Competition and confusion led to inefficient usage of medical supplies and massive back-ordering in US finds report

Call for national stockpiling standards to prevent next wave of healthcare product shortages

The US experienced a fragmented approach to securing supply that led to competition rather than coordination during the pandemic, according to a recent survey conducted by Premier Inc.

The survey found that either the health system or the state is directing the majority of stockpiling efforts, although product back-orders are inhibiting requests to replenish the stockpiles and provide timely care.

Nearly 90% of healthcare providers are contributing to stockpiles of critical medical supplies and drugs intended to last as long as 90 days. As new COVID-19 hotspots emerge, however, the survey shows local efforts to build stockpiles must be supported with a national strategy to avoid redirecting supplies away from front-line caregivers and exacerbating ongoing product shortages.

The products that providers cited as heavily back-ordered include:

  • N95 masks and bouffant caps (both cited by 53% of respondents)
  • Isolation gowns and shoe covers (both cited by 49% of respondents)
  • Testing swabs and test kits (cited by 40% of respondents)
  • Surgical gowns (cited by 35% of respondents)
  • Exam gloves (cited by 32% of respondents)
  • Surgical masks (cited by 30% of respondents)
  • Syringes (cited by 7% of respondents)

The report advocates for the creation of a U.S. national standard that integrates stockpiling needs at the federal, state and health system levels. Premier recommends a hub-and-spoke model that leverages the Strategic National Stockpile (SNS) as well as a network of state and health system stockpiles, with an emphasis on collaboration and coordination between the entities maintaining inventories of supplies.

Specifically, the report makes the following recommendations:

  • That the SNS maintain a minimum 90-day supply of critical medical supplies and drugs, as dictated by surge demand from hotspots such as New York and Washington.
  • The Administration, working alongside private sector partners, create a streamlined and efficient process for states to access supplies and drugs from the SNS.
  • The SNS provide, at minimum, a detailed monthly report of supplies that were distributed, including the recipient and quantity sent. During a public health emergency, reporting should occur weekly.
  • The SNS partner proactively with group purchasing organizations to forecast demand and increase capacity to avoid shortages; ensure the SNS is continuously stocked with in-date products; and rotate soon-to-expire stock out of the SNS and into health systems at a discounted rate.
  • The SNS work to ensure that critical medical supplies and drugs are located as close to the delivery of care as possible, including exploring opportunities to leverage health system warehouses.
  • Health systems or regional buying groups be considered as potential stockpile operators. These organizations would be responsible for managing the stockpile for the providers in a region, allowing an efficient means to rotate inventory and assuring accountability for the stockpile.
  • Creation of a customized stockpile for nursing homes with appropriate supplies, drugs and other needs.
  • The SNS develop an integrated data infrastructure that utilizes clinical and supply predictive analytics to forecast geographical disease progression and surge demands to provide real-time insights to supply needs.
  • The SNS seek feedback on the critical medical supplies and drugs it maintains from a public-private advisory council that includes representatives from the private sector, federal agencies, the Veterans Health Administration, Indian Health Services, prisons, first responders, state and local representatives, and others.

“During the pandemic, the nation experienced a fragmented approach to securing supply that led to competition rather than coordination,” said Blair Childs, Senior Vice President of Public Affairs at Premier. “States and health systems need to feel confident in their ability to access an emergency stock of supplies, but absent a clear national strategy, we risk not being able to support providers through a regional surge in cases. To protect our front-line workers and patients, we must reinforce providers’ efforts with a national strategy that ensures coordination and reliability across stockpiles.”

“We learned from the first wave that a disconnected approach is unsustainable,” said David A. Hargraves, Senior Vice President of Supply Chain at Premier. “As we work alongside our members to increase access to critical products, we recognize the need for a cohesive national stockpiling strategy to help support and stabilize the U.S. supply chain. Premier’s stockpiling recommendations are holistic, and would enable the SNS to work for any group that may need to leverage its contents – an entity built by providers for providers.”

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