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The end-to-end global supply chain continues to experience unprecedented disruptions, which are affecting multiple economies and industries, including the U.S. healthcare industry.
Supply Chain Impacts Persist as Russian Attacks in Ukraine Continue
Russia’s invasion of Ukraine carries on into its second month just as the world is entering year three of the pandemic – further exacerbating ongoing constraints on global supply chains. The war and sanctions on Russia are anticipated to exacerbate existing energy, transportation, and manufacturing (limiting access to raw materials) challenges.
Spotlight on Semiconductors
Russia’s invasion of Ukraine is disrupting access to critical raw materials used in semiconductor production, including rare neon gas, chemical C4F6, and multiple types of metals (palladium, nickel, rhodium, and titanium). Healthcare has many supplies where semiconductors are used ─ MRI machines, pacemakers, blood pressure monitors, chemistry and blood gas analyzers, and bedside and wireless patient monitors.
At this time, we are not seeing direct shortages of semiconductors in healthcare resulting in impacts to patient care, yet a proactive approach is warranted to mitigate potential disruptions. On April 12, Premier joined a Semiconductor Roundtable hosted by White House staff ─ and was the only GPO to attend the meeting. The forum’s purpose was to discuss concerns with semiconductor access and how investments in the Bipartisan Innovation Act can spur U.S. manufacturing and strengthen our supply chains.
Overall, Premier believes semiconductors should be prioritized for healthcare supplies. Unlike the consumer tech and automotive industries, healthcare has smaller volumes of chips comparatively (less than 1% of the overall market), yet the need exceeds that of other industries given the potential for patient harm.
Premier is encouraging Congress to include the CHIPS Act as part of the conference on the COMPETES Act. We support its movement and arrival for signature on the President’s desk as expeditiously as possible.
Food Availability and Pricing
The FAO Food Price Index (FFPI) is a measure of the monthly change in international prices of a basket of food commodities. In March 2022, the FFPI averaged 159.3 points ─ an increase of 12.6 percent from February and the highest level since its inception in 1990.
The latest increase reflects new all-time highs for vegetable oils, cereals and meat sub-indices, while sugar and dairy products also rose significantly. Additionally, there are growing concerns that the Russia-Ukraine war can lead to additional inflation and potential food shortages in upcoming months.
Here in the U.S., Premier is monitoring the situation related to new cases of bird flu. As of April 22, the USDA Animal and Plant Health Inspection Service (APHIS) reports that there are approximately 31 million birds affected in at least 29 different states.
Premier Assessed Impacts:
COVID-19 Lockdowns Across China
Adding to global supply chain challenges is the COVID-19 outbreak in China, resulting in workplace closures and extra precautions that can slow manufacturing and the flow of commerce ─ and further increase port congestion.
The nation’s largest city of Shanghai, a major global shipping and manufacturing center, was scheduled to re-open on April 1, but the lockdown has been extended indefinitely ─ a move that casts further uncertainty over Chinese supply chains.
While major Chinese ports remain open, the number of ships waiting to load or discharge at Shanghai's port had skyrocketed five-fold to more than 300 in late March 2022. Overall global port congestion has also reached an all-time high in late March, with major increases on the U.S. East Coast and North Europe.
As a result of additional pressures from both Chinese lockdowns and the Russian/Ukraine war, tightened transportation capacity and rising fuel costs are anticipated to sustain higher ocean and air cargo rates over the next several months, and at a time of the year that usually sees rates decrease. Asia-U.S. West Coast prices are at $15,811/FEU ─ 168% higher than the same time last year. Pre-pandemic, ocean freight costs for this same route averaged between $3-6K per container.
Added Domestic Challenges
Premier is closely monitoring a potential dock worker strike on the U.S. West Coast. The International Longshore and Warehouse Union’s (ILWU) contract, representing 22,000 workers over 29 West Coast ports, is expiring at the end of June. If the parties cannot come to a resolution, port congestion and supply chain delays could further increase.
Additionally, recent data points to a shortage of approximately 80,000 truck drivers in the U.S., which is projected to double by 2030 if current trends continue.
Since the White House released its action plans, there have been historic increases in trucking employment, with 2021 marking the highest jobs growth in the industry since 1994. Premier is supportive of expanding and improving trucking jobs, which we believe helps enable a modern good movement system that can boost U.S. competitiveness and reduce costs.
What We Can Do
Providers should continue to consider ordering early and rethinking inventory management strategies as product lead times ─ the timeline between placing an order and receiving it ─ have increased significantly. In addition, and alongside the Strategic National Stockpile (SNS), hospitals should maintain judicious conservation and stockpiling strategies to help keep supply levels maintained.
Premier is continuously assessing medical categories that:
As such, we’ve developed a Category Watch List, inclusive of products that require additional risk and resiliency measures due to limited suppliers in the market, raw material constraints, offshore manufacturing locations and/or have increased usage. Examples of current categories we’re monitoring:
Premier’s full Category Watch List and other related resources are available for members on our Disaster Response and Shortages and Disruptions pages within PremierConnect.