How Predictive Maintenance and Localized Distribution Are Shaping Pharma’s Future

In a video interview with Pharma Commerce, Heather Zenk, Cencora’s president of supply US supply chain, describes how today's distribution networks must seamlessly connect manufacturers to care sites that range from large academic centers to rural pharmacies and physician offices. This “last mile” delivery is essential because, as Zenk notes, “all healthcare is local.” Patients want access to advanced therapies close to home, and distributors play a critical role in making that happen.

A major focus in this effort is maintaining product integrity, especially for cold chain items that must be stored between 2–8°C. Innovations in cold chain management now go beyond temperature tracking; they include predictive maintenance of infrastructure such as freezers and compressors. Distributors not only monitor product temperature but also evaluate the performance and potential failure risks of the equipment that manages the cold chain environment.

Zenk emphasizes the importance of marrying manufacturer data with real-time logistics. For example, if a care site accidentally stores a cold chain product outside the optimal range for a short period, data from the manufacturer can often confirm whether the product remains viable. This responsiveness supports safe patient care and reduces waste.

Another important innovation is the use of reusable cold chain totes, which service over 90% of the US market. These require robust freezing systems and operational oversight to ensure readiness and reliability. Zenk underscores that preventing failure, rather than simply reacting to it, is the next frontier in pharmaceutical distribution. By using data-driven insights and predictive engineering, the distribution process becomes more resilient, ensuring that patients can access vital therapies without delay or compromise.

She also comments on the advanced technologies that are proving most effective in enhancing real-time visibility and operational efficiency; strategies organizations should prioritize to ensure compliance while minimizing disruptions for manufacturers and providers as the DSCSA compliance date approaches; lessons learned from recent drug shortages and global disruptions; the practical steps that can be taken in transportation, packaging, and warehousing to meet sustainability goals without compromising reliability or cost-effectiveness; and much more.

A transcript of her conversation with PC can be found below.

PC: As pharma products become more complex, how is the distribution strategy evolving to ensure timely, safe, and compliant delivery? Alongside that, what innovations in cold chain technology are setting the standard for ensuring product integrity across these complex distribution networks?

Zenk: We're sitting between the manufacturers and the sites of care, and we really see ourselves as the connector. I'm connecting access from a manufacturer's new and innovative therapy to a site of care, and that site of care could be an independent pharmacy in a small rural town, all the way to a large academic medical center in a huge urban area, to a physician- based office. We really look at all sites of care, because realistically, all healthcare is local.

You don't go outside of your community to receive care. You like to see your physician at the grocery store. You like to see your pharmacist around town. It provides comfort, it provides the realness of human connection. We really take it seriously that we're connecting new therapeutic ways to the sites of care. And with that, it's how do we make sure their product is viable? With a lot of the sustainability and new products that are coming to market, we need to keep in 2-8°C, which, for the common person, is refrigerated. We also want to make sure that we have a way to track that. The manufacturer would know when they develop it, what the exclusion is, so if it gets to 9°C, how long can it be at 9°C, and still viable if it gets to 1°C?

But realistically, if you keep it in 2-8°C, the expiry date that's on the package would be the therapeutic window that a site of care could deliver it. A lot of what we're doing is trying to connect—as we tend to do every day—the data with the time. If by chance, a site of care would call to say, “oh shoot, I got that cold chain product. It's sitting on my shelf. I didn't notice it. It's probably been about two hours, is it still okay if I give that to my neighbor, my friend, my patient?” Most of the time, we have data from the manufacturer that can say that's viable. It can be out of this window. Then two, we're taking seriously inside our four walls. It’s monitoring the temperature, yes, but it's also monitoring the equipment that manages the temperature. Think of it as, and this is non-sexy stuff for supply chain, but compressors, think of it as HVAC units. Think of it as the entities that are running our freezers that have the basic material that goes into our reusable totes that we use every single day. We have reusable totes that are driving 90-plus-percent of the US market. How do we freeze those? If a freezer’s equipment is going to fail, it's us understanding this compressor is now at 70%, and we should have someone either fix it, look at it, stop it, or understand the risk that we have.

Monitoring temperature is table stakes. You have to be able to do that. It's now how do I anticipate if a piece of equipment is going to fail? Does that piece of equipment need a preventative maintenance check by a maintenance team member? Setting those types of things up as much as we can to eliminate equipment failing or anticipate when it might and take those signals. I don't think I would have thought about doing that as a as a pharmacist, but we all think about our home life. Your refrigerator fails at the worst possible time. How do we stop that? What types of engineering things can we look at to eliminate that? And that's really where we're going—from a tactical positioning—so we don't have large failures. And two, I think it's also connecting manufacturers’ data from how they develop a product, how they get it to finish dosage, where do they take it?