Healthcare Supply Chain Management

Over the past weeks, headlines have again reminded us how fragile the global context remains. Escalation in the Middle East, the continued war in Ukraine, disrupted trade routes and rising transport uncertainty are no longer distant geopolitical issues, they are part of the operating reality healthcare systems face today. In this environment, healthcare systems are learning a hard truth: reliability matters as much as efficiency, and often more than price. When uncertainty rises, the question shifts. It’s no longer just “can you supply?” It becomes “will you still be there when it gets hard?”. Clinicians and healthcare leaders have lived the consequences of fragile supply chains over recent years. Shortages, substitutions and delays do not stay on spreadsheets. They surface in operating rooms, wards and already overstretched teams at precisely the moments when resilience matters most. This is why supply chain resilience deserves a more nuanced, healthcare‑centered conversation. What has become clearer to me is that supply chain resilience is not about where a company is headquartered or the flag on its logo. An American MedTech company may manufacture predominantly in Europe. A European one may rely heavily on Asian components. What truly matters is how deliberately the supply chain has been designed, governed and prepared for disruption. As a result, reliability has become a core element of differentiation not as an abstract concept, but as a practical enabler of healthcare continuity. The organizations that have earned trust during recent disruptions didn’t do so by chance. They made deliberate, and often uncomfortable, choices such as: - Diversifying manufacturing and critical suppliers - Building flexibility into logistics and transport - Holding inventory where failure has clinical consequences, not just where spreadsheets optimize turns - Connecting procurement, operations, regulatory strategy, quality of care and ESG into a single system view This shift also has implications for procurement and tender design. The most robust decisions increasingly ask questions like: - How resilient and diversified is the manufacturing and supply footprint? - What options exist if a site, supplier or transport route is disrupted? - Where is inventory held relative to areas of highest clinical risk? - How are regulatory, logistics and operational decisions coordinated under stress? - What contingencies are in place before they are needed? Embedding these questions early helps healthcare systems move beyond unit price as the default and select partners capable of sustaining care delivery when conditions deteriorate. In MedTech, trust travels quietly through the supply chain. Reliability isn’t always visible until it is missing. I explore this further in the article below and would genuinely love to hear your perspective #SupplyChain #Healthcare #MedTech #Resilience #Procurement #geopoliticalconflicts #healthcarecontinuity

With multiple blockbuster LOEs approaching, growth will increasingly rely on portfolio diversification, BD, and M&A. Each of the major players has a different portfolio makeup - here's a closer look at a few of the largest: Lilly remains one of the most concentrated large pharma companies: cardiometabolic therapies generated $13.8B, representing over 78% of total pharma revenue. Mounjaro and Zepbound continued to dominate Q3, supported by scaled manufacturing capacity and global reimbursement uptake. To reduce concentration risk, Lilly is expanding through RNA-based medicines (recent deals with SanegeneBio and MeiraGTx) and strengthening its AI ecosystem through new discovery and manufacturing partnerships — early steps toward a more balanced portfolio. With $16.3B in Q3 revenue, Pfizer is rebuilding its portfolio post-COVID. As Comirnaty and Paxlovid continue to decline, the Eliquis alliance remains a major contributor. The recent acquisition of Mestera, following a competitive bidding war with Novo Nordisk, signals Pfizer’s entry into the increasingly crowded obesity market. AbbVie delivered one of the strongest Q3 performances across Big Pharma. Immunology reached $7.05B, led by Skyrizi + Rinvoq, which together surpassed $6.8B (+40% YoY) and now fully offset Humira losses. Beyond immunology, AbbVie is allocating major investment toward Neuroscience ($2.36B) and Oncology ($1.68B) - reinforcing the company’s post-Humira growth engines Merck continues to diversify as KEYTRUDA’s US LOE approaches in 2028, offsetting softness in GARDASIL with growing momentum from WINREVAIR and new assets from Verona and Cidara. Merck reported $15.7B in Q3 pharmaceutical revenue (+4% YoY), driven by sustained oncology strength and accelerating cardio-pulmonary expansion. KEYTRUDA generated $8.1B, maintaining leadership across metastatic and early-stage cancers despite intensifying PD-1 competition. J&J continues to maintain one of the most diversified portfolios in large pharma, with oncology contributing $6.53B (driven by Darzalex, Tecvayli, and Rybrevant), immunology adding $4.17B, and neuroscience generating $2.02B. Its oncology unit remains one of the strongest globally, anchored by bispecifics, CAR-T therapies, and a growing radiopharmaceutical franchise. AstraZeneca delivered one of the fastest-growing oncology performances in the industry, generating $6.64B in Q3 from Tagrisso, Imfinzi, and Enhertu. Its oncology growth trajectory now rivals Merck’s but is supported by a more diversified base across tumor types and mechanisms. Beyond oncology, AstraZeneca remains a major force in cardiometabolic diseases, reinforcing long-term growth through a mix of primary-care expansion and next-generation targeted therapies.

I have an 88 year old patient who had not been to the doctor in 20 years. She literally had zero office visits and was taking no medications. In April she had a stroke. She was discharged from the hospital to the nursing home on: Amlodipine Atorvastatin Apixaban Aspirin Lisinopril She is currently on the following medications scheduled: Melatonin Gabapentin Tramadol Apixaban Atorvastatin Acetaminophen Lisinopril Furosemide Aspirin Amlodipine Potassium I am amazed in both the community and long-term care settings how medications start to accumulate. Could the amlodipine be causing peripheral edema? If we stopped the amlodipine would that eliminate the need for furosemide then also the potassium? Does she need to be on both aspirin and apixaban? Is the gabapentin effective? If not, lets discontinue it. It doesn't seem right that a patient would go from 0 medications to 24 (scheduled + PRN) in 7 months. We can do better and pharmacists are certainly part of the solution, especially at identifying the prescribing cascade and bringing it to the providers attention. #pharmacist #prescribingcascade

🚨 𝐑𝐚𝐝𝐢𝐨𝐩𝐡𝐚𝐫𝐦𝐚 𝐂𝐃𝐌𝐎𝐬: 𝐓𝐡𝐞 𝐑𝐄𝐀𝐋 𝐁𝐨𝐭𝐭𝐥𝐞𝐧𝐞𝐜𝐤? 🚨 Is Radiopharma going to hit a wall? There's an awful lot of excitement around new therapies, deals, M&A… But beneath the surface, there's an issue is quietly limiting progress for the whole sector: 🚨 CDMO manufacturing bottlenecks 🚨 This isn’t some “future risk”.... ➡️ Clinical trials are at risk of delays. ➡️ Even though funding is there. ➡️ And Demand? Off the charts. But if you can’t lock in manufacturing - or isotopes - you’re in trouble. 👇 𝐁𝐢𝐫𝐝’𝐬-𝐄𝐲𝐞 𝐕𝐢𝐞𝐰 👇 🧬 Isotope Squeeze - Ac-225, Pb-212, Lu-177: demand is way ahead of supply - Developers fighting for every available batch - Delays? Happening now, not later 🏭 Scale-Up: Who’s Winning? - AtomVie Global Radiopharma Inc., Nucleus RadioPharma, PharmaLogic, Curium Pharma - building quickly to keep up. - ITM Isotope Technologies Munich SE, NorthStar Medical Radioisotopes, LLC, PANTERA, TerraPower - controlling the isotope flow - Perceptive Inc., ABX-CRO INC., PSI CRO AG & others - enabling complex clinical trials & logistics, ensuring effective use of manufactured therapies. 🤝 The Land Grab - Eli Lilly and Company bought POINT Biopharma, a wholly owned subsidiary of Eli Lilly and Company - AstraZeneca bought Fusion Pharmaceuticals - Bristol Myers Squibb grabbed RayzeBio - Novartis took Mariana Oncology - Lantheus acquired Evergreen Theragnostics (CDMO supply is now vertical) Everyone wants to own timelines, lock in capacity, and squeeze out competitors. ...and there's a LOT of vertical integration going on (makes sense, given the timing sensitivity & manufacturing complexity...) 💥 𝐓𝐡𝐞 𝐑𝐞𝐚𝐥𝐢𝐭𝐲 𝐂𝐡𝐞𝐜𝐤 💥 (1) There’s a full-on war for Ops, QA, and Regulatory talent. (2) CDMO manufacturing slots? In very high demand. (3) Whoever can deliver GMP supply, at scale, wins the market. But here’s what I'd love to know: ❓ Who’s quietly building the next wave of capacity? ❓ What’s the single biggest roadblock on the ground? Tag the companies (or people) building solutions for the sector. Or drop some challenges in Radiopharma nobody’s talking about 👇 #Radiopharma #CDMO #RLT #Oncology #Theranostics #Isotopes

Sustainable Supply Chains 🌎 Sustainable supply chain practices have become central to how businesses manage risk, meet regulatory expectations, and maintain access to global markets. Supply chains today reflect not only operational performance but also broader environmental, social, and governance exposure. Strategic alignment with suppliers requires more than contractual compliance. It demands clear sustainability criteria during procurement, structured capacity-building programs, and transparent performance evaluation. These measures enable companies to build more reliable partnerships while supporting industry-wide progress. Traceability and data are critical enablers. With growing scrutiny across the value chain, companies need robust systems to monitor material flows, track impacts, and generate actionable insights. Metrics tied to emissions, water use, and human rights conditions help prioritize interventions and benchmark performance over time. Efficiency must also be redefined. Reducing waste, optimizing logistics, and lowering energy intensity contribute not only to cost management but also to climate mitigation and operational continuity. Integrated planning across business units enhances responsiveness to disruption while aligning with decarbonization goals. Technology adoption accelerates this shift. Digital tools such as blockchain, AI, and advanced analytics enhance visibility and accountability. However, their value depends on the quality of the data, the clarity of governance frameworks, and the organization's ability to act on the insights generated. Sustainable supply chains are built on consistent standards, collaborative innovation, and long-term thinking. Companies that treat supply chain sustainability as a strategic function are better positioned to navigate uncertainty, unlock new value, and contribute meaningfully to global sustainability goals. #sustainability #sustainable #business #esg #climatechange #supplychain

We finally built new antibiotics… and the business model tells us not to sell them. 🤯 Here’s the hard math: ◉ 1.27M people die each year directly from antibiotic-resistant bacteria; 4.95M deaths are linked. ◉ It costs ~$1B and 10-15 years to develop a new antibiotic. ◉ Stewardship (the right thing) caps volume, so first-year sales often land <$50M. ◉ VC money flows ~17× more to oncology than to antibacterials. ◉ World Health Organization says the pipeline is “not enough, not novel enough.” ⁛ Bright spots: #gepotidacin (first new oral class in ~30 years) and #sulopenem - both real wins, used sparingly by design. ⇶This is a textbook market failure: society wants “fire extinguishers” on every floor, but hopes they’re never used. So… pay for availability, not volume. What works, from the evidence-backed perspective: ⩗ Delinked “subscriptions”: pay a fixed annual fee for access/readiness. The UK model is live and working. ⩗ Push funding to de-risk early R&D (CARB-X, GARDP, REPAIR). ⩗ Blended finance: public/philanthropic first-loss + private capital for Phase II/III. ⩗ Procurement + stewardship together: guaranteed supply, guardrails on use, real-time resistance data. What to actually do next: ⇉ Adopt subscriptions at scale (EU multi-country deals; pass PASTEUR in the US). ⇉ Target the worst bugs (WHO priority list) with clear eligibility for pull rewards. ⇉ Bundle access from day one (tiered pricing, #LMIC pathways via SECURE/Global Antibiotic R&D Partnership (GARDP)). ⇉ Fund the full stack (not just pills): rapid diagnostics, infection control, vaccination. ⇉ Measure value like insurance: we pay for the option to stop an outbreak fast. Strategic peek: ▸ Governments: lock in 10-15-year, delinked contracts per qualifying drug. ▸ Investors: back late-stage assets aligned to subscription criteria; use blended vehicles. ▸ Biotechs: design trials and labels around priority pathogens + access plans. ▸ Health systems: connect procurement ↔ stewardship ↔ surveillance so money buys readiness, not resistance. 🧐 Antimicrobial Resistance (AMR) isn’t an unsolvable science problem; it’s a solvable incentives problem. Fix the incentives, the pipeline follows! Inspired by Global Biotech Revolution's GapSummit at the University of Cambridge, where the Master of Trinity College Cambridge, Dame Sally C. Davies, gave us a mind-blowing lecture on AMR. #AMR #AntibioticResistance #GlobalHealth

What Amazon did to retail, pharma is now doing to healthcare: cutting out the middlemen ... and diagnostics will be the gateway! Here’s what’s happening: AstraZeneca launching AZ Direct on October 1, 2025, giving eligible US patients discounted access to medicines through a new digital platform. Bristol Myers Squibb introducing BMS Patient Connect in January 2026, starting with Sotyktu, offering direct shipping and discounts of over 80% for cash-pay patients. Eli Lilly and Company already live with LillyDirect, providing home delivery of select Lilly medicines (diabetes, obesity, migraine) alongside digital pharmacy and telehealth services. Pfizer running PfizerForAll, a consumer-facing platform that helps patients schedule telehealth visits, access vaccines and tests, and connect directly to Pfizer medications. Novo Nordisk offering #Ozempic at $499/month for eligible U.S. cash-paying patients via its own pharmacy channel and telehealth partners. Roche CEO Thomas Schinecker has confirmed the company is considering direct drug sales to US patients, signaling intent from one of pharma’s most institutional players. According to a recent ixlayer survey, 94% of pharma companies are either live, launching, or planning DTC programs. Nearly half believe it will become standard across most brands in the next five years. (Fierce Pharma) So if DTC is becoming the new front door of pharma, what does this mean for diagnostics? Every DTC pathway runs through a diagnostic checkpoint. To prescribe safely and responsibly, pharma must integrate testing and monitoring. That means: - at-home and digital diagnostics will sit side by side with pharma’s DTC platforms, enabling eligibility checks and ongoing monitoring. - companion diagnostics will expand as pharma uses DTC to segment patients and prove therapy effectiveness. - lab data will merge with prescribing data, creating closed-loop insights for outcomes-based care. Patient experience will be defined by seamless diagnostic + drug journeys, not siloed transactions. In other words, you can’t have direct-to-patient pharma without diagnostics as the gateway! Labs that position themselves as embedded partners to pharma DTC will be the ones powering this new model. And the best part: - patients gain earlier, simpler, often cheaper access to therapies guided by testing. - pharma gains direct data, stronger adherence, and the ability to personalize treatment through diagnostics. - diagnostics providers move from background players to the centerpiece of the DTC healthcare economy. The question is no longer if pharma will go direct, but who will own the diagnostic-drug ecosystem that defines this next chapter in healthcare. ♻️ Repost this if you're following pharma and diagnostics, and follow me at Eliad Josephson for more. #diagnostics #pharma #directtopatient #directtoconsumer

PhonePe’s Pincode launch is being celebrated as the next frontier in healthcare delivery but I think it’s a dangerous sign 🚨 ⚠️ Because this ZERO DARK STORE model is irresponsible. You cannot treat healthcare like FMCG and you definitely can’t treat local chemists like mini-warehouses. Without dark stores, here’s what really happens 👇 1. Sourcing inconsistency will break trust at scale 1 out of 4 drugs in India are counterfeit or substandard & many Tier 2 chemists source from unofficial wholesale channels with 0 quality checks. → Imagine someone receiving a substitute for chemotherapy meds. That’s the risk we’re normalizing. 2. Cold chain compliance is not optional and yet, not traceable India already has a massive cold storage gap over 3.2M MT & temperature-sensitive drugs like insulin or biologics can degrade from a single lapse. In a pharmacy-led model, you have no temperature logs or last-mile validation or even an escalation protocol. If you can’t trace it, you can’t trust it. 3. Absence of FIFO Warehouse infra allows for automated inventory rotation based on expiry dates (FIFO: First In, First Out). And in this model, you’re betting that hundreds of 3rd-party stores will suddenly start doing inventory hygiene? Unlikely. Get ready for expired or near-expiry meds. 4. Batch traceability collapses in a decentralized model 69% of Indian pharma players can’t recall products effectively. Now remove centralised tracking too? You’ve created a system where no one knows who got what. 5. This model’s fulfillment logic is not scalable   You expect pharmacies to: Pick meds → Pack safely → Dispatch in 10 min → Coordinate delivery → All without logistics infra or training? And none of them are on performance SLAs. Unless PhonePe is ready to burn through capital with incentive-heavy subsidies, this model collapses the moment demand spikes So while this model might deliver on convenience and speed, what it gives up is trust, traceability, and long-term safety. PS: This might sound harsh but I’d rather say it now than wait till lives are impacted. Because with medicine, there’s no refund button. PPS: If Grofers evolved to Blinkit 3 years ago, aren't we going back in time?

📋 The NHS Strategic Commissioning Framework – Your Executive Summary The new NHS Strategic Commissioning Framework is essentially a rulebook for how ICBs must buy NHS services from April 2026. It tells ICBs to move from transactional purchasing (paying for activity) to strategic commissioning (paying for population health outcomes over the long term). The three big shifts it's designed to enable: → Sickness → Prevention → Hospital → Community → Analogue → Digital What makes this different from previous commissioning guidance? 1️⃣ Population accountability — ICBs become responsible for the health of everyone in their area, not just people using services 2️⃣ New contract architecture — SNPs, MNPs, and IHOs create vehicles for neighbourhood-level contracts that didn't exist before 3️⃣ Provider role expansion** — The framework explicitly says providers (including primary care) can take on commissioning functions, not just deliver services 4️⃣ Decommissioning is on the table — The document repeatedly mentions ICBs should "rearrange and potentially decommission services The gap that matters: It's a framework for commissioners, not providers. Primary care is described as "at the heart" of neighbourhood health — but there's no guaranteed seat at the table. The most mature networks will be in the strongest position. Call me naïve, but I choose to be hopeful. Otherwise… what's the alternative? Check out more NHS summaries using the link below ⬇️ #strategicomissioning #NHS #primarycarenetworks

A UK start-up enabled the £834m AI scribing business case for the NHS. It then didn’t get the contract… 🤷♂️ TORTUS is a UK company and its ambient voice technology was the tool tested in the largest AI scribe trial the NHS has ever run. ↪️ 9 sites ↪️ >17k patients ↪️>23.5% patient interaction time ↪️13.4% more A&E patients per shift = an £834m national value case modelled by York Health Economics Consortium. This informed NHS England’s national guidance, the T.E.S.T. Framework and the 10 Year Health Plan itself. Three weeks ago, the South West London Acute Provider Collaborative signed the largest AVT deal in NHS history. 20k clinicians across St George’s, Epsom and St Helier, Croydon and Kingston and Richmond. The winner - Lyrebird Health, a Melbourne start-up founded in 2023 that registered a UK overseas establishment in late 2024. Lyrebird is a credible operator with real product depth and we’ll see if it delivers the outcomes promised. From what i can see the decisive factor was Oracle Cerner Millennium integration. Lyrebird had built native plumbing into the EPR shared by all four trusts, including automated clinical coding and RTT pathway data capture. The trust collaborative made a defensible call on that basis. RTT automation directly affects 18-week target performance and choosing the vendor with the deepest existing EPR integration is rational risk management at twenty-thousand-clinician scale. The structural problem sits higher up. UK healthtech founders are being asked to do the sometimes unpaid de-risking work for the system. They run the trials, generate the evidence and feed the national policy frameworks. Then commercial-scale procurement opens, EPR integration becomes the gating criterion and the contracts go to better-funded competitors who arrived after the evidence was already public. The NHS could have done something different here. It could have made Oracle’s integration roadmap a national procurement lever rather than a commercial gift to whichever vendor invested first. It could have ringfenced phase one of the SWL rollout for the start-up that built the case. It could have treated the £834m business case as an asset belonging to the company that generated it, not a public good available to all comers. It chose not to and the pattern is consistent. Heidi and Lyrebird are Australian. Microsoft Dragon is American. Of the AVT vendors now winning at scale, TORTUS is the only UK-founded business and it lost the flagship deployment built on its own evidence. If sovereign UK healthtech is valued, the procurement architecture has to reward the companies that take the early risk. Right now it does the opposite. So here’s the question for everyone shaping NHS digital strategy: if generating the national evidence base for an AI category is not enough to win the commercial deployment that follows, what exactly is the value proposition for a UK founder choosing to build in healthcare?