Cencora's Brent Wilhelm on the Inventory Paradox Behind Drug Shortages

In part 1 of a 3-part interview with our sister publication PharmTech, Cencora's senior vice president of global supply chain, Brent Wilhelm, unpacks a problem that frustrates both patients and providers: a medication can exist somewhere in the system and still not reach the people who need it. For Wilhelm, whose work covers the movement of pharmaceuticals, specialty and cold-chain products included, from manufacturers to patients across domestic and global networks, the issue is less about whether a drug exists and more about where it happens to be.

That geography problem sits at the heart of how Cencora's US network is designed. The company positions stock across more than 25 distribution centers, each placed to keep product near customers and forecasted demand so orders can be filled in hours. It works until the forecast is wrong. Regional RSV surges, Wilhelm notes, are a case in point: "When we have demand variability, moving inventory, although it's available somewhere in the network, it could be on the East Coast, but the demand's spiking on the West Coast." Relocating supply across the country isn't instant—so a product can be technically "in stock" nationally while being effectively unavailable locally.

Solving that, he says, means distributors and manufacturers sharing far more than they do today. If planning were informed by actual patient-level demand and dispensing activity, shortages could be anticipated rather than reacted to. The stakes are rising, too, as therapies shift toward real-time administration and providers pare back to ordering what they need on the day rather than stockpiling for the weeks ahead. As Wilhelm puts it: "The way that the supply chain is set up today across the US, it's much more of a historical demand, not a real time." The system, in other words, was built for a market that no longer exists.

He points to artificial intelligence as a key part of the answer—reading demand signals buried in ordering data and helping manage the sprawl of dosage strengths and formulations that distributors have to track. The remaining blind spot is what happens at the very end of the chain: what's actually dispensed at the point of care. It's a gap Cencora is now tackling in conversations with its largest customers, part of a broader push toward shared demand planning that keeps both the supply chain and patients protected.