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When shipping pharmaceuticals internationally, the decision of ocean shipping versus air shipping might seem obvious if the speed of air shipping is the only factor at play when sending sensitive medical supplies and drugs. For the last several years, however, more companies have decided to embrace ocean shipping as a means of delivering their medicines. Industry experts Alan Kennedy and Allan Klinge discuss how, with more cold chain control, a lower carbon footprint and lower costs, ocean-going vessels often have clear advantages over air freight.

Rising sea level: The transportation of pharmaceuticals by sea continues to gain momentum in the quest for greater supply chain resilience

Rising sea level - The transportation of pharmaceuticals by sea continues to gain momentum in the quest for greater supply chain resilience

MD Logistics, a third-party logistics (3PL) provider, has added electric vehicle (EV) trucks to their cold chain transportation services available in Garner, NC, right within the state’s Research Triangle Park region.

 Adding these trucks to the fleet allows the 3PL provider to offer a sustainable, local transportation option for pharmaceutical clients within the Southeast region.

“As organizations across the globe place more of an emphasis on adopting sustainable practices aimed at emissions reduction, we are actively looking at what we can do as a service provider to not only reduce our own footprint, but also how we can help our clients with their emissions output,” said John Sell, president and CEO of MD Logistics. “We are excited to debut two EV trucks at our facility in Garner, NC and continue to customize solutions to our client’s needs.

“The addition of these two EV trucks to our network will allow our client to experience a combined reduction of more than 275 tons of CO

 emissions annually, compared to a traditional diesel counterpart. MD Logistics as an organization has a storied tenure, collaborating with our clients to bring solutions for their supply chain challenges to fruition.”

The launch of the EV trucks is being done in partnership with Nippon Express USA, its parent company. These vehicles will be used for certain customer lanes within that region—Nippon Express USA’s goal is to add 14 EV trucks to the fold by the end of this year, eventually converting all of its trucks to EVs by 2027. This will reportedly result in an 11% reduction in CO

“The addition of these two EV trucks will allow MD Logistics to continue to be competitive in a sustainability conscious market as a leading 3PL within the life sciences and pharmaceuticals industry.” noted Emilie Gerbers, VP of business development for MD Logistics. “Partnering with our parent company Nippon Express on the release of this initiative will allow our team to scale this solution to clients, both current and future, and develop standards and commitments as it relates to sustainability.

“Our position at MD Logistics has always been to remain flexible to respond quickly to the needs of our clients and the industry in which we operate. This strategy is in place today and is what drives us towards the future. As we field more and more inquiries for additional solutions around sustainability and helping clients decrease carbon emissions, we are excited to be offering a solution such as this one and look forward to adding more EV assets in the near future.”

1. Third Party Logistics Provider, MD Logistics, Pleased to Announce Launch of EV Trucks in Garner, North Carolina. 

 August 27, 2024. Accessed August 30, 2024. 

https://www.mdlogistics.com/2024/08/third-party-logistics-provider-md-logistics-pleased-to-announce-launch-of-ev-trucks-in-garner-north-carolina/

The 3PL plans to convert all its trucks to electric by 2027. 

MD Logistics Welcomes Electric Vehicles to North Carolina Fleet

Tower Cold Chain and CRYOPDP are partnering up to boost their product offerings to the greater pharma supply chain.

 The agreement among the parties is expected to offer an array of solutions—mainly pertaining to clinical research—in order to address patient needs.

The companies are envisioning it as a “one-stop-shop” where customers can a peruse a variety of advanced temperature-controlled solutions and services, by providing access to company information (websites, booking services, etc.).

For one, Tower Cold Chain is utilizing CRYOPDP’s dry vapor shippers for cryogenic goods, which are capable of maintaining temperatures from -196°C to -150°C. Essentially, they consist of insulated aluminum vessels that are filled with liquid nitrogen and absorbent materials, in order to provide the proper transport and temperature preservation Overall, Tower’s passive temperature-controlled offerings all for it to accommodate temperature requirements from -196°C to +25°C.

As for CRYOPDP, the company will be providing customers with Tower’s KTEvolution range of fully reusable small boxes, available in 12-liter, 26-liter, and 57-liter options, which can support smaller payloads and last-mile delivery services at -80°C to +20°C temperature range.

“We are delighted to announce our collaboration with CRYOPDP, which allows us to expand our product range,” said Niall Balfour, Tower Cold Chain’s CEO. “This partnership enables Tower to offer sustainable, cryogenic-level solutions to the pharmaceutical supply chain, ultimately helping to improve patient outcomes worldwide.”

“Working with Tower Cold Chain enables us to become a one-stop shop for our customers,” commented Cedric Picaud, CEO of CRYOPDP. “We can now meet our sustainability targets by offering fully reusable containers for temperature-sensitive logistics. Together, we can provide pharmaceutical manufacturers with the most comprehensive range of temperature-controlled solutions available.”

Members of the industry who attended LogiPharma Europe earlier this year may recall the masterclass on “Unlocking the Benefits of Reusable Packaging: Enhancing Performance to Address Evolving Pharmaceutical Supply Chain and Patient Needs” that the parties led, featuring Martin Hawes, global head of product development, Tower Cold Chain, and Adri Sijben, senior business development director at CRYOPDP. The session explains the partnership’s effect on temperature-sensitive healthcare logistics, along with providing the benefits of reusable containers.

Being that reusability offers sustainable benefits for the environment, Hawes spoke with 

 at LogiPharma Europe in which he described how companies in the industry can collaborate on these efforts.

“I'm relatively new to the industry. I've been with Tower for three years, and one of the things that horrifies me is the amount of single-use packaging that the industry uses,” he noted. Well over 50% of all pallet shippers and small boxes are single use. That’s an inordinate amount of waste and a huge environmental impact. I’m hopeful that we can start persuading.

“Particularly now, people are more interested in the sustainability side of their business. So, our business is based on product life that exceeds well over five years, therefore much more circular solutions, and much better sustainability and low-waste opportunity. From a product development perspective, the challenge is building it now with robustness for no penalty of weight or volume, which we're starting to see now. I think as product values get higher, the potential of waste is much more significant."

1. Tower Cold Chain partners with CRYOPDP to expand temperature range. 

. September 11, 2024. Accessed September 11, 2024. 

https://www.towercoldchain.com/tower-cold-chain-partners-with-cryopdp-to-expand-temperature-range/

2. Saraceno N. LogiPharma Europe 2024: Tower Cold Chain Global Head of Product Development Discusses the Future of Cell & Gene Therapy and Cold Chain Storage. 

. May 6, 2024. Accessed September 11, 2024. 

https://www.pharmaceuticalcommerce.com/view/logipharma-europe-2024-tower-cold-chain-global-head--product-development-discusses-the-future-of-cell-gene-therapy-and-cold-chain-storage

The parties’ want to provide customers with a “one-stop-shop,” with the hopes that their services will be easier to navigate. 

Tower Cold Chain, CRYOPDP Collaborate on Growing Temperature-Controlled Offerings

Cardinal Health recently unveiled its new 8,000 square-foot Advanced Therapy Innovation Center.

 Located in a 172,000 square-foot Cardinal Health distribution center in La Vergne, TN, the new plant’s infrastructure and capacity provide it with the preparation that’s needed to battle logistical obstacles surrounding cell and gene therapies (CGTs).

“The opening of this new center is a testament to the growth we have seen with cell and gene therapies and the promise of their potential to impact patients,” said Fran Gregory, VP of emerging therapies, who recently spoke with P

 “Our investments in this space will have the potential to impact thousands of patients with rare diseases for which there are currently no or limited treatment options. We are excited to expand our capabilities to deliver treatments to patients that need them the most.”

As the industry may be aware of, being able to handle highly-sensitive CGTs requires a need for innovate shipping and storage solutions, which the new facility can provide.

“Many advanced therapies require specialized handling and temperature controls through the storage and shipping process to ensure their quality, safety and efficacy,” noted Joel Wayment, VP/GM, 3PL Services and Packaging Solutions. “The Advanced Therapy Innovation Center will allow us to further support manufacturers, so that patients receive the treatments that they need when they need them.”

The Advanced Therapy Innovation Center features a deep-frozen storage suite, including cryo- and ultra-low cold storage freezers to store products between -40 to -196°C (-40 to -320°F). And starting in October, Advanced Therapy Solutions will roll out Advanced Therapy Connect, an ordering portal that will allow customers to order all available in-network products from a one single platform. As a result, not only will administrative burden be reduced, but the order-to-cash experience will become more streamlined.

In other Cardinal Health news, the company also recently opened a new 350,000 square-foot distribution center in Greenville, SC that will solely focus on its Home Solutions business that provides healthcare medical supplies.

 Over time, the plant is expected to add about 200 jobs to the region.

"There's tremendous growth opportunity as healthcare continues to shift to the home," said Rob Schlissberg, president, Cardinal Health at-Home Solutions. "Consumers are setting the stage – they want to manage their health conditions comfortably from home, something that's especially important to our aging population. Our expansion into Greenville allows us to continue to deliver on our promises to customers and their patients, while creating a resilient supply chain to support this sustained growth."

1. Cardinal Health Opens Advanced Therapy Innovation Center in La Vergne, Tennessee. 

. August 26, 2024. Accessed September 2, 2024. 

https://newsroom.cardinalhealth.com/Cardinal-Health-opens-Advanced-Therapy-Innovation-Center-in-Lavergne,-Tennessee

2. Saraceno N. Making Adjustments to Reimbursement Models Impacting Patient Therapies in the Biosimilar Space. 

. June 24, 2024. Accessed September 2, 2024. 

https://www.pharmaceuticalcommerce.com/view/making-adjustments-reimbursement-models-impacting-patient-therapies-biosimilar-space

3. Cardinal Health celebrates Greenville, South Carolina, distribution center opening. 

. August 28, 2024. Accessed September 2, 2024. 

https://newsroom.cardinalhealth.com/2024-08-28-Cardinal-Health-celebrates-Greenville,-South-Carolina,-distribution-center-opening

The 8,000 square-foot facility—located within the wholesaler’s Le Vergne distribution center— is expected to help tackle cell and gene therapy logistical challenges.

 Cardinal Health Introduces New Tennessee Advanced Therapy Innovation Center

As life slowly moves back toward what we think of as normal, Covid-19 continues to test and transform our healthcare system. As a result, the patient support space is evolving in several important ways.

Patients are slowly moving back—back into doctors’ offices, back into hospitals, and, therefore, back into the patient support hub and through their patient journeys again—enough so that we’re now cautiously applying a post-pandemic lens.

It is incredible to consider that nearly one billion diagnosis visits did not happen in 2020, equating to just 19% of expected visits for the year, and some specialties—including dermatology, urology, and neurology—struggled more than others to bounce back.

Simply put, if patients don’t make it to the doctor’s office, they often don’t get diagnosed—and they can’t start on a course of treatment to help them get better. While telehealth doctor visits saw an uptick during the pandemic, the vast majority of patients, 70%, chose a nearby doctor for their virtual appointments, signaling they may at some point want to return to in-person care.

In fact, 50-60% of people who made virtual appointments with specialty providers (podiatrists; OB-GYNs; orthopedic surgeons; and ear, nose and throat specialists) booked a follow-up in-person appointment with the same practice.

 This points to telehealth continuing to be a complement for in-person care rather than an alternative.

As mentioned above, there’s no question that the pandemic has fueled a growing patient acceptance of and comfort with remote care. According to 

, while growth in digital health adoption had stalled pre-pandemic, healthcare consumers have shown an interest in virtual care, with 62% indicating they would choose virtual for health and wellness advisories and 57% open to remote monitoring of ongoing health issues through at-home devices.

In addition, as increasing numbers of healthcare consumers are open to receiving virtual healthcare services from their traditional providers (54%), they are also willing to receive virtual care from technology or social media companies such as Google and Microsoft (27%); retail brands such as Best Buy, Walmart, and Amazon (25%); and medical startups (21%).

Meanwhile, as the Delta variant stresses the country’s healthcare system, an uptick in the use of telehealth as a replacement for in-person care has been reflected not just nationally but in specific regions as they are impacted, with growth data corresponding to the timing of these regional virus flare-ups.

When it comes to paying healthcare provider (HCPs) for their teleheath services, payers are not yet in agreement about how to best go about it and providers are voicing their frustration. Some payers argue that HCPs should be compensated on par with their in-person fees, while others rationalize that because they can see more patients remotely and don’t have a full office staff to support, they should receive lower pay. Despite these growing pains, adoption continues to accelerate because all parties agree that telehealth is a powerful tool that ultimately benefits patients. Realizing its full potential means more than simply enabling remote clinical services. Telehealth has the power to reimagine how patients are understood, engaged and supported in their lifelong health and wellness journeys.

As a result of the pandemic and the associated isolation, patients are also moving to different sites of care. Pharmacists and pharmacies are now doing more than ever because people couldn’t get to the doctor’s office for more than a year. And patients have become used to this new route, seeing their pharmacy and pharmacists almost as surrogate doctors.

 poll of healthcare leaders revealed that nearly half of doctors, 49%, are working more hours, on average, this year than in 2020.

 With doctors busier than ever as we move through Covid recovery, patients continue to rely on pharmacies. Additionally, as more state and federal laws allow for more healthcare services to be delivered by pharmacists, demand and willingness of the patient care can be met at the pharmacy counter.

When looking at the ability of patients to get tested and immunized against the virus, community pharmacists have proven their ability to reach patients who were unable to visit their physician’s office. They have played a critical role in helping to ensure patients understand the importance of therapy and potential side effects they may experience, and to help ensure the best possible outcomes are achieved.

Recent data confirms pharmacists’ increasing role as a crucial link in patient continuation of therapy. In a ConnectiveRx analysis of patient compliance with a medication from Brand X, there was a nearly 24% improvement in compliance among patients under medication therapy management (MTM), based on the proportion of days covered. In addition, MTM generated a 37% increase in refill persistency per patient.

With an increased reliance on our devices, patients have become willing—and increasingly even expect—to access, share and receive personal health information through the internet, apps and bots, and the pandemic has only accelerated this shift. Whereas pre-pandemic, patients may have shown a hesitancy to enroll in services such as a copay cards, patient support (hub) services or patient portals, the combination of this consumerization and the impact of the pandemic has led a record number of patients to abandon their fear of sharing their personal health information online. From simple program enrollment to complex remote monitoring, patients continue to carry their consumer behavior into their healthcare journeys and are willing to share what it takes in order to get the care they need.

This growing willingness among patients to divulge personal information to HCPs, hospitals and apps ultimately can transform the patient experience and healthcare overall because the reports that are generated from this data have the potential to change the game.

Pharma companies are continuing to look for new ways to meet HCPs because rep visits were nearly decimated during Covid and are only slowly creeping back. According to a recent survey of over 1,000 HCPs by the Physicians Desk Reference,

 more than half of respondents, 55%, are not permitting rep visits, either because of institutional policy or personal choice.

In-person detailing is now approximately only 52% of the norm/pre-pandemic levels. Reps were saturated in offices, and some offices did not allow reps to visit. While the pandemic meant no rep visits, offices are now slowly letting them back—but only at 52-60% capacity, higher for some specialists.

Another way to look at it is share of voice: Brands have lost 50% share of voice in offices, so pharma continues to buy into new share-of-voice tools as they seek novel ways to get their brand messaging across to providers and patients. These tools that help brands reach pharmacists and that help pharmacists reach and educate patients have never been more valuable.

One example is in electronic health record (EHR) messaging, which has evolved from simply an advertising channel into a critical touch point between both pharmaceutical companies and prescribers and prescribers and their patients, enabling deeper patient education and support. Pharma brands are increasing their budgets in this area going into 2022, while also increasingly spending on digital and virtual e-detailing and share-of-voice tools, including text and telehealth services. According to a recent ConnectiveRx survey

of pharma manufacturers, respondents are most likely to report budget increases for digital marketing outreach (59%) and patient engagement (57%), followed closely by virtual e-detailing (52%) and prescriber engagement (48%).

Making the enrollment channel faster and easier for patients to access potentially life-saving therapies is just one of many successful strategies for increasing the likelihood that patients receive their first dose and remain on their course of treatment.

With continuing changes in patient and physician behavior, pharmaceutical companies will continue to adjust to these new realities and seek innovative partners to help.

Chris Dowd is Senior Vice President, Market and Product Development at ConnectiveRx.

1. IQVIA, “Monitoring the Impact of COVID-19 on the Pharmaceutical Market, Week Ending May 28,” June 11, 2021

4. “COVID-19 Impact on Prescribing and Rx Affordability” Physician Desk Reference survey of 1,050 healthcare providers, October 2021

5. “Patient Communication & the COVID-19 Pandemic” CBI and Informa Engage online survey for ConnectiveRx, September 8-20, 2021

The biggest areas of adjustment in patient support brought on by changes in consumer and physician behavior

Five powerful Covid-related shifts in patient care

The drug pricing reforms introduced by the Inflation Reduction Act of 2022 (IRA) are expected to significantly impact pharmaceutical companies’ revenues and profitability. The IRA requires the US Department of Health and Human Services to negotiate drug prices, introduces penalties for drug price increases greater than inflation, and makes manufacturers responsible for 20% of catastrophic care costs for Part D patients whose spending exceeds the $2,000 out-of-pocket (OOP) cap.

The USC Schaeffer Center for Health Policy and Economics reports that “taken together, these provisions have been estimated to lead to an approximately 31% decrease in US pharmaceutical revenues through 2039 and result in 135 fewer new drug approvals.” Similarly, an analysis from 5POINT10 predicts a more than 20% hit to the operating income of global biopharma (even more in the US).

Despite the challenges created by the IRA, brand leaders must keep their focus on the day-to-day work of helping patients access—and pay for—their medications. So, what does the IRA mean for patient access leaders, pharma brand managers, and patient service owners? I recently moderated a panel on the topic with three industry experts whose insights I’m sharing here.

According to Sarah Butler, chief commercial officer at ADVI Health, four key areas will be affected, and manufacturers will need to adjust their strategies going forward.

Pre-IRA, the market incentivized biopharma companies to launch a drug first in a smaller population, such as rare disease, because they could continue to earn revenue on the drug while conducting ongoing R&D to expand to additional indications. Now, companies have to make difficult decisions to choose which indication is launched first because once the molecule is on the market, the clock starts ticking to be selected for IRA negotiation.

Because manufacturers need to consider how to delay getting on the list as much as possible, looking at volume projections is more important than ever. Even with a medium- or lower-priced drug, if the volume is high, the drug can appear on the IRA negotiation list sooner than you might think. Market dynamics and the competitive environment also play a crucial role. For example, GLP-1s launched this year in weight loss and have completely impacted the order of drugs on the IRA negotiation list. Paying attention to those market dynamics while preparing for launch is critical.

Manufacturers are likely to launch new drugs in Europe or Asia first in order to develop the drug, conduct additional studies, and prepare to file for the indication that will have the greatest impact in the US. Restricting drug access in the US to potentially groundbreaking drugs is likely to cause a backlash among patient advocacy groups and other healthcare stakeholders.

In addition to changes in launch strategy that are likely to happen as a result of the IRA, brands are likely to face hard decisions around adjustments to copay assistance programs, hub eligibility criteria, the amount of free product they’re able to offer and where they go overall with the brand in order to continue providing support to patients who need it.

Data points to a potential reduction of as much as 40% in the number of FDA-approved drugs over the next 10 years—up to 139 therapies—as a result of the IRA. Some manufacturers may consolidate resources around fewer products and lower investments, while others could pursue assets they might not otherwise approve, and some may discontinue trials. Alexion, for example, has gone on the record and publicly discussed delaying some investments in R&D.

Manufacturers are also beginning to change their organizational structures and adjust engagement strategies to respond to IRA negotiation and create more alignment with their global pricing colleagues. Teams focused on government are getting larger.

Once the negotiated prices are announced in September before taking effect in 2025, the spillover effect on the commercial market will be significant, particularly with Part D, where pricing designs will likely become even more complex. It is important for manufacturers to know their places on the list and use projections to avoid any surprises in terms of submitting evidence packages to the Centers for Medicare & Medicaid Services.

When new laws directly impact patients, it is critical to educate them about how these regulations will affect their medication journey.

“It’s all about getting the information out to the patient, explaining it to them in ways they can understand it, and meeting them where they are—and not just the patient, but of course, caregivers as well,” said Richard Fahrer, oncology marketing director, patient solutions, at Pfizer.

Copay smoothing is one area Part D patients are likely to need help understanding. Designed to put a $2,000 OOP cap on medications and spread patient costs evenly over the course of the year to make monthly costs more predictable, guidance on this is evolving and still being released.

“For patients to be able to take advantage of the program, they need to understand how it works, how to enroll, and how to smooth out that copay,” noted Fahrer. “They’re also going to need to make sure they make their payments on time, because if they opt-in to copay smoothing and then miss payments, they risk being dropped from the program and expected to pay a lump sum.” Interestingly, in a post-webinar conversation with an attendee, Fahrer learned that at least one independent patient assistance charity is suggesting that patients who expect to gain charitable support should not sign up for smoothing as it could disrupt the charity’s qualification and approval processes.

Making that information available to both patients and caregivers, in multiple languages wherever possible, and also educating prescribing physicians, practice managers, reimbursement specialists, and other patient advocates—as well as internally within the pharma manufacturer—is also critical.

In addition, hub services vendors have an opportunity to act as an intermediary to enroll patients in the copay smoothing program “because that’s going to be a little bit tricky in 2025,” explains Butler. Since patients aren’t able to enroll at the pharmacy counter and need to do so via paper, phone, or online application, the process needs to be as easy as possible.

Payers are poised to buckle down and do all they can to shrink their risk around the IRA impact. According to Don Sawyer, senior vice president of market access at Stemline Therapeutics, “The negotiations are going to get much more extreme and they’re going to leverage everything they possibly can do.

In the absence of information, payers “are going to backstop themselves, and who’s going to be there to backstop them is who has always been there to backstop them, the manufacturers,” added Sawyer. Payers are also likely to raise premiums, potentially reduce the number of Part D options, and use a more restrictive benefit design with existing plans.

In anticipation of the IRA and expected reduction in hub, patient assistance programs, and affordability program budgets, manufacturers should be looking to streamline their patient support operations. Leveraging artificial intelligence, electronic benefit verifications, more sophisticated benefits support, and blended staffing models all can help brands do more with less without shortchanging patients. 

Chris Dowd is Senior Vice President, Market Development, at ConnectiveRx.

What does the legislation mean for patient access leaders, pharma brand       managers, and patient service owners? Industry experts weigh in.


The IRA’s Impact on Patient Hub, Access, and Affordability Programs

Sustainability has become a real necessity and the pursuit of organizations across the globe, as many now throw down the scientific gauntlet.

It is important for organizations to proactively set targets and focus on long-term initiatives that will provide value realization and business transformation toward creating a more sustainable and resilient future. Indeed, within our own business, our adherence to the Science Based Targets initiative (SBTi) through our strategic partnership with EY Parthenon

 underscores our commitment to conscientious corporate stewardship.

At the time of the announcement, I had noted that our alliance with EY Parthenon marks a pivotal advancement in our sustainability pursuit and that by leveraging their esteemed expertise in industrial decarbonization, we are poised to expedite our net zero objectives, thereby effectuating a meaningful reduction in our carbon emissions. Keeping that in mind, when it comes to net zero objectives, I am referring to “we” as large-scale manufacturers.

Overall, embarking on the journey toward decarbonizing entire processes will undoubtedly prove overwhelming for many. Still, if we want to restrict global temperature fluctuations, then it is one that we must all embrace.

Ultimately, it’s about looking toward the future and trying to understand wide-ranging stakeholder needs to create long-term and effective solutions. When it comes to addressing environmental schemes and proposals, every part of the manufacturing process needs to be considered. Organizations could look at a number of measures to reduce their carbon footprint, which could include:

Implementing an energy management system and increasing the usage of renewable energy sources, including solar power. This is something we do, with the aim of reducing fossil fuel consumption by 20-25%.

Improving overall equipment effectiveness (OEE) by addressing machine time hours to reduce energy consumption.

Looking at how and which devices can be used with the internet of things (IoT), in order to continually monitor energy consumption, as well as to create energy-efficient designs.

Reducing waste generation within premises and upcycling where possible.

Promoting the use of electric vehicles and making the move toward hybrid models.

Undertaking sustainable practice through the use of zero liquid discharge, which can enable plants to save power and generate daily energy.

Creating biodegradable and compostable barrier films and coatings, promoting the use of single polymer plastics when it comes to packaging materials, while also working with companies to reduce overall packaging size.

The mission to reduce the overall carbon footprint remains a driving principle for the pharmaceutical sector, with a focus on making manufacturing “contained, continuous and connected,” while optimizing raw material use and reducing waste.

We must continue to work collectively to achieve this goal, ensuring clear communication and complete transparency. We are moving in the right direction and already we’re seeing visible gains.

Shivshankar S.R is the CEO of ACG Packaging Materials.

1. Kulkarni M. ACG Joins Forces With EY-Parthenon For Strategic Partnership. 

https://www.pharmanow.live/latest-news/acg-joins-forces-with-ey-parthenon-for-strategic-partnership

Why is it important for organizations to set long-term goals when planning for a sustainable future?

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