Tuesday, August 16, 2011

Why the Shortages of Drugs and Medicines in the Global Supply Chain and What We Are Doing to Help

You may have been reading the recent news about the shortages of certain drugs and medicines that are essential to the survival of the patients, including cancer patients, that so desperately need them.

From an article in the USA Today, and recent articles in The New York Times, including one that highlighted that 75% of the drugs in the US are generic ones with the majority being produced abroad in plants that are rarely inspected, it is clear that we are in a crisis situation.

Of the 34 generic cancer drugs on the market, as of this month, 14 were in short supply. They include drugs that are the mainstay of treatment regimens used to cure leukemia, lymphoma, and testicular cancer.

Indeed, according to Ezekiel Emanuel, writing in The Times: In 2004 there were 58 new drug shortages, but by 2010 the number had steadily increased to 211 and these numbers include noncancer drugs as well.

How can this be happening in the richest and most technologically advanced country in the world, with leadership in medical know-how?

How horrific that patients, whose treatments and very survival depend on such drugs, cannot procure them in a timely manner?

In a recent paper of ours, Multiproduct Humanitarian Healthcare Supply Chains: A Network Modeling and Computational Framework, Anna Nagurney, Min Yu, and Qiang Qiang, we discuss the issues of shortages of various drugs and vaccines, including the leukemia drug, cytarabine, and how to design and redesign supply chains so that medicines are delivered to those who need them. In the paper, we state that:

Despite significant advances in supply chain management in terms of both methodology and application, healthcare supply chains, and, in particular, humanitarian health care supply chains have not received the needed attention. In particular, humanitarian healthcare supply chains have many unique characteristics. For example, as pointed out in the introduction section of the handbook published by the Pan American Health Organization and World Health Organization (2001), ``The various stages in the flow of supplies from their point of origin to the moment they reach their recipients -- whether they be the organizations managing the emergency or the actual beneficiaries of the assistance -- are a chain made up of very close links. How any one of these links is managed invariably affects the others. Supply management must therefore be the focus of an integral approach that looks at all the links in the sequence and never loses sight of their interdependence ...". Therefore, an appropriate framework for healthcare humanitarian supply chains must capture the entire relevant network.

In this paper, as well as in some of our earlier studies, whether on supply chains for critical need products, supply chains under demand and cost disruptions, or supply chains with outsourcing, our goal is to optimize within the constraints. By developing analytical, transparent tools, one can capture the major issues and can then evaluate how to redesign the networks so that those whose lives depend on drugs and medicines can get them when they need them. We must put in place the proper incentives for decision-makers to guarantee the sustainability of our humanitarian healthcare supply chains.