As I sat last week at my wife’s upstairs desk writing this editor's letter, earbuds on, I couldn't quite drown out the noises from downstairs—motorized sanders zigzagging the floors, the occasional hammering and loud thuds, and other ambient sounds; not the pleasant ones. Like so many along the destructive path of Hurricane Ida earlier this month, my home in NJ was damaged heavily by massive flooding. Thankfully, my family was safe and we're grateful beyond words to the many friends, co-workers and family members who have lent such amazing help and support in the weeks since with cleanup and the beginnings of restoration.

As draining as this experience has been mentally and physically, we know we’re but one of the countless families and neighborhoods impacted by extreme weather events that are becoming increasingly more frequent. 

Trying to settle my thoughts to write this, I found myself thinking about Ida in the context of industries like pharma, and functions within such as the supply chain. Affected personally, I’ve gained a deeper respect and appreciation for the ways manufacturers, suppliers and logistics companies navigate weather crises to avoid significant disruption to the transport and delivery of critical medicines.

All we could really focus on was grabbing a few things, rounding up the pets and getting to dry ground. It’s hard to imagine all the contingencies related to tracking and monitoring hundreds of freight containers traveling by ship or dozens of pallets loaded onto a aircraft, and not to mention the logistical maneuvering likely required at ports and warehouses to keep deliveries on schedule to pharmacies and hospitals. And then there’s the challenge of maintaining stable control of temperature-sensitive products.

Of course, it’s never perfect, there is disruption, concessions made, expectations missed; how could there not be as the wider magnitude and full devastation from these events are often unforeseen. But it’s no less impressive.

, in recent coverage, has featured expert insight and discussion around the implications of weather catastrophes for the pharma supply chain, particularly amid the added pressure on distribution during the Covid-19 pandemic. We touch on the topic again this month in our 

, noting the importance of using advanced data analytics to help suppliers identify ideal transport routes—and through tracking data revising those routes as needed to lessen the sting of weather events that could threaten on-time delivery of temperature-sensitive cargo. Executives interviewed in the article also stress that cold chains should have a certain level of flexibility and adaptability fundamentally built in to address unforeseen circumstances, including changing weather patterns.

 this month, underscores the opportunity for pharma to achieve carbon neutrality in the coming decade, as a UN climate change report sounds alarm bells on global warming trends that could trigger even more frequent extreme weather events.

 on supply chain management, we chronicled how weather catastrophes like Hurricane Maria in Puerto Rico, back-to-back typhoons in Asia and severe blizzard conditions earlier this year in Northeastern US wreaked havoc for manufacturing facilities and supply chain operations related to active pharmaceutical ingredients (APIs), excipients, finished products and medical devices.

Volker Kirchner, director of temperature control solutions for World Courier, puts things into perspective in this month’s 

, pointing out that a delay of five or 10 hours could be the difference between a successfully delivered drug shipment or a patient, waiting on treatment, succumbing to illness.

As families like mine recover from Hurricane Ida, and work to get back to whatever a normal life is these days—something that may never happen for those who lost loved ones (the storm killed over 80 people in the US, including 30 in NJ), industries and businesses like pharma find themselves with similar, albeit different level, challenges. In both cases, at least for me, it’s easy to marvel at the effort involved.

Michael Christel is Editorial Director of Pharmaceutical Commerce. He can be reached at

Articles

Hurricane Ida reminds us of the importance of an effective supply chain

When the extreme hits home

Click the title above for a link to open the Pharmaceutical Commerce September 2021 issue in an interactive PDF format.

Pharmaceutical Commerce - September 2021 Issue (PDF)

In recent years, ongoing advances in the development and dissemination of temperature-sensitive pharmaceutical products — ranging from the Covid-19 vaccine and vaccines for other infectious diseases, biologic therapies to treat rare and chronic diseases, novel oncology treatments and cell and gene (CGT) therapies — have created more complex cold-chain requirements than ever before. These lifesaving products must be maintained at refrigerated, frozen or deep-frozen temperatures during every moment of the journey, from packaging and storage through transportation and delivery.

Biopharmaceutical manufacturers, working in close collaboration with their packaging suppliers and third-party logistics (3PL) partners, are distributing temperature-sensitive specialty medications and vaccines to more regions of the globe, with more extreme temperature profiles, longer distances and more “last-mile” challenges more than ever before. Concerning the latter—the final leg of the cold-chain journey and handoff of product—this often happens in a place or location that does not have sufficient infrastructure in place to sustain the ultra-low temperatures required.

Specifically, ongoing investments in the space aim to develop or improve:

Advanced container designs that optimize internal payload volume without sacrificing thermal performance.

State-of-the-art insulation materials, including vacuum-insulated panels and phase-change materials (PCM).

Real-time monitoring of location, temperature and condition, predictive analytics and data visibility.

Strong partnerships with other cold-chain players that help to enable the many seamless handoffs that are needed to complete product transport.

For both parcel and bulk shipments, domestic deliveries typically have a range of 24 to 72 hours, while international transportation is usually designed to cover a range closer to 120 hours. “Any temperature-controlled delivery only has so much time in its temperature-control budget, yet that fixed time budget must last all the way until the therapy has reached the patient’s arm or mouth,” notes Adam Tetz, director of worldwide marketing for Peli BioThermal.

Globally, spending on biopharma cold-chain logistics has been rising steadily since 2018, and it is projected to grow by another 25% over the next three years, reaching $21.3 billion in 2024, according to the 2020 Biopharma Cold Chain Sourcebook published by 

Raising the stakes on temperature and time

The unprecedented demand for Covid-19 vaccines that require frozen and deep-frozen temperatures—in parallel with growing volumes in other therapeutic categories—has upped the ante for manufacturers of shipping containers, intermediary 3PL partners and specialized trucking and airline companies. The two Covid-19 vaccines that are based on the mRNA platform have set new standards for ultra cold-chain requirements, with the Pfizer-BioNTech vaccine needing to be maintained between -80°C and -60°C (-112°F to -76°F) and the Moderna vaccine at -25°C and -15°C (-13°F and 5°F).

Even though mRNA-based vaccines and therapies have shown promise for many years, because of their extreme-temperature requirements, “no one wanted to build the critical infrastructure needed to handle them,” says Shea Vincent, senior marketing director at Stirling Ultracold, “but the Covid-19 pandemic and the rapid, high-volume rise in mRNA vaccines have blown the doors wide open.” Today, it seems that development plans for mRNA-based therapies and partnerships are being announced every day.

The many innovations that were required throughout the cold chain to enable massive distribution of the novel mRNA vaccines for the coronavirus “would typically have taken five to six years to develop and bring to market, but during the pandemic, these were completed within five to six months,” adds Gregory Demitrack, strategy and consulting manager, supply chain and operations at Accenture.

But even before the pandemic, the need to scale existing and emerging technologies to manage modern business challenges was prevalent, says Carly Guenther, Accenture’s managing director and North America life sciences and supply chain and operations lead, and will continue to be a driving factor within the pharma cold chain. According to recent research by Accenture,

 81% of supply chain executives agree that they are facing technological changes at unprecedented speed and scale, and that Covid has been their organization’s largest stress test.

To meet the exacting requirements of today’s pharma cold chain, collective effort is underway to improve the competing packaging and shipping container designs and enable novel refrigerants and PCMs. This applies to active systems that require an energy source to maintain the cold temperatures, and passive systems that do not rely on a battery power or active compressor/thermoelectric cooling to maintain their temperature setpoints during transit. PCMs are based on hydrated salts, paraffins, fatty acids, alcohols and once conditioned to the setpoint temperature, they are able to reliably store and release energy to maintain ultralow setpoint temperatures inside the container for the duration of the trip.

“The pandemic really shifted the way we perceive cold-chain solutions, particularly when it comes to pharma and patients receiving vaccines and medications in a quick and efficient manner,” says Wes Wheeler, president of UPS Healthcare. “We believe the industry will continue to become more optimized regarding its efficiencies, reliability and resiliency, pushing cold chain and pharma distribution forward.” UPS Healthcare recently established UPS Healthcare Cold Chain, a comprehensive suite of cold chain technologies and capabilities.

When it comes to CGTs, there is more momentum than ever to bring these innovative therapies to market. Based on the current pipeline and the clinical success rate of these products, the FDA is expected to approve 10 to 20 CGTs by 2025.

To keep up with the projected influx of approved therapies (and the related clinical trials), stakeholders are working to build up additional capacity for cryogenic storage. Such efforts, coupled with today’s proven methodologies and processes “will enable our partners to scale their specialty CGT product shipments from many to millions,” says Albert Cooksey, SVP and general manager of 3PL services for ICS, a division of AmerisourceBergen, adding that the parent company, through its network of businesses, has supported every manufacturer that has launched a CGT product in the US to date. ICS has recently doubled it refrigeration storage capacity (2 to 8°C) and invested in additional liquid nitrogen storage capacity (-180°C). In 2020, AmersourceBergen integrated World Courier, its global specialty logistics provider, and ICS to create a single specialty logistics provider to deliver complete support from clinical trials through commercialization, including a complete cryogenic supply chain.

Advances in packaging, shipping containers

“Ongoing advances in cold-chain shipping containers are able to provide extended temperature stability against a variety of environmental conditions, enabling safe and secure deliveries to very remote communities, areas with limited infrastructure or regions with extreme climates—like winter in Moscow or summer in Dubai,” says Nick Porter, SVP and general manager (global), World Courier.

Whether the payload is a single dose of high-value CGT or a pallet worth of lifesaving therapies or vaccines, it’s a million-dollar challenge to do whatever it takes to reduce spoilage, deliver the package on time and be able to meet business objectives. One disruption along the way can have an enormous impact.

A notable recent engineering innovation is the development of highly engineered vacuum-insulated panels that outperform many traditional insulation options. Vacuum-insulated panels are constructed from a microporous core material (i.e., glass or silica fibers, foams, mineral or glass wool) that is sandwiched between two pieces of multi-layer laminate barrier film. “Compared with widely used alternative options for insulating the thermal shipping containers, these slim-profile insulation panels provide R-values (a measure of how well a type of insulation resists the flow of heat) that are 10 times higher than conventional materials,” says Tom Weir, chief operating officer at CSafe Global.

World Courier recently introduced a passive thermal packaging tool, called Cocoon (left), which allows pharma companies to transport pallet-sized shipments within a low-frozen range, over great distances, to locations where the local infrastructure may be unreliable. According to World Courier, the Cocoon shipping containers use a combination of honeycomb, vacuum-insulated panels and advanced PCM to provide stable thermal protection for 168 hours across multiple temperature ranges: controlled ambient, refrigerated and frozen, and they are 30% lighter than comparable containers, the company says. To date, the Cocoon temperature-controlled containers have been used to ship pharma products from more than 110 locations worldwide, including those with an unreliable infrastructure, and those that are prone to customs delays, extreme climate variations and more, notes Porter.

World Courier has developed another novel shipping container called PharmaCube—an active, compact, custom-built shipping container designed specifically for the ground transportation of products controlled at ambient, refrigerated and frozen temperatures. It can be stored in a van, is powered by the vehicle’s battery and performs like a mobile refrigerator.

Stirling Ultracold offers ultra-low temperature (ULT) freezers that are small (the size of a beach cooler) and transportable and are able to maintain temperatures from -20°C down to -86°C. Powered by a free-piston Stirling engine (rather than traditional compressors), these ULT freezers use less than one-third the electricity of standard compressor-based ULT freezers, and they use 100% natural refrigerants, according to the company.

“You’ll never get a compressor-based engine small enough for the size of portable units we offer, and phase-change materials don’t exist to service needs lower than -40°C,” says Vincent.

The latest portable unit from Stirling can be battery-operated, plugged into a car charger or operated solar power. An upright, under-the-counter model is also available to provide ultracold freezer capacity in laboratories and pharmacies. “This portability creates a lot of opportunity to manage last-mile challenge and enable the delivery of ultrafrozen vaccines and therapies to remote parts of the world,” explains Vincent, who notes that this small-footprint option is also well-suited to help support today’s decentralized clinical trials (discussed ahead). In May 2021, Stirling was acquired by biopharma CDMO BioLife Solutions.

Stirling recently partnered with Walgreens to support the company’s widespread Covid vaccine-administration efforts at its 9,000 US retail pharmacy stores. Walgreens developed a hub-model storage plan that designated many of the bigger or more remote stores as hub locations to receive vaccine shipments and help manage the ebb and flow of Covid vaccines out to individual stores. To equip the hub centers, Walgreens purchased 300 portable ULT freezers and 105 undercounter freezers from Stirling. The company’s ULT freezers have also played a pivotal role in Puerto Rico’s mass-vaccination campaign in recent months and is a key supplier to UPS Healthcare to support its cold-chain efforts.


The growth of decentralized clinical trials

While the randomized clinical trial (RCT) process remains the gold standard for demonstrating the safety and efficacy of promising investigational therapies, informing dosing strategies and supporting the regulatory-approval process, the traditional RCT approach has always been flawed in several ways—including the need for trial participants to travel to centralized locations repeatedly for drug administration, testing and observation. According to recent research from Sanofi, 70% of potential trial participants live more than two hours away from the nearest study center. 

In direct response to trial disruptions caused by the Covid-19 pandemic, there has been growing appetite for the use of decentralized clinical trials, and this has created a paradigm shift for all stakeholders, including providers of cold-chain packaging. “Over the last year we’ve seen one of the largest shifts in the history of clinical trials,” says Wheeler. “Virtual and decentralized trials offer a pragmatic, flexible approach” that aims to allow a given trial (where appropriate) to be conducted across smaller, local clinical settings to reduce patient burden and travel requirements and in some cases, to allow patients to participate from their homes, rather than travel to any clinical site, he adds.

In a year-over-year comparison between March 2019 to March 2020 in the US, Medidata reported patient access to trial sites was reduced by 66%.5 “Now in 2021, decentralized trials have already become a reality and represent the future of the industry, offering patients, providers, sponsors and vendors another option while enhancing the overall experience for trial sponsors, contract research organizations and patients, while reducing the risk of trail failure,” says Wheeler.

While this newer model is being heralded for enabling improved participation rates and reduced burden on the patient, it is also producing additional challenges vis-a-vis the cold-chain requirements when the investigational therapy must remain refrigerated or frozen and then stored and administered properly at home. Specifically, stakeholders have had to develop more nimble packaging and shipping options, as well as logistics systems, to enable smaller, more customized deliveries, and develop the needed monitoring and support protocols to ensure that the small clinics and individual patients will then be able to play their part in the exacting chain of custody required for these experiment treatments.

Importance of monitoring and data analytics

The use of sophisticated monitoring devices, coupled with advanced data analytics capabilities, have the potential to turn real-time data into actionable insights. During the planning stages, trends and patterns gleaned from historic tracking data can help stakeholders to identify the ideal transport route— and then use tracking data to revise it regularly, as needed, to minimize the impact of transit delays, weather crises and other factors that could arise to threaten the on-time delivery of the time- and temperature-sensitive cargo.

Today, different types of monitoring devices can be embedded within the shipments—to collect and transmit real-time data related to entire cargo containers, individual pallets and even individual product packages—from the moment they begin their journey to the moment they are delivered.

“Cold-chain management practitioners are not unfamiliar with data gathering and analytics. Until recently, however, the process to generate data-driven insights from that information was costly. It required time, manual efforts, and in many cases specialized data science skills,” says Demitrack of Accenture. “However, in today’s world, that is no longer the case.”

The affordability of tracking devices and data-analytics capabilities has continued to come down in recent years.This allows stakeholders to cost-effectively monitor multiple parameters of importance, including not just location but ambient temperature and humidity inside and outside the shipping container; vibration; shock and tilt events; the number and duration of every open-door event and more. Transmitting that data easily via cloud-based platforms provides unprecedented insight into what’s really happening to these high-value products during storage and transit.

“We’ve come this far in terms of being able to gather so much data, but the future wave will be defined by our ability to use advanced analytics techniques to use that data even more effectively to inform and drive behavior change to hone in on the most secure packaging and transportation,” says Stirling’s Vincent.

“We use data analytics and advanced monitoring solutions to protect our clients’ products and provide them with the actionable intelligence needed to make the right decisions in real time,” adds Cooksey of ICS. In addition to monitoring devices that are able to track individual shipments, Cooksey notes that 3PL providers “can also leverage 852 and 867 sales and trade [activity] data from downstream trading partners (such as wholesalers) to provide analytics that identify customer behavior patterns to help enhance business decision-making.”

“With increased digital capabilities throughout the pharmaceutical cold chain, companies can achieve greater relevance to customers, stronger resilience to disruptions and enhanced responsibility to society and the planet,” adds Accenture’s Guenther.

According to colleague Demitrack, “When, through continuous monitoring, real-time data can be collected, conditioned with business rules and logic, contextualized, and presented to the user, it enables an intelligent response that allow stakeholders to address temperature excursions as they are happening—not after the fact.”

Specifically, manufacturers and suppliers can also use such data to spot and forecast trends, enabling better predictive and preventive intervention for all partners handling the shipment along the way.

“We’ve built internal tools that allow us to analyze past data using artificial intelligence (AI) methodologies to help predict the future, and this has really helped us in our asset-allocation solutions to get our products (active and passive containers) to the right place at the right time,” says Weir of CSafe Global. “This helps to improve planning around which products to transport in which lanes—building confidence for our customers and credibility for us.”

Similarly, these technology advances have other workplace implications as well. “Natural language processing (NLP), low-code platforms, robotic process automation and other sophisticated data-analytics techniques are democratizing the cold chain,” says Guenther. “This, in turn, puts powerful capabilities into the hands of people across the supply chain.” She believes those people closest to day-to-day business problems will be empowered to create technology-driven solutions themselves. For example, creating more accurate forecasts or squeezing more efficiencies from manufacturing processes. “We must invest in every employee in the supply chain workforce—they will be the innovators that will optimize work, fix pain points, and keep the supply chain operations in lockstep with new and changing needs,” says Guenther.

The global disruption and unprecedented speed of the development and deployment of Covid-19 vaccines ignited “a scramble for enterprises to reimagine their supply chain partnerships, and multi-party systems gained newfound attention,” notes Guenther.

Demitrack adds: “By leveraging with closely integrated partnerships, supply chains can gain greater resilience and adaptability; unlock new ways to approach and serve the market; and set new, ecosystem-forward standards for their industries—especially as new players come into the landscape.”

When it comes to the pharma cold chain, “owning the end-to-end supply chain is the most expensive method for bringing products to market, as you have to be an expert in all areas of the supply chain,” says Ammie McAsey of McKesson US Pharmaceutical. “A multi-player supply chain provides cost efficiencies, scale and expertise.” She notes that each distinct handoff or “touch” creates an opportunity for risk or disruption. However, the current pharmaceutical supply chain is stable and reliable. The players in the market are experts in their discipline. So, leveraging each strength and collaboration across the industry is vital.

“The Covid-19 vaccine distribution efforts have reinforced the importance of proactive planning, as well as communication and collaboration among partners across the supply chain,” says Cooksey of ICS. “By engaging 3PLs early in the commercialization process, pharmaceutical companies and their partners can design and execute a robust supply chain strategy that leverages flexibility, storage across different areas, and the right packaging solutions to maintain product integrity across all conditions.”

Cooksey goes on: “Looking ahead, it’s critical for manufacturers to identify a 3PL provider with flexible shipment solutions and robust and tested business continuity measures that can help them navigate potential challenges and protect against supply chain disruptions.”

McKesson has played a pivotal role in supporting the US government’s efforts to distribute the Covid-19 vaccine. “From our partnership with the Centers for Disease Control and Prevention (CDC), the manufacturers of the vaccines and various technology partners, we’ve built a best-in-class approach to handle the different temperature requirements of the frozen and refrigerated Covid-19 vaccines,” says McAsey. As of early September, McKesson has delivered more than 199 million Covid doses all over the world, according to the company.

“We know that—despite tremendous progress to date— the global vaccination rollout is still in its early stages and a tremendous amount of work is still needed to ensure these vaccines reach communities around the world,” says Porter of World Courier, which has worked with partners to distribute millions of coronavirus vaccines to more than 20 countries over the past year. “As the vaccine supply increases, our teams will continue to work with partners across the supply chain to design and optimize logistics strategies and identify how we can best leverage our global network and temperature-controlled solutions to support successful distribution efforts.”

Executives stress that it is critical for cold chains to have a certain level of flexibility and adaptability to attend to unforeseen circumstances, including changing weather patterns, packaging or hardware malfunctions or vehicle breakdown. Using next-generation sensors, smart-label technology and other tracking advances, can help create those dynamics, says UPS Healthcare’s Wheeler. “We are now able to monitor a given package down to 10 feet anywhere in our network, and that has enabled us to achieve a 99.9% on-time delivery rate for our vaccine shipments.”

For some cold-chain situations, single-use (disposable) packaging options make more sense; for others, reusable shipping containers that may allow 40 to 50 shipments before they need to be retired are a more financially and environmentally sustainable option. “In the last two years, we have noticed a drastic change in sustainability leading strategy and many of the actions behind cold-chain decisions, ranging from packaging considerations to 3PL service agreements, and we expect to see more aggressive commitments in this arena, as the sustainability theme continues to grow in relevance,” says Vivian Berni, director of product management for Sonoco ThermoSafe.

“These days it is very popular to offer environmentally friendly, sustainable options—especially in certain geographies—and some of today’s newer cold-chain packaging products are both recyclable and curbside compostable,” adds Tetz of Peli BioThermal. While some current compostable packaging options may not be as robust with regard to extreme temperature control, they are still likely to find a niche in the direct-to-patient model that is growing in decentralized trials, where there is a small window of time but a relatively short distance to distribute the refrigerated or frozen medications. “This would allow the patient to safely dispose of the single-use packaging at home and not require the pharma company to keep track of and retrieve the shipping container from each patient,” says Tetz.

When it comes to the ability to reduce the overall carbon footprint associated with individual cold-chain shipping efforts, today’s model for leasing reusable shipping containers has also continued to evolve, experts contend. “Shipping containers that may go from New York to Tokyo will be managed in such a way that they travel back full,” says Tetz. “We work closely with our global network of service centers to balance out the travel schedules, in order to ensure that there will be the fewest possible number of empty travel legs as possible as these shipping containers are moving around the globe.”

All of these changes have continued to shape the landscape throughout the biopharma cold chain. “Traditionally, the supply chain has almost always been considered a back-office, transactional function, but increasingly, this activity—especially as it relates to time- and temperature-sensitive pharma products—is being recognized as a critical pillar in an organization’s success,” says Berni of Sonoco ThermoSafe. “It directly informs and shapes the strategic direction, growth and competitive positioning of that company, and ensures that patient access to therapy will not be upended.” As a result, she adds that proper investment needs to be funneled all throughout various levels of leadership, “supported by the right tools to manage dynamically—not Excel spreadsheets.”

Such technological approaches go hand-in-hand with today’s larger mindset among the C-suite when managing the supply chain in the life sciences. “Historically, pharma companies tended to worry about the cost of one package, but today, stakeholders are taking a much broader view of all risks, considering the entire infrastructure and advanced technology options that are required to ensure reliable delivery from end to end, and making their decisions more smartly,” says CSafe’s Weir.

Adds Berni of Sonoco ThermoSafe: “The ongoing changes throughout the pharma cold chain will continue to create both challenges and opportunities—and potential competitive advantage—for those willing to break from the status quo.”

https://www.pharmaceuticalcommerce.com/view/2020-biopharma-cold-chain-sourcebook-forecasts-a-17-2-billion-logistics-market

https://www.accenture.com/us-en/blogs/business-functions-blog/technology-vision-2021-a-supply-chain-perspective

https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-and-peter-marks-md-phd-director-center-biologics

https://www.sanofi.com/en/science-and-innovation/patient-participation-in-clinical-trials/

https://www.medidata.com/wp-content/uploads/2021/06/COVID19-Response4.0_Clinical-Trials_20200504_v3.2-1.pdf

The pressure is on for stakeholders to continue pioneering novel engineering designs, insulation options and advanced monitoring and data analytics tools—to meet the complex demands of today’s temperature-controlled products while keeping costs low

Pharma Cold Chain: Pushing the Envelope

A fascination with the world of logistics “was always my kind of thing, even as a kid,” Volker Kirchner recalls proudly. “Some people played computer games—shooters or something like that. I was always the 

kind of person.” Not surprisingly, the natural progression from there, and his first choice when he started his career, Kirchner says, was the logistics field, beginning his professional life in freight forwarding and traditional trucking. Enjoying his work but seeking something more challenging, the German native eventually joined World Courier, where, today, as the company’s director of temperature control solutions, he is approaching 20 years with the organization, which is part of AmerisourceBergen. Kirchner notes, however, that his introduction specifically into healthcare- and pharmaceutical-related logistics happened more so by accident, noting that World Courier 20 years ago didn’t just serve those sectors exclusively. 

“It wasn’t that I was looking for a healthcare logistics company, but I certainly appreciated the fact that we evolved more into that over time,” he says. “I just love the challenge, the puzzle of getting a new drug from A to B—and maybe you need to go via C. Then suddenly what you’re transporting turns out to be something that is more important than other products; therapies that really make people’s lives livable.”

That mindset likely helped guide Kirchner and his globally dispersed team through some very challenging times in pharma distribution in the last 20 months. 

 caught up with the expert in temperature-controlled transport, logistics and packaging to discuss all things Covid, cold chain, and taking on future threats to the safe delivery of critical medicines.

, we explored some of the early Covid-19 implications for temperature-controlled storage and transport of drugs and vaccines, but much was still uncertain at that point—pre the massive vaccine deployment and distribution effort that would come. Fast-forward a year later, what key learnings about cold chain logistics (packaging and storage) during the pandemic will be critical to support the next wave of temperature-sensitive products?

It’s been really a remarkable episode. Since the start of the pandemic, waiting for the first signs of a vaccine coming out, I think what we noticed at first, in terms of temperature requirements, the temperature ranges involved, and the packaging solutions sizes, was that there was really nothing new under the sun that was needed to handle this. We didn’t have to develop new packaging systems on the market. Everything that you needed to transport the vaccines or the components needed to produce the vaccines was already there essentially.

But what we saw happening in late autumn [2020] was a level of coordination needed in the industry and between all players—the manufacturers, the logistics providers and the packaging providers. The situation was so unique and so unexpected that the coordination needed to get that moving at speed was not something that had been tried before. What we saw happening in the early part of this year was everyone scrambling to source packaging. Manufacturers were scrambling to provide information to the logistics partners on what was needed in terms of requirements. In the absence of clear information, the logistics providers were reaching out to packaging providers to get their stock.

Everyone was trying to secure things as much as possible, and that led to a rocky start in the beginning. Because every packaging developer, from Styrofoam box producers to the more-involved packaging suppliers, we’re receiving requests from every major player on the market trying to get as much as possible in excess of their monthly production. So logistics providers were unable commit to any one client to provide a certain level of service. That went on for a while until it became known how much was going to be needed to be transported to where, in what volumes and which temperature ranges. Then suddenly it became apparent, “oh, we have the ability to do this with the existing tool set.”

The lesson learned moving forward is that we see that unexpected things can happen at any time that no one really has a contingency plan set up for. The tools may be there, but knowing exactly how to then come together and to sit down and work out a plan to completely address any new situation will really be necessary moving forward. I think that’s something that all sides learned in this.

Maybe it’s strange to bring the Ever Given situation (the large container ship that blocked the Suez Canal in March) into this question because it seems so unrelated [to the pandemic]. But with both, we have seen two cases recently where things just happened that even the most comprehensive contingency plans really didn’t foresee, and that caused major shock waves throughout the entire logistics ecosystem. We didn’t need to start from scratch, but everyone was in the same boat essentially.

2. How did the Covid vaccine distribution effort unfold early on? Was it

more complicated to ship vials outside of the US?

It was. Another unexpected thing was the complete drop in global air freight—the unavailability of airplanes, flights being canceled everywhere, almost no planes in the sky. That really made life difficult. The shipments themselves, they were essentially normal vaccine shipments, so nothing that airlines had a problem with in general. There were no regulatory concerns like if you were transporting patient specimens from an Ebola trial, for example. So the shipment itself was fairly straightforward and simple.

What was most helpful was the overall political will for this to move forward. There were no obstacles being put in place by any authorities, any governments. That facilitated things greatly. But suddenly being down on air freight capacity by 60 to 70% in the beginning of the year or during the first months of the distribution, that lead to big logistical challenges in securing space on airplanes.

Those of us who don’t have a dedicated fleet, don’t have to fuel and fill their own airplanes had it a little easier because we could source from various different passenger and cargo airlines to secure space. The big integrators who have their own fleets and aircraft, they were a little more autonomous in terms of not needing to cancel those freighters; you still saw freighters moving almost regularly. On the other hand, those were also in high demand everywhere else, and some countries, of course, didn’t allow any foreign operators to come in.

3. Have those dynamics stabilized in recent months?

I think we’re coming back up to almost 2019 levels, as far as I’ve seen. At the moment, it looks favorable, but I think we all sort of have that worried look toward the autumn of this year to see what happens next.

4. Supply chain demands triggered by the pandemic and other factors (i.e., emergence of advanced and complex therapies, evolving technologies in cryogenic storage/transport) have required next-level support across functions such as logistics planning and data monitoring, analysis and communications. To that end, how have approaches to internal quality management and GDP and GMP changed to better safeguard the cold chain? Are gains from “smart thermal packaging” beginning to bear out more in practical application?

In the area of smart packaging and the new technologies that are coming out, we see a lot of products in the market now that have integrated live temperature loggers and things of that nature. With cell and gene therapies, the autologous therapies, while it’s a highly new area of medicine, they’re being transported at cryogenic temperatures and the dry shipper is mainly being used in airlines. I’m going on 20 years at World Courier and I think even the first weeks back when I joined the company I saw dry shippers being used; the tech has been around for a while.

So this connects a little bit with the first question, because the tool sets to transport the product and to maintain the temperature, there’s been nothing very new there. Smart technology, though, is an interesting area, because you hear a lot of promotion about GPS loggers or live temperature loggers, with GSM or Bluetooth that offer telemetry. We and others are still excited about the new developments there, and there are certainly enough new products coming out, especially now.

But I think one surprising thing is the expectation on how smart technology related to packaging would change the pharmaceutical quality system and approach. It’s surprising insofar as how it hasn’t affected it as much as we thought it would. I don’t mean to say that these applications don’t have a great benefit, operationally speaking, in terms of internal processes or monitoring. But as far as the quality system or the GDPR, the telemetry, or the metrics that these devices offer, regulatory authorities are mostly still expecting an unbroken temperature record for temperature-sensitive products. Those have been supplied for decades through temperature loggers that are read out after the fact. There’s nothing really being demanded by the regulators for these kinds of shipments that would be assisted through these smart technologies.

Also, a lot of these devices don’t offer the level of accuracy in the temperature probes that would allow them to be used as the sole regulatory temperature record for a shipment. The quality need for these devices has not been there yet. We very rarely have seen any requirements for providing a humidity record, air pressure, or light or tilt— things that some of these loggers offer from all along the shipment chain; they aren’t really quality relevant. We do see these devices gaining appeal for logistics providers to track the location of the package. Did, for example, the airline really send it to New York and not misroute it to Miami instead? It does offer great service-recovery options, and it’s a good way to secure transfers for en route if you’re worried about a large shipment being hijacked potentially in some way.

I think we’ll see these devices continuing to come onto the market and being used in ways that will facilitate the transport of products and being an internal process safeguard on the logistics side, but will be not really be as high a requirement from the customer side.

5. It’s safe to say, then, that these technologies won’t be replacing the function of traditional data logging anytime soon, correct?

Honestly, not. We don’t have any customers that I can think of who require for clinical purposes a compliant temperature record for the shipment who do not want us to put an actual, pharmaceutical grade temperature logger inside the shipment as well as one of these live devices.

What we’re seeing is these live devices when they’re being required or requested by clients, is they’re being used as an add-on layer of visibility into how the temperature is trending. Can you see how it’s changing over time? Can you monitor the location of the shipment to prepare the people at the loading dock to receive it? But, in the end, if temperature control is a requirement, you’ll always see a robust traditional kind of temperature logger being requested as well, because at least on the regulatory side, these [smart] devices aren’t yet up to spec in terms of being able to safely offer the record for the entire shipment. Also, there is such a price differential between the highest level of these devices, these live loggers, and single-use USB temperature loggers; it doesn’t make sense to replace them just for having a more modern device.

6. Do you see regulators perhaps providing guidance on the more practical use of these smart, live shipment devices?

For controlled substances, I’d see requirements on the government side coming for being able to monitor the position and the location. But in terms of safeguarding the temperature stability or the product stability of a temperature-sensitive product, I don’t think that there is going to be much coming from that side because the perfect solution for that was already there to begin with. If regulatory authorities are concerned with whether a product was exposed to any adverse temperatures along the transport chain, all they need in the end is the complete record from A-Z.

7. What are some particular challenges in clinical trial logistics related to the cold chain and keeping today’s time- and temperature-sensitive medicines moving?

If you think of autologous or gene therapies, where you’re transporting the patient’s own material somewhere, maybe across the world, to be modified in a way to treat for a life-threatening condition, those are shipments that are so critically important, even though there is mostly no new temperature ranges involved; it’s mostly going to be cryogenic storage, partially on dry ice.

So, again, we’re still dealing with well-known temperature ranges. But the importance and the implication of possible service failings means that you have to really make sure ahead of time that these packaging tools that have been well established are the safest possible things to use in this regard.

This brings us back to smart packaging technology; in this case, it’s not a requirement we’ve seen so far for either autologous or allogeneic therapies, but it makes sense for the logistics provider and all points involved to have very close visualization around questions such as 1) where is the unit?; 2) has it left the clinical site?; and 3) has it reached the hospital at the end of the chain?

Nothing can go wrong with these shipments; that’s not an option. There’s very little margin for error in these therapies. So very close coordination between all players is crucial—having great eyes on things through these new technologies like GPS loggers and keeping all points coordinated: the airlines together with the freight forwarder and others involved.

What we’ve seen from our work with these therapies is it’s a great level of complexity to make sure that all risks in the process are already mitigated. It’s less of a temperature-control challenge than an overall logistical one.

8. Are there any unique “last-mile” challenges associated with the transport of cell and gene therapies?

Honestly, for these advanced therapy shipments, it’s the first and the last mile that are usually the easiest ones. Particularly if you’re spread out, if you have a global presence—and that’s a key to success here as well, knowing that you have your own staff at all points of the chain, that the training and the knowledge that you need to handle these safely are in your own hands, not outsourced to someone who may or may not have expertise.

If we have control over the logistics at both ends, it’s really more about the “main mile” or the main leg; it’s that flight from New York to Frankfurt or from Buenos Aires to Shanghai. That’s the black hole that you fall into where you have to hope the airline has loaded the shipment to the right aircraft, hope that the storage booked is the one that’s executed. It’s really speaking to the airlines and stressing the importance of the shipment and making them aware of what’s at stake. Even putting artwork or signage on the parcels to express that this is a lifesaving shipment for the patient at the end of the delivery. Including artwork that depicts a patient or patients can impress on anyone involved, any warehouse worker in any warehouse across the world that this is a special shipment.

9. That’s interesting about the artwork being a big factor but maybe an overlooked one. Does your company do the

design or do you work with partners on things like that?

We’ve spent a lot of time working with our own people and outsourcing to our friends and partners in artwork development and marketing development on the most effective ways to convey this impression to handlers and to logistics people to help make sure a box, wherever it’s standing, is seen as something special. If adding blinking lights to it would be helpful, we would consider that as well.

For these kinds of shipments, nothing is too crazy or too off the table to make sure that they don’t get stuck somewhere in a corner and aren’t seen again. Because [saving] five hours or 10 hours could be the difference between a successful shipment or a patient not making it. [The artwork] has been helpful in making it easier to convey to people involved, be it a driver or an airline booking rep, that there’s a life on the line here.

A conversation with Volker Kirchner, director, temperature control solutions, World Courier

The Temperament for Transport

Last month’s UN Intergovernmental Panel on Climate Change (IPCC) report sounded alarm bells that unless we all act with urgency to reduce greenhouse gas emissions, sea levels will rise faster and higher than previously estimated. The report revealed that, “The world will hit one-and-a-half degrees warming much earlier than expected, possibly the middle of 2034,” leading to more frequent extreme weather events such as droughts and floods.

Given this bleak outlook, it is reassuring that many pharma manufacturers have already committed themselves to ambitious environmental, social and governance (ESG) initiatives in the coming decade. For many companies in this sector, achieving and demonstrating carbon neutrality is at the top of this list.

For therapies that require strict temperature control during transit, reliance on expedited shipping drives cost and increases emissions. When the therapy reaches its clinical destination, the packaging that kept the payload protected has a good chance of ending up in a landfill, particularly if EPS like styrofoam was used for thermal protection. This only adds insult to environmental injury. With thousands of various medicines needing to reach millions of patients in every corner of the world, the pharmaceutical supply chain is understandably complex. But as consumers increasingly embrace adoption of reusable packaging, pharma manufacturers have a significant, attainable opportunity to make measurable progress in reducing CO2 emissions from supply chain activity.

Drug manufacturers that have adopted circular economy practices as part of their distribution strategy are today experiencing material sustainability improvements such as water and energy conservation, less landfill waste and reduced CO2 emissions. Consider the Covid-19 vaccine. In 2021 so far more than 4.4 billion doses of vaccine have been distributed. Had this distribution been grounded in reusable thermal packaging, the calculated sustainability savings would have been non-trivial:

480 million kilograms of CO2 emissions reduced.

12 million kilograms of landfill eliminated.

4 million megawatt hours of energy saved.

A reusable shipper that ultimately is returned for refurbishment can act as a conduit of information delivery and collection. From connected packaging that can be leveraged to drive a user to product literature on dosing, to the recovery of IoT devices monitoring and relaying the real-world experience of the shipment, a supply chain grounded in sustainability can deliver benefits beyond cost savings and ESG improvements. For example, the establishment of a cold chain visibility control tower giving real-time and actionable insight as to the location, status and condition of each package in order to identify and intervene as needed around bottlenecks, quality concerns and even inventory needs.

Further, as treatment modalities such as cell therapy and personalized medicine continue to proliferate, the need for cold chain protection only expands. Many of these will distribute directly to the patient as new care models emerge in response to Covid’s negative impact on access. Consumers are demonstrating comfort returning containers for reuse, though some need assistance. Opening lines of communication with patient-users reflect another, and unexpected, opportunity for manufacturers. This is the reimagined courtesy call that most patients and their caregivers are happy to take since it has to do with personal well-being: confirming the product arrived, confirming condition and initiating the container return (which requires no more effort than leaving the emptied container on the doorstep for retrieval).

Though the IPCC report was sobering in terms of illuminating the climate damage human activity has already created, taking action to cut greenhouse gas emissions 

could stabilize or slow rising temperatures. The pharmaceutical industry has a simultaneous challenge and opportunity before them. Even by electing to adopt re-use for thermal controlled therapies only, the reduction of dangerous gases is material enough to fuel marked reductions in CO2 for the ESG bottom line of the entire enterprise. This may represent the “low hanging fruit” for the biopharma industry, with upside around brand reputation, including positive consumer sentiment for eco-consciousness at this critical inflection point.

Pharma’s prime chance to reduce carbon emissions from supply chain 

The Opportunity for Sustainability

Pharmaceutical companies are facing higher transportation costs due to capacity constraints and the need for special handling. The higher costs are further complicated by a complex global supply chain that makes managing and tracking such costs difficult. However, there are ways to mitigate high transportation costs, such as understanding the role that packaging plays, transportation options and understanding the charges associated with each shipment.

The Covid-19 pandemic has placed unprecedented constraints on supply chains, driving up rates and surcharges, and often resulting in delays. While no industry is immune to these constraints, there are a few ways companies can potentially mitigate supply chain costs.

For example, collaboration with supply chain partners is essential, particularly in times of uncertainty. By maintaining regular communications, companies can stay abreast of market changes and respond quickly to sudden changes. In addition, supply chain partners can also act as trade consultants by providing such recommendations as alternative ports and airports based on capacity, pricing, and/or arrival/departure times.

Working closely together with supply chain partners in terms of transportation options is also essential. Depending on the situation, a single mode of transportation is fine, but sometimes a combination of air and ocean freight services or rail and truck services may be more cost-effective. Sometimes it may even come down to a truck carrier versus a parcel service provider. Thanks to the growth in e-commerce, the lines are blurring between less-than-truckload (LTL) trucking carriers and parcel service providers. LTL trucking carriers are moving an increasing amount of e-commerce goods, typically more oversized items such as furniture or exercise equipment and bulky items such as big bags of feed or pet food.

Because special handling is needed for pharmaceuticals, understanding the capabilities of each transportation provider is critical. The capabilities to consider include the following:

The types of vehicles: Whether or not they are climate/temperature-controlled and at what levels.

Monitoring climate/temperature levels: How often are the levels monitored, can the levels be managed remotely and can the readings be shared with regulatory officials?

Certifications/training: Are drivers and other handlers trained to handle pharmaceuticals? Is the company certified through an association such as the International Air Transport Association (IATA)?

Once one has an understanding of the capabilities, understanding the costs is another consideration. It’s not cheap, even in a “normal environment,” to transport pharmaceuticals. There is an agreed-upon rate, either via a contract or a spot rate. Contract rates are typically negotiated rates for a particular period.

These periods are usually two-to-three years and include such things as volume commitments; any penalties the shipping company may have to pay if volumes fall below or above a certain level; either particular trade lanes or a blanket agreement for a region or globally; and more.

If a shipping company decides not to utilize a contract, spot rates will usually be used. These rates fluctuate depending on market conditions. Spot rates will be high in times of tight capacity like we are currently seeing across supply chains.

For parcels, there are no spot rates. Instead, shippers will likely have to pay published rates available on UPS or FedEx’s websites unless the shipper can negotiate an agreeable rate.

In addition to rates, there are surcharges—fuel, additional handling, hazardous goods, signature, address correction and a host of other surcharges are added on top of the rate, depending on the situation. Monitoring climate/temperature levels may be priced separately as well.

Monitoring shipping invoices is very important. Compare the charges against the contract and if there are any discrepancies, let the carrier know as soon as possible. Many companies opt to have third-party businesses review invoices and work with carriers to obtain refunds. There are also a growing number of technology solutions that can do this as well.

While mitigating costs begins with the actual costs, packaging also plays a role. Package dimension and weight is one of the main factors in determining shipping costs. To put it simply, the larger the package, the more one will have to pay for shipping it. The same goes for package weight—a heavier package will cost more to be delivered.

The package size should be big enough to hold the product but snug enough to keep dimensions to the minimum to avoid inflating shipping costs. In addition, a smaller packaging size is more likely to protect the product from unnecessary shaking and damage.

Packaging should also be designed such that the packing time for a given package is minimized. Employees can pack goods more quickly and efficiently, meaning less money spent on handling the product and its packaging.

More efficient packaging also improves the sustainability of one’s business and reduces carbon footprint.

However, suppose the product that is being shipped is temperature-sensitive. In that case, one needs to follow the general guidelines outlined earlier and ensure that the packaging meets the temperature range required for the item.

Also, determine whether or not dry ice will be needed. This could impact shipping expenses since dry ice is legally considered a hazardous material.

Temperature-sensitive packaging can be purchased by such providers as FedEx and UPS, as well as specialized businesses. Like everything else, though, compare the options with what is really needed. Using a neutral, third-party consulting service may be beneficial.

Because of the nature of pharmaceuticals, transportation costs are high. But, by choosing the proper mode(s) of transportation, manufacturers could help offset unnecessary higher costs. Optimizing packaging also plays a significant role in reducing shipping costs as well—choosing the right size, reducing filler and the proper temperature-sensitive packaging are among some considerations to make.

John Haber is the Founder and CEO of Spend Management Experts.

The steps pharma manufacturers can take to mitigate transportation costs amid Covid’s supply-chain crunch

Shipping Strategies in Unusual Times

The past 18 months and counting, amid a global health emergency, have opened the floodgates to a new mix of digital and in-person interactions across the life sciences. While office visits and live events still provide a critical foundation for relationship building, most healthcare professionals (HCPs), still navigating the Covid-19 pandemic, now say a hybrid blend with personalized, on-demand digital communication is their preferred way to engage with field teams.

This explains why last year’s spike in remote meetings and emails continued into 2021 even as more organizations loosened restrictions.

 (See Figure 1 below). As traditional sales calls reach a new baseline, it’s time to rethink biopharma commercial strategies with a hybrid mindset.

The implications of a company’s hybrid strategy span its field deployment models, educational and promotional content, and engagement channels, as well as the data that provides a backbone for it all. An intentional approach in each of these areas can help go-to-market teams make the right choices about when, how and why to connect with a physician in person, over a virtual meeting, or via email.

To understand how this is playing out in real-world settings, we asked practicing physicians and industry leaders which digital skills and data are key to success in the evolving pharma landscape.

Based on their observations, life sciences is well on its way towards a new standard of personalized, two-way, and data-driven customer experiences.

While biopharma leaders point out that the trend toward digital started well before the pandemic, it is gaining steam as doctors realize they can no longer wait for a sales representative’s next visit. Many HCPs are also raising the bar, asking reps to prioritize only the most pressing information their patients need.

“Our HCP customers still say that their biggest source of information is from field-based pharma reps,” said Corinne Yaouanq-Lyngberg, director of omnichannel strategic enablement at Novo Nordisk. “Yet, as digital accelerated during the pandemic, physicians began expecting actionable information at their fingertips. We can better serve HCPs—and, by extension, their patients—when we embrace other ways to build relationships.”

Companies like Novo Nordisk are employing creative solutions to deepen HCP connections in less time. They’re using new channels that allow them to continue educating and engaging customers (from a distance when necessary) while respecting their individual interests and preferences. This means sharing information through virtual calls, mobile apps, electronic health record (EHR) systems and digital content that doctors can pass along to their patients.

The pandemic has made an indisputable case for online engagement, helping field teams warm up to digital channels. Even sales organizations that have heavily invested in building in-person relationships for years now see the value of an omnichannel customer experience. Field reps know it’s crucial to augment engagement in between visits using resources from their digital toolbox.

“The biggest nut to crack isn’t training people to use a new tool,” noted Yaouanq-Lyngberg. “That part is actually easy since our reps have used digital tools for some time now. It’s more about helping them best orchestrate the entire customer experience leveraging this evolving mix.”

Connecting through on-demand digital channels

With telehealth adoption rising to levels 38x higher than before the pandemic,

 HCPs have grown comfortable using technology. In their personal lives as well, doctors are now accustomed to online communications and self-service access to relevant information when and where it’s most convenient. In fact, 70% now consider themselves digital natives.

John Panozzo, MD, of Primary Health Associates, appreciates how virtual tools help him keep up with important treatment options. “For the last 20 years, we’ve had reps come into the office in person, usually unannounced, and wait in the lobby for an opportunity to talk to us,” he said. “Now, with digital, it’s more efficient because I can request samples online, speak to a scientific liaison in a virtual meeting and go through a new article or study without disrupting my time with patients.”

With fewer interruptions, HCPs are more attentive and engaged during these conversations, which end up becoming more scientific and meaningful. However, Panozzo notes that it’s easier to connect online with a rep he already knows. “The relationships we had in place before Covid were easier to maintain during pandemic restrictions, while interactions with new reps became more difficult,” he said. “We get thousands of emails a day and don’t have time to look at each one.”

Engagement patterns across Veeva’s customer base reflect this. HCPs with established rep relationships open their emails 4x more often, attend 3x more remote meetings and spend 3x longer in those meetings than their peers.

 (See Figure 2 below). Life sciences companies have a prime opportunity to differentiate themselves by taking these relationships to the next level with more intimate, concierge-like experiences for HCPs across channels.

As the hybrid engagement model evolves, HCPs such as Panozzo are looking for interactive, user-friendly digital tools that can help them build new relationships with reps. They want the ability to proactively request information about medications their patients need, rather than waiting for updates whenever pharma companies think it is the right time to intervene.

Relearning HCP preferences with the help of data

To deliver ideal experiences in the face of these new expectations, reps should look at HCPs from a different vantage point. Eric Solis, director and lead data scientist at Takeda, noted, “Before the pandemic, our approach was centered on face-to-face interaction with other tactics sporadically playing supporting roles. While face-to-face interaction and building personal relationships with HCPs is critical, the risk is that this “door-to-door salesman”-centric approach is becoming outdated and won’t cut it post-Covid. We need to leverage data to aid our teams in relearning our customers one-by-one to help figure out the right mix of engagements to meet each HCP’s individual needs.”

While nine in 10 HCPs say they want either all virtual or a combination of virtual and in-person meetings moving forward,5 companies are noticing huge variation across their customer bases in terms of how doctors want to engage in the hybrid environment. This makes it hard for field reps to know the best ways to deliver information to each individual HCP.

“As we move away from homogeneous HCP interactions and preferences, we need to understand our customers several layers deep,” adds Solis. “Beyond simple operational things, like when reps can get into an HCP’s office, it’s important to know what content is most appropriate for each touchpoint.”

Field reps should keep in mind that even when they can get in the door, that doesn’t mean in-person is the most effective way to share information. Instead, they can focus on meeting each physician where they are, with the specific information they need to make a difference in how they treat patients.

Keeping up with these changing dynamics requires robust data across the entire patient journey. Solis’ team, for example, uses real-time insights to advance Takeda’s goal: connecting education about rare disease treatments with the right physicians and patients to accelerate diagnoses.

“Particularly with rare diseases, timely delivery of relevant informative content is absolutely essential to patient care,” he said. “Pinpointing these opportunities is a fundamental part of any interaction between physicians and reps.”

Data and analytics can also recommend next-best actions for each HCP and help commercial teams measure their impact. This involves boiling down a broad spectrum of data sources into insightful, actionable nuggets of information and getting those to the field in ways that help them adapt to new digital tactics. When commercial organizations help field teams do their jobs more efficiently and deliberately, reps can better focus on delivering key content to HCPs and, in turn, their patients.


The possibilities of hybrid are far-reaching. Companies that transform commercial models to embrace a flexible blend of face-to-face, virtual, and on-demand meetings can deliver the experience that HCPs truly want and expect. This is critical, since pre-Covid face-to-face engagement levels aren’t returning, even as healthcare organizations begin to allow in-person activity again. Needs and expectations have changed too much in the meantime for a return to business-as-usual.

Brands need to reimagine how they connect with customers, deliver great patient support and services and adopt digital channels as permanent and foundational components of engagement. Companies that do this well will drive higher levels of commercial sales, ultimately helping those who have the most to gain: patients.

Dan Rizzo is the global head of commercial business consulting at Veeva.

2. McKinsey & Company, “Telehealth: A quarter-trillion-dollar post-Covid-19 reality?,” July 2021, 

https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality

3. “Intelligent HCP Engagement in Europe” Veeva Whitepaper, 2021, 

https://www.veeva.com/eu/wp-content/uploads/2018/08/VE172-Across-Health-Remote-Engagement-WP-Redesign.pdf

Three keys to achieving digital excellence in the next normal, where a hybrid commercial model will be the standard for physician engagement

Pharmaceutical Commerce - September 2021

When the extreme hits home

Pharmaceutical Commerce - September 2021 Issue (PDF)

Pharma Cold Chain: Pushing the Envelope

The Temperament for Transport

The Opportunity for Sustainability

Shipping Strategies in Unusual Times

New Blueprint for HCP Relationships

2021 Cold Chain Service Provider Directory

The True Reliability of Real-World Data

The Future Heats Up Due to Cold Chain