilient Drug Supply Project focuses on the supply chains and global disruptions for the most critical drugs for life-saving and life-sustaining treatment. As part of this work, CIDRAP is developing a detailed mapping of the entire supply chain for critical U.S. drug products, from key starting materials to patients.

Outcomes of this research will improve the health care supply system’s ability to maintain a steady and adequate supply of critical medicines and supplies worldwide.
For the past 18 months, CIDRAP, supported by Christy Walton through the Walton Family Foundation, and in partnership with the New Zealand Medicines & Medical Devices Safety Authority, has been investigating the vulnerability of the U.S. healthcare system to shortages of drugs and their active pharmaceutical ingredients (API) and especially those made in other countries, principally China and India.

This critical drug supply chain is likely to be significantly disrupted by the COVID-19 pandemic.

Preliminary findings include:

• 156 critical drugs have been identified that are needed for acute care within a few hours to days or patient mortality rises;

• many of these drugs are made, formulated, packaged, or have an API made in China, India, Italy or other severely affected countries;

• the precise health risk of drug shortage to the U.S. healthcare system is difficult to determine due to the lack of structural transparency and available supply chain data about drugs, which may be known by pharmaceutical companies, wholesalers, suppliers, and contract manufacturers, but not shared with the Food and Drug Administration or the public;

• if pharmaceutical companies, their suppliers, and contract manufacturers do not disclose supply chain information on critical drugs, including their current inventory and relative dependency on any China/India-based supply chain, it is assumed that some of the 156 critical drugs will be in short supply within the next 90 days.

“With the COVID-19 pandemic expected to last many more months and with more patients in need of life-saving drugs, we call upon the pharmaceutical companies and their partners to publicly come forward with current inventory levels and information on the status and relative resiliency of their critical drug supply chains,” said Michael T. Osterholm, Co-Principal Investigator of the project and University of Minnesota Regents Professor, McKnight Presidential Endowed Chair in Public Health, and director of CIDRAP. Osterholm added information on supply chains is essential to healthcare systems, nursing homes, pharmacies, and public health agencies as they plan and prepare in the event a shortage of drugs arises.

“This is life and death, and the public needs to know where their drugs come from and be assured they will always be available in a timely manner,” according to Stephen W. Schondelmeyer, Co-Principal Investigator of the project and Professor in the College of Pharmacy at the University of Minnesota, Century Mortar Club Endowed Chair in Pharmaceutical Management & Economics, and Director of the PRIME Institute.

(Continue . . . )

Last night, CIDRAP News carried a news story on this study, and provided additional information on current drug shortages.

Experts say COVID-19 will likely lead to US drug shortages

Filed Under: COVID-19Robert Roos | News Writer | CIDRAP News |
Mar 27, 2020

While the jury is still out on how bad COVID-19 will be - at least in developed countries who are able to keep their healthcare systems functioning - it will severely test our global supply chains in the months ahead, and its repercussions could last long after the virus has abated.

COVID-19 is unlikely to be the last stress test of our global supply chain, so hopefully we'll put the knowledge we gain - and the time we have before the next crisis - to good use.