Continuity of care is generally defined in terms of a patient’s ongoing contact with a clinical team and how smoothly their care progresses between providers. Often overlooked is the pharma supply chain and its role in ensuring this continuity.
Reliable sourcing, distribution, and contingency planning for essential medicines and healthcare products are vital for strengthening patient care. Understanding this connection better, and how pharma supply chains can improve their resilience, is ultimately a matter of improving patient health outcomes.
Why Supply Chain Resilience Matters for Patients
The impact of supply chains on patient care tends to be most apparent during a crisis. The pandemic, for example, provided stark evidence of the consequences of supply chain disruptions. Disruptions in sourcing, manufacturing, logistics, and distribution quickly became a healthcare issue as patients struggled to fill prescriptions and providers, in turn, struggled to maintain consistent care.
Despite the lessons of the pandemic, supply chain-related shortages remain a concern. Chemotherapy drugs are currently in short supply in the U.S., with doctors reporting that some cancer patients are at risk of not receiving the treatment they need as a result. More than 20% of all cancer centers in the U.S. report shortages in five or more medicines in 2026. This has resulted in providers limiting the use of certain drugs and reducing prescriptions to minimum usage where possible. At best, treatment is simply delayed or altered, but even so, care is invariably interrupted by these shortages.
Reduced continuity of care can also build slowly. Many treatment plans pair a medicine with the supplies needed to use it or to manage the condition around it. A patient with diabetes needs pen needles as much as insulin, and a patient treated for an infected leg ulcer relies on dressings and compression garments alongside antibiotics. When those items arrive late, the gap falls hardest on patients managing chronic conditions at home, who rely on healthcare and medical supplies arriving on schedule as much as on their prescriptions. A missed delivery can stall a healing wound or lead to a hospital visit that should never have been needed. Consistency in patient care rests on providers, and just as much on the supply chains that support them.
Where Supply Chains Are Most Vulnerable
Here are some of the key areas where pharmaceutical supply chains tend to be most vulnerable:
Routing Issues Related to Geopolitical Events and Transport Delays
Geopolitical events continue to place some of the most significant strain on global supply chains. Most recently, the escalating war in Iran and the Middle East disrupted two major supply corridors and, with that, brought concerns about drug availability. In 2023, the U.S. counted over 200 drug shortages, with geopolitical tensions contributing to nearly 30% of these shortages.
Another transport-related pressure on the supply chain is the growing need for pharmaceuticals to be transported in temperature-controlled conditions – a factor that raises the cost in many instances. It also makes any delays en route more consequential. If critical medicines are stuck on the road without proper temperature controls, they can spoil and contribute to larger shortages.
The Risk of Overreliance on Single Suppliers and Regions
Manufacturing issues are another widely felt vulnerability, often caused by raw material and API shortages. Adding to this problem is the fact that only a handful of countries produce the majority of the world’s supply. About 78% of U.S. APIs are supplied abroad. Generic, low-cost options and antibiotics, which tend to be in the highest demand, are imported primarily from India and China.
The risk of supplier concentration is that it becomes more difficult to diversify and seek alternative sources in case of delays. Overreliance on a single supplier or region means that any geopolitical events nearby can result in that supply being halted.
Diversification has emerged as the key strategy to address the issue. What complicates this is that the choices that suppliers make in terms of what to manufacture, and how much of it, are also shaped by the market and regulatory requirements. The U.S. for example, has suppliers that are able to produce generic drugs at low prices, but a system based on price competitiveness doesn’t always reward manufacturers for maintaining a steady supply.
Demand Spikes and Inventory Challenges
Unexpected demand changes can also quickly upend supply chains. This was another weakness that the pandemic exposed. N95 masks increased in demand almost overnight, and shortages followed soon after.
Overstocking can be equally problematic. An oversupply of medical products can create expiry and storage risks. Without accurate forecasting and visibility, the balance between these two extremes can be challenging to maintain.
Practical Strategies for Building a Resilient Supply Chain
The goal of building more resilient pharma supply chains is to have systems that “provide products as expected despite unexpected disruptions.” As discussed above, there are many vulnerabilities to address. Some of these cannot be directly solved by the supply chain itself. The strategies for resilience then need to be about strengthening the mechanisms of the supply chain itself to better withstand whatever context and crises it may be challenged with.
Strengthening Supplier Diversification and Partnerships
Developing qualified alternative sources can, in itself, reduce the risk of shortages. Geographic diversification then adds another layer of risk mitigation. One of the strategies for maintaining multiple supplier partnerships is to operate from a baseline of dual- rather than single-sourcing. In the event of a shortage or delay, supply chains can then be more nimble.
From a manufacturing perspective, similar strategies of diversification apply. It’s also about building greater capacity for flexibility. If demand for a certain drug suddenly spikes, having some flexibility in terms of shifting production between different sites or partners can assist in meeting that demand more readily.
Part of this exercise of diversification needs to be an analysis of where the supply chain dependencies are and the potential impact that supplier failure could have. Mapping the potential consequences is likely to illuminate where contingencies and diversification strategies are needed most.
Improving Visibility from Source to Patient
Improving supply chain visibility has particular consequences for patients who may be awaiting life-saving drugs and products. If providers are kept informed of when products are expected to arrive, they are then better equipped to manage treatment in the meantime and make patients feel supported.
Creating this visibility from source to patient, however, requires extensive collaboration. Transactional supplier relationships are not enough. Regular communication needs to be established regarding forecasts, capacity, raw materials, and potential delays. It’s important, too, that this information flows both ways.
Patient demand and supplier capacity are linked. If suppliers are informed early of a demand increase, they may be able to better meet that demand without incurring a shortage.
Preparing for Disruptions Before They Happen
Proactive disruption planning falls into two main categories: contingency planning and early flagging. Enacting systems that flag early warning signs of shortages or delays can ensure that supply chains act before disruptions actually occur. Creating contingency plans and response protocols can then improve the efficiency of these actions.
Testing contingency plans and disruption scenarios can make these responses even more effective. It can also help identify further opportunities to avoid delays.
Connecting Supply Chain Resilience with Better Healthcare Outcomes
There are notable social outcomes associated with pharmaceutical supply chain operations. A resilient supply network can help ensure timely access to medicines and healthcare products, reliable availability when prescriptions need to be refilled, and support overall care continuity.
When pharmaceutical supply chains are operating as intended, they’re almost invisible to the patient. It’s when they break down that their connection to healthcare outcomes becomes apparent. That’s when providers may have to recommend substitute medications and even add follow-up appointments to monitor prescription changes.
If patients can’t refill a prescription, that might cause a break in treatment that then increases the risk of complications or disease relapse. Patient outcomes are hugely dependent on the medicines and products they receive in treatment. When the supply networks carrying those products are resilient and dependable, they create greater stability and continuity in patient care.
Building Resilience as an Ongoing Healthcare Priority
Building resilience in pharmaceutical supply chains is about more than operational or commercial objectives. Sharing information along the supply chain to improve visibility, creating and testing contingency plans, diversifying suppliers, and building flexibility into manufacturing are strategies that address not just the health of the supply chain, but the health of those who rely on that supply network.
There are many challenges that global supply chains are grappling with. Resilience can assist in navigating these challenges and treating risk proactively so that delays and shortages are avoided before patients have to feel the cost.
It’s why this supply chain resilience needs to be seen as an ongoing healthcare priority. It is as vital to patient care as the providers delivering that care.
About the Author
Lesley Barton is the National Clinical and Training Manager at Bunzl & Atlas McNeil Healthcare Community, with over 40 years of healthcare experience. A Registered Nurse, Midwife, and Continence Nurse Specialist, she transitioned into healthcare sales and management, leading education in continence, wound care, and medical consumables.
She serves as a Board Director at the Continence Foundation of Australia and founded the Clinical Care Connections (CCC) program, playing a key role in developing Atlas McNeil Healthcare’s education and training initiatives to support best practices in clinical care.