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Managing and Mitigating Drug Shortages: Andy Brailo with OSF HealthCare, Part Two

This is the second article in a multi-part series.

Andy Brailo, Premier’s Chief Customer Officer, continues his conversation with Jerry Storm, Senior Vice President of Pharmacy Services at OSF HealthCare in part two of this 3Q episode to discuss new tactics for improving access to at-risk drugs.

Andy: OSF HealthCare has been a long-time leader in proven solutions to address drug shortages. Can you discuss some of the strategies you and your team have deployed that are making a difference?

Jerry: Drug shortages historically has always been a challenge, especially probably even more of a challenge today for a single entity hospital that's not part of a larger size integrated delivery network (IDN). We found out that you can't sit on your laurels and hope that you can address the drug shortages. What work today may not work tomorrow. We have gone with implementing an inventory management system. We now have greater visibility of our inventory across all of our entities. You have to have strong communication between the entities to be able to identify what their volume of uses of the drug and see if it can be shifted from one entity together. You definitely have to continue to work on a diversified approach on drug shortages.

We have developed a centralized distribution center and we've centralized a lot of our purchasing operations. This allows us to be able to operate and stand up like a hub and spoke model so that we're able to look at medications where they lie across the ministry. If they are being allocated every facility can then order their maximum amount of allocation and then we're able to distribute that drug to the sites where it's being utilized the heaviest. The site that maybe ordered it may not have as great of a demand. This has been beneficial for helping us to be able to plan on demand, to be able to optimize our purchases and also be able to move product around internally where the greatest need is.

Shortage assessments and response if we discuss on a weekly basis within a call that is system wide, and every facility participates in that discussion. That allows us to identify the demands at each one of our facilities, and we're also using our electronic medical record (EMR) to include when we know are aware of a drug, it's going to be in short supply or one in which we are not getting the amounts of the quantities we ordered. We can then include in their EMR a drug shortage alert. So, providers know upfront that this drug is in short supply and that we also include alternatives for them to choose from so they can address it at the time of ordering rather than pharmacy intervening after the fact or at one time if we totally run out of the product to be able to have available.

We've also been a member of Premier’s ProvideGX program since the get go because it's one program that help us address some of the ongoing drug shortages that go on routinely with various drugs. By doing ProvideGX we are able to identify a commitment. We have to identify our usage for the previous 12 months and then by making that commitment and guaranteeing a demand for that product that gives the manufacturers assurance to be able to provide that product, knowing that they're not going to be basically stuck with product that isn't going to be used, which really minimizes their risk that they have in manufacturing their products.

We primarily focused on product categories where there is a lack of competition. Say there is only one or two manufacturers of a specific product. We look at diversity around the geography. Where is our product made? We all experienced a few years back the IV fluid shortages as a result of the hurricane. So, it's important to be able to identify that, not find other sources besides one source word in one specific geographic location, and then we also look at contingency plans for different drug products that is on short or is historically come on off the shortage list from the American Society of Health-System Pharmacists (ASHP).

When there are greater incentives, we need to work on for these manufacturers and OSF has pooled investment dollars, partnering with Premier and other health systems to incentivize generic drug-makers to be able to take on expanding out some of these products that an ongoing shortage of these generic products. An example is Exela. We've partnered with them in order to be able to propose products that is beneficial for them that will also help us be able to address some of these drug shortages that we struggle with on an ongoing basis. It supports a greater domestic and diverse manufacturing of some of these critical drugs. We all have struggled in the past with emergency syringes and that's, you know, the example we've used with emergency syringes just ProvideGX to guarantee those. Provide incentives for manufacturers to stay or enter the markets will be critical in order to be able to overcome these ongoing shortages. We have these older drugs whether it's just not a lot of money in them for the manufacturers and then also to help promote long term disability to the market.

Up Next: Andy and Jerry discuss what healthcare stakeholders can do to strengthen the pharmaceutical supply chain in part three of this 3Q episode. To view future installments of our series, click here.

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