McKesson : Raising Supply Chain Standards at Health System and Hospital Pharmacies

Your drug supply chain can be much more than just a way to get pharmaceutical products delivered to your health system or hospital pharmacy on time. It can also be a powerful tool to improve drug safety and patient outcomes.

In this edition of Ask a Supply Chain Expert, Scott Mooney, vice president of distribution operations at McKesson, explains how the expanded use of supply chain standards can generate the data your pharmacy needs to improve care for your patients.

What are you responsible for in your role at McKesson?

Mooney: I'm responsible for implementing special projects across all our supply chain processes. Those projects include drug product serialization, track and trace and some other compliance-related issues. I also spend a lot of my time working with external stakeholders on industrywide supply chain standards.

How do you interact with health system and hospital pharmacies?

Mooney: I interact with them a fair amount through different industry forums. One is the Healthcare Transformation Group. That's a group of health systems that share supply chain best practices. Another is the GS1 Healthcare US Initiative. That's a group that sets global standards to improve the performance of the supply chain. I co-chair the GS1 US Prescription Secure Supply Chain Work Group.

What are some common operational challenges that you hear from hospital pharmacies?

Mooney: One of the things that we spend a lot of time talking about is product identification. That means being able to consistently identify a product and define what it is between trading partners. So, whether you're a manufacturer, a distributor or a hospital pharmacy, everyone should have the same understanding of exactly what the product is that we're talking about. You need a consistent definition of a product, and you need to have a unique identifier for each product.

What are the operational benefits to a health system or hospital pharmacy of consistent product definitions and unique identifiers?

Mooney: They make everything you do more efficient. For example, it makes it much easier for you to spot counterfeit drugs in your supply chain. You can point to one bottle of pills and say, yes, this is real, or no, this is a fake by comparing the data in the bar code with data assigned by a manufacturer. Recalls are another good example. Instead of recalling everything, you can recall a portion of a batch made during some time frame of one day at one plant. Returns will become easier, too. The law requires that your pharmacy return unused drugs to the distributor that provided them. You will be able to know instantly if you're returning them to the right distributor rather than trying to figure out where they came from.

What are the clinical benefits of consistent product definitions and unique identifiers?

Mooney: The real power of consistent product definitions and unique identifiers is their ability to turn your drug supply chain into a force to improve patient outcomes. In the future, you will scan that product data into a patient's medical record. Then you can connect that drug to an outcome. Did it help? Did it hurt? Did it work better than another drug? Did it work with some drugs but not with others? Did it work with some patients but not others? You and the other pharmacies can download that information into a database and create evidence-based drug protocols. But it all starts with each drug having a consistent definition and unique identifier.

What compliance standards are you working on now with health system and hospital pharmacies?

Mooney: The big ones now are the new USP 800 practice standards for pharmacies from United States Pharmacopeia. They take effect on December 1st. The standards tell you what you should do to safely handle and manage all the hazardous drugs that distributors ship to your pharmacy and that you store and use in your pharmacy. They tell you what protective gear your staff should wear, what type of ventilation you need, what safe storage containers you need, how to label hazardous drugs. Those kinds of things. The goal of the standards is to reduce the risk of exposure to your staff, patients and the environment.

What drugs used by health system and hospital pharmacies would be most affected by the standards?

Mooney: One example would be chemotherapy drugs. Another example would be chemicals or other agents that are active product ingredients that you use to make other drugs. You need to open and store them in negative-pressure rooms. That means air can flow into the rooms but not out of the rooms in case of a spill. Your pharmacy should be working with your pharmaceutical distributor to make sure it delivers these drugs separately and labels them properly. That reduces the chances of them being mixed in with other drugs and creating an exposure risk.

What other supply chain trends should health system and hospital pharmacies stay on top of?

Mooney: One that your pharmacy should be on top of is the new track and trace requirement for the return of unused saleable drugs to your distributor. The rule is part of the Drug Supply Chain Security Act. As I mentioned earlier, you have to return your unused saleable drugs to the same distributor that you bought them from. All the invoices, serial numbers, lot numbers, expiration dates and global trade numbers have to match up. It's no different from needing a receipt to return something you bought from the store. The requirement starts in late November. Your pharmacy should get its paperwork in order now and set up systems to keep it in order from now on. It's a good thing for your pharmacy and your patients because it maintains the safety and integrity of unused saleable drugs in the supply chain that may help other patients.

How will the daily life of a hospital pharmacy supply chain leader be different five years from now?

Mooney: You'll have all kinds of data at your fingertips, and data will drive everything you do. You'll be working in an entirely digital environment. That will give you all kinds of new capabilities. For example, you'll be able to do very granular tasks like identifying where a specific bottle of pills came from, how it was used and who used it. You'll be able to do broader tasks like inventory management. The data will help you source, price, buy, and store the drugs that you need with precision and without waste or added cost. And you'll be working closer with clinicians as you connect your drug data to patient outcomes.

What do you like most working with hospital pharmacies on their supply chain issues?

Mooney: I like working with them on standardizing product definitions and identifiers and then helping them use technology to check a drug before they give it to a patient. You can get the wrong drug or the wrong dose or the wrong milligram when you check a drug by hand. But when you can scan a bottle or vial with a machine, it's black and white. It either matches what a prescriber ordered for a patient or it doesn't. It's using the supply chain to make care safer and more effective for patients, and that's what it's all about.

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Related: Learn more about McKesson's pharmaceutical distribution services for hospital pharmacies