Julian Upton

Lance Hill, CEO of insights management company Within3, talks about how the insights gathering process supports better drug discovery and more representative outcomes, and how data can democratize healthcare and mitigate DE&I in the industry.

Podcast is available directly on SoundCloud.

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Understanding markets, influencers, and patients through better stakeholder engagement and faster analysis

Insights on Insight Gathering

Jay Johnson, senior manager of Labelmaster Services for Labelmaster, is a long-time expert in packaging and logistics solutions for the chemical and biotech industries, with a focus on dangerous goods (DG) and hazardous materials. He has been an active participant and major resource in the development and implementation of international dangerous goods regulations and is an active member of the Council on Safe Transportation of Hazardous Articles (COSTHA) and the Dangerous Goods Trainers Association (DGTA).

 to share his thoughts about recent disruptions and advances in the area of cold chain, and to emphasize that companies need to choose packaging and distribution systems that really fit a checklist of their needs.

: With the pandemic and other crises, what key changes have you seen affecting cold chain in the last couple of years?

 As the global pandemic has exposed logistical problems for lithium batteries and temperature recorders, people are going back to something of an “old school” approach. There had been this desire to have devices that could do everything—track shipments from space, for example—but they take a lot of power to run. And it is annoying to try and figure out whether such devices activate while they’re in the air, which the airlines certainly don’t like from a security standpoint. So, I’ve seen people going back to things like mechanical temperature recorders and chemical monitors, which only tell you when something’s gone out of range. These are inexpensive devices, particularly for last mile, and so are appealing to companies that have been scaling back from a cost standpoint.

Another change is that companies aren’t filling warehouses with Styrofoam coolers anymore. Instead, there are all sorts of things happening with insta-boxes, pop-up liners, fabric bags, cool liners, and products that have reflective metal or recycled material. We’re getting very creative with the new packaging that’s available. Now, we can ask, is all of it good? No. Does all of it work for everything? Hell, no. Companies must map out what they’re doing and select the packaging system that 1), fits their needs; 2), fits their time period; and 3), fits their price point. Now, Styrofoam panels were inexpensive, but it was difficult to sustain the right temperature because of gaps in the panels. And you’ve also got countries that don’t want Styrofoam, as they’re not able to recycle it. But if your system is built so that you can get your molded coolers back, you can run these coolers 10, 20 times. As long as you set up parameters to make sure that they’re not contaminated and you can easily replace the outer box if it gets damaged, the cooler itself could go on not indefinitely, but certainly for a long time, which means major savings.

People always want the less expensive option. They want something that takes up less space and they want something that will work for the duration and at the price point for what they’re doing. But companies should really look at what they’re trying to accomplish. What temperature range do they actually need? Is it 2–8℃? Or could they really go for 0–8℃, which is much easier to maintain? Do they really need seven-day monitoring? Or would they know by the third day if something is wrong and move on? These kinds of questions help them to pick a better price point for what they’re trying to do.

In terms of DG in the cold chain, what else has changed over the last two years?

I think that the way information is being communicated is different. There are still lots of conferences, but there’s not going to be as many as before because people have figured out a way to get their information from other sources. You’ve got people turning more than ever to pay services and websites and trade magazines because they couldn’t get together and hash it out at a conference during the pandemic. And people realized that the world didn’t come to an end when they didn’t go to conferences.

From my standpoint as a trainer and educator in the field of dangerous goods, we used to feel that if you didn’t do a DG class live then you weren’t getting trained. Now, people feel very different about that. But it took a pandemic to open that Pandora’s box. There were countries in Europe, Switzerland for example, that previously didn’t allow online training. They have had to make adjustments. Now I’m getting requests globally for training where they don’t expect me to fly over there; they want me to teach the class virtually and answer questions live. That’s a big difference.

Are you seeing changes in the way life sciences companies are approaching cold chain challenges?

People are asking more questions and pharma companies are getting more pushback from different regions internationally regarding packaging. One region might not want a particular item and so the pharma company has to figure out what alternatives they can use to get them even close to the temperature range they were getting at the price point they had previously. I’m getting a question like, “As opposed to Styrofoam or urethane foam, if I used an open-cell polyethylene foam, or even air bubbles or bubble bags, what kind of temperature can I maintain?” I usually try to push back and tell them really need a thermal lab to make sense of that; you can’t just take a chance on bubble wrap.

Pharmaceutical companies are held to a higher standard; it’s about more than just fines and penalties for regulatory noncompliance. If a company starts to cut corners in storage and shipping, people are going to say, “Are they also cutting corners to make the drug that I’m taking? Are they cutting corners to make the device that I’m using to keep me alive?" A pharma company could be setting itself up for a PR nightmare that it really doesn’t need to have, because complying with regulations is going to be significantly cheaper than the PR ramifications of not doing that.

What balance are you seeing in terms of active and passive temperature control?

I’m seeing more active systems, and I think there’s a lot of opportunity there. Couriers can build refrigeration or heating into certain sections of the vehicle that is shipping the goods. I know they’re stiving to make customers feel more comfortable that refrigeration is maintained throughout the entirety of a shipment, without the use of additional insulation or passive materials. If an item is only being shipped from A to B and the courier can guarantee the temperature range without the need for cold chain packaging, then it might be worth companies paying more to ship it that way because they will save on the packaging.This technology is really moving forward because courier operators like UPS and FedEx want to keep all the stuff within their systems. By having active temperature control, whether it’s elevated or refrigerated, couriers can make the customers more dependent on them for a particular route, so I think we will see more investment in this active technology.

Articles

A conversation with dangerous goods expert Jay Johnson

‘Old School,’ New Technology

This month at the European Society for Medical Oncology (ESMO) Congress in Paris (September 9–13, 2022), AstraZeneca (AZ) presented new data supporting its ambition “to redefine cancer care.” A total of 15 approved and potential new medicines from AZ were featured across more than 75 abstracts in 13 tumour types, including results underscoring the efficacy and safety of Imfinzi, Tagrisso, and Lynparza across multiple cancers with high unmet need and data reinforcing Enhertu’s transformative potential in HER2-targetable cancers.

 sat down with with Greg Rossi, AZ’s senior vice president of oncology, Europe and Canada, to talk about these results, AZ’s other oncology activities, and his vision for the future of cancer treatment.

Pharma Commerce: What key changes have you seen over the course of your career in oncology, and particularly during your last 11 years at AZ?

 There have been huge advances. When I started 25 years ago, we were talking about how much chemotherapy could we deliver in what we called dose-dense chemotherapy, and how could we support those patients that we knew were going to receive toxicities. Now, we talk about really exquisite chemistry, really exquisite protein engineering, have a deep understanding of biology in terms of biomarkers, and are much more precise in thinking about patient selection. That’s manifested in things like immuno-oncology therapies, where we talk about harnessing the immune system to interact with tumors, or, for example, the antibody drug conjugates (ADCs) such as Enhertu that we have in our pipeline, which I think will be transformative medicines. These represent really intricate engineering work in terms of taking a cell surface protein and basically linking an antibody to it and looking at how you deliver chemotherapy at a dose that is unparalleled into the precise tumor cell. How do you make sure that everything dissociates in the right place at the right time, so that you’re killing the cancer cell but sparing the healthy tissue? A hundred years ago this was the stuff of Paul Ehrlich’s magic bullet, but now it’s a reality. I think it is the biggest transformation we’ve seen, and it’s not stopping there. Where will we go now with this technology we have at our fingertips?

Among these innovations, what have you been proudest to be associated with at AZ?

For me, LYNPARZA has been interwoven in my last 10 years, as it has with many people at AstraZeneca. First, the impact it’s having on patients—whether in ovarian cancer, prostate cancer, pancreatic cancer, or breast cancer—is transformational. And this is complex biology; we were pioneering the science here. We were trying to understand which patients would respond best, how to best use the drug, at what dose, and what schedule. There are two studies in ovarian cancer, the SOLO1 study and the PAOLA-1 study, for which we just presented results at ESMO. The five-year follow-up of the PAOLA-1 Phase III trial showed that LYNPARZA plus bevacizumab meaningfully extended survival with 65.5% of homologous recombination deficiency (HRD)-positive patients surviving 5 years versus 48.4% treated with bevacizumab and placebo, doubling the rates of what you would’ve seen historically. The SOLO-1 Phase III trial demonstrated 67% of advanced ovarian cancer patients with BRCA mutations treated with Lynparza were alive at seven years vs. 47% on placebo. Ten or 15 years ago, that figure of 67% would have been more like 25%. So, that has been a very proud part of the last 10 years for me. And it shows that pioneering in a space is tough—it takes dedication, resilience, and a bit of humility. But when you succeed, you can really have an impact.

How has COVID-19 impacted AZ’s activities in the oncology space?

COVID has clearly had a very significant and negative impact on cancer patients on a number of levels. Firstly, there are the referral rates. I read a report recently saying that up to a million cancer patients went undiagnosed through the pandemic, with 10 million screening appointments missed. We know that diagnosing early is really important if we want to have the opportunity to cure patients. The impact of the pandemic is that more people will be diagnosed at a later stage and their outcomes will be poorer. But I’m proud of AstraZeneca, not just for its work on the COVID vaccine side, but for the effort and energy that the organization put into its oncology efforts during the pandemic. We worked with patient groups and the healthcare system to make sure this issue of timely referral was not forgotten. We supported campaigns in many markets to put the message out there. And we provided support for patients so they could be treated at home, with tools to help review symptoms and toxicities, for example. A lot of these ideas and practices have applications beyond the pandemic; some of the things we were able to do we’re going to apply more broadly going forward.


What kind of innovations are you advancing to help alleviate the health system burden?

First and foremost, AstraZeneca is focused on delivering really high impact medicines in oncology. We’ve delivered seven over the past few years; we hope to double that over the next few years. We have been very faithful to that concept of “the right patient at the right time with the right medicine.” This involves using biomarkers; making sure that health systems understand the potential value of diagnostic technologies and adopt these biomarkers; and making sure that patients are getting the most precise diagnosis that helps match their right treatment. We have positioned, as a central pillar of our oncology strategy, the concept of moving early, because that’s where we think the cure is most appropriate. That requires us to partner with a number of folks within the oncology ecosystem, not just health systems but also technology partners.

One company we’re working with, Grail, for example, has a multi-cancer detection test called the Galleri test that is very interesting and aligns very closely with our principles of being able to diagnose cancer early. And we’re continuing to innovate in diagnostics and medicines in the lung cancer space. There are lots of patients who are not diagnosed early enough with lung cancer. But they might come into the health system for a chest X-ray or something else. We actually saw this during COVID. People were coming in for chest X-rays and the new technologies were picking up potential cancer signals from those images. So, we are working with a couple of companies to take these radiographic images and scan them using AI technologies to identify the 1% of people with what we call incidental pulmonary nodules (IPNs), which could become cancerous, and then triage them into an early referral process. This is where new technology is really starting to make a difference.

We hear about patient-centricity a lot. What have you actually seen in your career in terms of the involvement patients in oncology?

Many companies talk about patient centricity and with very good intentions, but at AstraZeneca it’s a core theme in how we think about the way we develop and commercialize our medicines. But I think it is always worth questioning how we are implementing our plans, strategies, and engagement to validate that patient-centric approach. Actually, I would say there has been an increase in the way we’ve been thinking about that over the last few years. First, we now have a patient partnership program that is a part of how we design our trials. Patients and patient groups can basically come and talk to us about the impact of certain studies from the patient perspective. That’s been very influential. We are also working very closely with patient groups around the support, education, and awareness that they need to manage their disease, and also in terms of policy initiatives. In Europe we are involved with the European Union’s Beating Cancer Plan; that is now expanding to national cancer plans. Having a common purpose with patients, identifying patients appropriately, and promoting early diagnosis is an essential part of our work.

As I mentioned, our COVID learnings showed us how new technologies and tools can be really valuable in the routine care of patients. And we’re thinking more about things like equity and access to clinical trials for different underserved patient groups. What is the variation in access to care across the region and what can we do around that? These are the sorts of areas that have become central to our work more recently and that we are committed to engaging in further.

Can you outline what the next few years will look like in terms of AZ’s oncology efforts?

I think we’ve had a remarkable journey over the last 10 years. Much of what we have been doing has become more visible in the last five years, but it was initiated by CEO Pascal Soriot when he joined in 2012; he really provided the impetus, the pace, and the urgency to change. I’m very excited when I look toward the next 10 years in terms of what we have in our clinical pipeline, our technologies, and the philosophical approach we are taking to partnerships. We know that not all the science is done inside the walls of AstraZeneca, so it requires broad engagement and partnership, both on the science and patient sides.

In particular, our ideas around early diagnosis, precisely identifying patients, and harnessing a range of different technologies in combination to treat them are going to be transformative. Being able to do that in a way that delivers local solutions to physicians and patients around the world is going to take us, I think, to a leadership position in oncology.

AZ’s Greg Rossi talks about the company’s oncology activities and his vision for the future of cancer treatment

AstraZeneca: Redefining Cancer Care

: What has been the main impact of the last two years on Lundbeck’s supply chain activities?

Like many others, we are seeing increasing costs and increasing lead times. There are a number of elements at play, not just the pandemic. Some of it relates to capacity issues in the industry and the increasing cost of raw materials, energy, freight, etc. But those are the main challenges we face: cost increases and longer lead times.

Among other things, the pandemic emphasized an over-reliance on raw materials and goods from India and China, for example. Was that something that affected Lundbeck seriously?

For several years, we’ve done an annual business impact analysis, where we host workshops related to supplier risk and facility risk, looking into things that might occur at our production warehouse facilities. Based on scenario planning, we focus on the main risks in terms of potential impact and we formulate and implement mitigation strategies. These could involve dual sourcing, inventory management strategies, stronger relations with key suppliers, etc. So, we had been doing that, but then COVID came along and, subsequent to that, the high inflation that we’re seeing now. All this put extra pressure on us. I’d like to say that we’re in a better position to deal with it than if we’d done nothing, but to prepare for all this disruption was extremely difficult.

Some of the scarcity, for example, we had not predicted, even when COVID broke out. One of the things that we expected was the impact on glass for vials, etc., which did occur and which we were able to mitigate with our suppliers by planning ahead. But one of the things we did not expect was the shortage of filters for production, for example, and that hit the industry widely. Suddenly, everyone was fighting to get their filters up and running. We had to look at our portfolio and quickly take action on this.

Have you been further impacted on the supply chain side by the Russia–Ukraine war?

We don’t have direct supply from Russia or Ukraine, but we do have second- and third-tier suppliers there. That’s where it gets tricky in terms of trying to get visibility and understanding the dribble-down effects of the conflict. Our first- and second-tier suppliers obviously also start to look for alternatives as soon as they are hit by difficulties, but that puts pressure on the markets in other area. Again, it can be hard to predict the fallout from all this.

Has this period been the toughest in your career?

Certainly, the industry-wide impact has been profound, and I could point to single incidents that for us as a company were extremely difficult to navigate. Everything has been hit: our fiscal supplies, our energy consumption, our ability to transport goods around, everything inbound and outbound.

We hear a lot of US-based companies talking about increasing domestic manufacturing and ushering in America-first type policies. Could you see this kind of thing happening more in Europe?

I want to say yes, but it’s a long journey. To fully internalize some of these supply chains is extremely difficult if not impossible. One element that has previously driven decision to source within Europe is regulations such as REACH, the European Union’s (EU) regulation on chemicals and their safe use. This requires companies to register any substances imported or manufactured in quantities of more than 1 metric ton per year with the European Chemicals Agency (ECHA). The existing 30,000 substances produced or imported within the EU must be registered. However, active pharmaceutical ingredients (APIs) and excipients are exempt from registration, evaluation, and authorization if they are already registered with the European Medicines Agency (EMEA) as an ingredient of a medicinal product for human or veterinary use. Lundbeck has made some progress here in terms of its excipient starting materials. Our API plants are in Europe and our suppliers are largely European based, which puts us in a good place in terms of our first-tier supplier base, however not the full supply chain.

What are your hopes and fears for the next 2–3 years in terms of managing the supply chain?

We’re going to be living with all these implications for a while. Getting costs down again is going to be a struggle for us all. And then there is the whole shift toward sustainability, which has been a consideration for some time but is definitely picking up speed now and adds to an already challenging environment. We want to balance sustainability initiatives with certainty of supply at a competitive cost, which is still very hard. Part of it will be driven by demand in society, but I’m sure we will also see further regulation, either by carrot or whip, in terms of pushing the industry toward sustainability goals.

How much is increased digitalization helping in terms of facilitating a more efficient and secure supply chain?

From a supply chain point of view, we can use digitalization to create transparency and also to analyze data and offer predictions and suggestions. There are definitely opportunities with digitalization that we can harvest. From a cost perspective, using data and advanced analytics also helps us to see what we can optimize, partly with our supplier base, but also internally. The difficult part is setting it all up. There is not a lot out there in terms of standards, so this digitalization is not something you can achieve overnight.

In this Q&A, Kristian Sibilitz, senior vice president, pharmaceutical production & supply chain at Lundbeck, outlines the impact of the last 2+ years on the Danish drugmaker’s supply chain activities

Lundbeck: A Supply Chain Perspective

Cognizant, a global IT company and provider of digital solutions for the health science and pharma industries, recently announced that it has signed a multi-year agreement with Organon, a global pharmaceutical company (originally formed through a spinoff by Merck) that focuses on women’s health and provides more than 60 medicines in areas including reproductive health, dermatology, and more. Through the agreement, Cognizant will help scale Organon’s healthcare business by delivering industrial technology support for Organon’s global pharmaceutical manufacturing sites. The partnership will work to:

Help improve the company’s delivery of healthcare products and crucial medicinal supply chain management

Increase real-time visibility of the manufacturing process and ensure pharmaceutical development continuity

Enhance supply chain oversight, increase medicinal yields, reduce cycle times and get products to patients faster.

To discuss the partnership and how the technology Cognizant is providing will help solve supply chain issues for Organon, 

 spoke to Surya Gummadi, Cognizant's SVP of global health sciences and SVP Americas.


Pharma Commerce: Why did Organon turn to Cognizant to improve its delivery of healthcare products and supply chain management?

 Cognizant will help scale Organon’s healthcare business by delivering full-stack industrial technology support for the company’s global pharmaceutical manufacturing sites in the United Kingdom, the Netherlands, Belgium, and Indonesia. 

This includes managing Organon’s manufacturing systems with SAP’s S/4 HANA enterprise application suite. Additionally, by providing remote and onsite support teams to increase real-time visibility of the manufacturing process and ensure pharmaceutical development continuity, Cognizant will help Organon enhance supply chain oversight, increase medicinal yields, reduce cycle times and get products to patients faster.

What will be Cognizant’s first steps in helping Organon toward its delivery and supply chain goals?

Cognizant will begin with two parallel workstreams.

We will provide support teams within those four major pharmaceutical manufacturing factories. This will provide local resources, who speak the local language, to support the shop floor manufacturing and lab systems.

In parallel, we will also stand up a remote team to support the global systems such as S/4 HANA.

How does Cognizant aim to increase real-time visibility of the manufacturing process and ensure development continuity?

For Organon, technology is a key pillar of differentiation in fulfilling the mission of becoming the world’s leading women’s health company. With local and global project teams, Cognizant will continue to enhance Organon’s connectivity journey—connecting local and global systems.

How will you enhance supply chain oversight?

Similarly, the continuing connectivity journey of connecting the shop floor systems to global systems such as S/4 HANA will provide near real time information about the supply chain and the progress of medicinal products through the manufacturing facilities.

What is the global reach of the partnership and where are the areas of priority?

The reach of the partnership is truly global, with its four major pharmaceutical manufacturing sites in Europe and Indonesia. The technology priorities focus on Organon’s manufacturing systems with SAP’s S/4 HANA enterprise application suite.

How will Cognizant work with Organon on the ground at different locations to achieve the partnership’s goals?

Growing local teams, with the right skills and the local language, will be critical to achieving the partnership goals. The blend of local and global teams to support the manufacturing systems will bring benefits in terms of quality and total cost of service.

We expect that the unique insights and understanding that will come from working inside the factory with Organon staff will drive a heightened level of overall service excellence and help Cognizant meet or exceed the goals of the partnership.

Surya Gummadi discusses the partnership between global IT company Cognizant and pharma company Organon, for which Cognizant is providing the technology to combat supply chain challenges

Cognizant and Organon: Speeding the Delivery of Women's Healthcare Products

The Health System Owned Specialty Pharmacy Alliance (HOSP) is a nationwide, member-led organization of leading health systems, which aims to be “the face and voice of the integrated specialty pharmacy industry.” It promotes the message that the fully integrated health system specialty pharmacy model is “the optimal way to improve patient outcomes while reducing the total cost of care.”

Recently, HOSP has led the way in embracing the new term “gold bagging.” “Bagging” refers to the physical packaging of a dispensed drug and how it is delivered to the care setting for administration to a patient. The other bagging terms are:

Clear bagging—when a health system’s own specialty pharmacy delivers medication to the clinic, hospital suite or provider office for administration to a patient

White bagging—when the medication from a pharmacy, typically an outside specialty pharmacy, is shipped directly to and administered at the hospital, physician’s office, or clinic.

Brown bagging—when a patient acquires drugs through their pharmacy and brings them to a hospital to have the product prepared and administered on-site. (This practice has typically been banned at hospitals and health system.)

The term gold bagging, however, “represents the most holistic, patient-centric, and best practice approach because it is a more controlled process within a health system with fewer potential failure points,” says HOSP. Under this method, the health system typically controls the purchase, receipt, preparation, and delivery to the point of care within its own closed environment. Gold bagging acknowledges and represents “the essential pharmacist-added value to the medication use and delivery process, ensuring safe, efficient, timely, and accurate drug administration.”

 sat down with Gary Kerr, president of HOSP and chief pharmacy officer at Baystate Health, to further explore gold bagging terminology and discuss why it is time for the concept to be more widely known .

Pharma Commerce: Can you tell us a bit more about what gold bagging means ?

 It is terminology more than it is an actual event or process. We at HOSP are using the word “gold” to most firmly emphasize how, in preparing the product for the patient, the health system owned pharmacy (HSSP) brings a series of value-added steps that would not occur if the product were simply shipped in from another vendor or supplier. Many HSSPs have teams of clinical pharmacists and they can and do access the electronic medical record (EMR), which outside companies cannot do for privacy reasons. So, if I, for example, as a health system clinical pharmacist, go into the EMR, I know that the patient’s clinician is also looking into it also, and he/she is going to see when my appointments are, what my lab values are, etc. Essentially, it’s a tremendous safety net to wrap around the process; our pharmacists communicate with our clinicians face to face and inside of our EMR and we’re continually making sure that things are good. And if they’re not good, we make sure that they are made good for the employee or for the patient. This could include medication adherence, disease monitoring, lab monitoring and side effects.

We’re circulating the term gold bagging to draw more attention to the extra value that is added when our staff is involved in the care of the patient. It’s like me saying that here in Western Massachusetts, when our pharmacy is involved, we’re taking care of our community patients with local and regionalized care. It’s not about a widget that’s coming from Dallas or from Fort Lauderdale; it’s a widget that’s purchased into our health system and enhanced with robust clinical pharmacy services. We double-check it, we control the delivery, the preparation, the lab monitoring, etc. And if the drug is to be infused in one of our infusion suites, we’re the ones doing the sterile mixing and the labeling and we’re talking with the nursing staff about how to administer it. These are all steps that would not necessarily happen with a product coming from outside.

You have mentioned that you’re confident that the terminology will become firmly established within five years…

That’s wishful thinking to a degree, but many of the health systems in the United States are being held more and more responsible for the patient experience as well as patient outcomes. HOSP recently published a White Paper which, among other things, compares the Net Promoter Scores (NPS) of integrated HSSPs with other specialty pharmacies. The specialty pharmacies have an overall NPS of 59, some a lot lower, while the HSSPs typically score in the 80s, indicating excellent customer satisfaction. This is the result of face-to-face communications with clinicians, patients, and caregivers; genuine human connections with commitments to follow-through; and a true high-touch, white-glove service throughout each patient interaction. These scores are an endorsement of the gold bagging concept, and our mission is now to elevate it. There are probably other organizations in the country that are comfortable with the clear bagging terminology, which is when the hospital buys the drug and dispenses it. We’re saying, yes, clear bagging implies transparency, we get that, but there is so much more going on behind the scenes that’s not reimbursed and is not acknowledged, which is why we want to push the terminology harder.

Do you envision any resistance to this terminology change idea, from payers or PBMs, for example?

The short answer is no, but we believe some organizations or pharmacy trade associations will be opposed to us disrupting the status quo terminology here. They are comfortable with clear bagging because they’ve been using the term for a while. They may say we’re going to confuse the marketplace by introducing a new term. I’d say to them however that we are simply trying to bring recognition to the power of our clinical care model, which patients are experiencing on a day-to-day, hour-to-hour basis. Many downstream implications within the industry could be hypothesized.

Can you outline some of the waste reduction advantages that the concept of gold bagging would bring?

Our ability to work within the EMR and see and communicate things that are happening in real time is something that the long-distance, third-party drug supplier would not be able to do. One of our pharmacists may be in the EMR, looking at labs and progress notes by physicians, and could say, wait a minute, we’re not going to dispense a $15,000 drug to somebody who clearly has an infection, or clearly has something wrong with their red blood cell count, or has been missing appointments. But another supplier would ship this drug, and once it leaves their loading dock, there’s not much that can be done with respect to returning it. But we can manage real-time dosing or regimen changes and we can manage the yes or no decision at the point the patient is supposed to be treated. In some instances the health system already owns the financial and medical risk within their contracts.

What brought HOSP to the gold bagging concept at this point in time?

It’s a sub-plot of the larger message we’ve been pushing out, really. Our commitment as a trade association is to get the word out about the value of what we’re doing, because otherwise it’s taken for granted and it’s not public. There may be drug access and payor network access implications. At HOSP we are all profoundly committed to improving/enhancing patient care. We are a bona fide group of pharmacy professionals in leadership roles that believe firmly and deeply in this powerful yet unrecognized process. We’ve all been spun around by COVID and its lingering and unprecedented financial and social impact on patients and communities. For us it is all about the power of the patient story—the patient experience and the patient outcomes—that’s what drives and informs everything we do.

The HOSP Alliance‘s Gary Kerr on adding another level of value to the packaging and delivery of dispensed drugs and modifying terminology
