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Partnering to deliver critical medicines through bushfires and COVID-19

Securing a local and global supply chain through closed borders, roads and airports

07/12/20

East Coast Australia, 4 January 2020

The mercury hits 48.9°C in Penrith Lakes in the Sydney basin, making it one of the hottest places on earth. Even usually mild Canberra reaches 43.6°C. Bushfires are blazing, the earth is scorched, and roads are closed. Families and firefighters desperately scramble to save homes, businesses, livestock - and human lives. Despite the extreme conditions and devastation, people living with serious illness in all corners of Australia still need to access their medicines. Many of these medicines need to be stored between +2 and +8°C. And they need to be delivered by road.

Worldwide, 11 March 2020

The World Health Organization declares COVID-19 an international pandemic. Major airports around the world are closed. Passenger flights are cancelled and so no cargo is available. Supply sites in Europe also provide medicines to Australia. These medicines need to reach our borders and then be distributed – regardless of the cost.

So, how, in the midst of the most destructive bushfires our country has ever experienced, and then, in the midst of a worldwide pandemic, was Bristol Myers Squibb able to ensure an uninterrupted supply chain where no patient missed a dose of their critical medicines?

The answers to these questions lie in the company’s singular focus on patients at the centre of every decision made at every step of the supply chain – and in the partnerships formed across entire distribution networks to help deliver on that patient promise.

Delivering specialised medicines is complicated business

Just like so many other things we have learnt for the first time in 2020, not all medicines have straightforward ordering, distribution and storage requirements. Many of Bristol Myers Squibb’s medicines are highly specialised, providing treatment for cancer, autoimmune and rare diseases. The supply chains for these medicines are complex, with 6500 locations that can request product at any time.

Some medicines require cold chain management, where a constant temperature between +2°C and +8°C needs to be maintained from the time of manufacturing until the time they are used, and the chain of consistent cool temperatures can never be broken.

Other medicines require controlled distribution, with strict conditions around their supply to both pharmacies and patients. Pharmacists need to verify that they have counselled the patient and conducted a pregnancy test where needed, before dispensing each prescription.

Partnering internally

The first step in ensuring uninterrupted supply of such specialised medicines during 2020 involved all parts of the company to be aligned internally, both locally and globally.

“This began with the blessing of our Finance Director and Managing Director to ‘spare no cost’ in getting our medicines to patients,” says Samantha Comey, Associate Director, Market Supply Operations at Bristol Myers Squibb, Regional Asia Pacific. “Everyone dedicated their energy and time to supporting Supply Chain and the only imperative was to ensure the medicines were delivered so patients could access them.”

From here, we approached the challenge with a customer experience lens and focused on what mattered most to our customers whether they are health care professionals or patients. We tapped into the expertise across various functions across our business with a single focus on our customer. “Through daily meetings, we managed every step involved in our medicines reaching the right patients in the right place at the right time – with no costs passed onto patients.”

Partnering with suppliers during Australia’s ‘black summer’

During the height of the bushfires, Samantha recalls the difficulties of reaching pharmacies in parts of Australia most impacted: “We needed to deliver direct to pharmacy and the roads were closed. We literally could not get to Bateman’s Bay. We could not get to Queensland. The trucks just could not get through. In those heat waves, cold chain was particularly difficult, because you cannot afford to wait a day. This is where having the right partners and connections was essential.”

Working with supply partners who specialise in healthcare enabled the company to navigate these road closures, finding alternate routes, even if it meant travelling hundreds of additional kilometres in unfamiliar territory, and deploying additional drivers and vehicles.

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As a global operating company, natural disaster and pandemic risk scenarios are an integral part of DHL Supply Chain’s continuous risk planning.

We continuously monitor these types of situations both globally and locally to ensure we respond to guidance from advisory organisations and government bodies. We activate plans according to the local situation to ensure deliveries continue to reach patients, hospitals and pharmacies.

—Saul Resnick, CEO DHL Supply Chain, Australia & New Zealand

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Bristol Myers Squibb also needed to supply medicines to patient access programs across the country during this time. “To fulfill urgent deliveries,” says Samantha, “we worked with DHL to use ‘next flight’ arrangements. This is where we book a premium service to airfreight a shipment to the destination. When the flight lands, there is a courier waiting at the airport for it, who drives the medicine directly to the location where it is needed. This type of micro-management of routes was required constantly.”

Partnering globally during COVID-19

The COVID-19 pandemic added another layer of complexity to the timely supply of medicines that are imported into Australia. When international airports were closed, passenger flights were cancelled, and so no cargo was available. The usual direct routes such as Europe-Dubai-Australia or Europe-Hong Kong-Australia used for medicines needed to change.

“With the help of our global partners, DHL, we were able to route through the US,” explains Samantha. “With the US still open, we routed from Europe-London-New York-San Francisco-Sydney. It was taking twice as long. It was challenging because we had cargo moving through so many different airports. This meant getting deviations from global shipping lanes. Our global team come together very quickly to get all the approvals to approve substitute routes to get the medicines here.”

One particular medicine required a specialised import permit, which is sent between various parties by post. But the impact of COVID restrictions on Australia’s postal system meant that the import permit was lost - and these permits cannot be reissued. Bristol Myers Squibb partnered with the highest levels of the Office of Drug Control and Australian Border Force to get this medicine cleared in Australia so they could continue to meet patients’ needs.

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“The psychological effect for our patients of missing a dose when they are already stressed and in a state of heightened sensitivity is enormous. It was our team’s responsibility to use every measure possible and absorb the cost to make sure we could move the medicine to them. If they couldn’t attend their usual pharmacy, we would get it to a pharmacy that they could reach.

“We have had no reports of patients who had missed or delayed treatment cycles as a result of bushfires or COVID.”

—Sheridan Charlton, Manager – Logistics Operations MSO EMEA/APAC , Bristol Myers Squibb, Australia and New Zealand

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Partnering with pharmacies and Medicines Australia

As the impacts of COVID-19 intensified, Australian patients became concerned about global supply chains and began to stockpile their medicines, asking their pharmacy to dispense up to 6-months’ supply in advance. When this happened, it was essential for Bristol Myers Squibb to understand the demands and manage inventory to ensure every patient could access their medicine.

Importantly, Medicines Australia, as the voice of the pharmaceutical industry reassured the public that Australia had sufficient supplies of medicines and strongly discouraged panic-buying and stockpiling of medicines. “It was about giving people the confidence that we had product,” notes Samantha. “We responded daily to Medicines Australia surveys about stocks of medicines and we were able to confidently confirm that we didn’t have issues.”

Reflecting on 2020 and its many challenges, Managing Director Neil MacGregor feels it was the strength of the company’s partnerships, internally and externally, that enabled Bristol Myers Squibb to maintain timely and safe delivery from the point of manufacturing medicines to final patient supply: “Some deliveries required a 10-fold or more increase in delivery costs, but our only priority was our patients. Our patients are always at the heart of every decision we make, and 2020 has brought this into even greater focus. Nothing was going to stand in the way of getting our medicines to our patients.”

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Partnering to deliver critical medicines through bushfires and COVID-19

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