Scott Whyte, chief digital officer at AeroSafe Global, looks at how control towers in pharma can help bolster the supply chain for drugs.
Control towers in the traditional sense are integral to safe air travel. Operators are stationed in tall structures for 360-degree visibility of air traffic, along with radar technologies to augment what can be seen visually, and radio communications to relay vital updates to pilots. It’s safe to say that most travellers and crew members would not fly without support from air traffic personnel sitting in the tower.
While biopharmaceutical supply chain control towers lack the soaring height of their air traffic counterparts, they offer visibility to ensure that prescribed medications arrive at their destination safely – particularly those that are temperature controlled. Today most newly approved medications have strict temperature control and handling requirements. Yet according to a 2019 IQVIA Institute study, the pharmaceutical industry loses around $35 billion annually for temperature-related product issues. With mRNA-based treatments accelerating along with precision medicine and other biologic drug discoveries, the need for strict thermal control will only increase in urgency.
Ensuring Patient Safety and Optimal Outcomes
The traditional pharma manufacturer control tower has received recognition across the ongoing Covid-19 landscape for ability to proactively identify upstream issues such as active pharmaceutical ingredient (API) shortages, or downstream issues such as delays leading to possible temperature excursions. Real-time data from carriers, IoT enabled devices, suppliers and more, feed the control tower construct not unlike how real-time flight status updates inform operators in an air traffic tower.
This process of surfacing, normalising and aggregating data creates a framework for identifying problematic events, and a foundation for generating actionable insights – but what actions and when? Defining these events or thresholds that should be acted upon by an authorised operator is another important piece of a control tower implementation. As an example, a user that is alerted to a delayed delivery of a medical device for a patient’s scheduled surgery should be empowered to intervene if the delay may lead to a cancelled procedure.
The goal of each intervention is to seamlessly enable the best patient outcome. In the above scenario, the intervention could consist of placing a call to the clinic to simply communicate the delay – though in another scenario, the operator would procure a replacement product with overnight delivery while simultaneously retrieving the delayed package for return to the manufacturer.
Downstream Effects of Excursions
In another example, consider the cancer patient waiting for the delivery of post-chemotherapy medicine to stimulate the generation of protective white blood cells. If this expensive medicine were to be delayed, the patient would likely need to go to a clinic to receive the injection – an inconvenient trip and more expensive delivery site that places the patient in a public setting while immunocompromised. The worst-case scenario is a package of this important therapy sitting outside, in the heat, while its efficacy starts to wane yet the patient, feeling weak, sick, anxious – takes it as directed and yet still ends up admitted to the hospital with an infection because the medicine was degraded by the extreme heat and melting coolant.
This is why the most impactful supply chain control towers are comprised of a robust intervention program. By prioritising the removal of any potentially impacted therapy from last mile distribution, no patient ever receives a subpar therapy whether it be medication to treat an ailment, or a vaccine to prevent illness onset. And in this era of heightened vaccine hesitancy spurred by Covid, deploying control tower capabilities to eliminate degraded therapies from the medical ecosystem may assuage lingering concerns related to product authenticity or condition.
A Cold Chain Control Tower in Action
In early 2021 as the mRNA-based Covid vaccines were being deployed to elderly residents of long term care homes, the media focus was primarily on the supply of doses and how to prioritise recipients. Beyond the actual vaccine vial, other administration supplies were required to deliver the injections such as syringes, PPE, dry ice and alcohol wipes. As clinicians were focused on keeping the rate of vaccination high, there was little time to source supplies – yet without these accessories, vaccines could not be administered.
The urgency of this situation, and the sheer number of entities involved generating data feeds, lent itself to the fail-safe nature of a supply chain control tower. After needed vaccine supplies were sourced for replenishment, every single shipment was tracked to alert an operator around unexpected carrier status changes. At the first sign of a potential delivery failure that could cancel a vaccination clinic or lead to wasted doses, an operator intervened. This happened with nearly 5% of all shipments due to weather delays, package mis-sorting and damage. The alerting system would identify the issue and the operator would intervene based on the need and severity. Over the course of this program, more than 2,000 product replacements were swiftly sourced and delivered, enabling the ongoing delivery of lifesaving vaccinations.
Driving Towards Autonomy
At the outset of a supply chain control tower deployment, decision making is reactive based on alert logic. However, over time as data accrues, patterns emerge that might point to discrete sources of risk that would otherwise take longer to crystalise. A good example here is lane performance analysis. As data reveals that specific shipping lanes are high-risk based on intervention history, problematic lanes can be discontinued and replaced with lanes that are high-performing based on their on-time history. And as lane performance and confidence increases, there may be opportunities to optimise packaging for longer duration, lower cost shipping.
Knowledge is Power
The introduction of the Covid vaccine illuminated the therapeutic cold chain for many consumers that had never previously pondered how therapies are packaged, shipped and stored. Further, given the impact of Covid on supply chains across nearly every industry, the need for the real time visibility has never been more evident: according to Gartner, supply chain visibility is the top funded investment initiative prioritised for nearly 50% of organisations. Over time a robust control tower can reduce problematic scenarios, drive better efficiency and inform decision making while the remainder of supply chain activities seamlessly execute – all with the goal of better patient quality of life.