Managing medication supply chains: Lessons learned from Taiwan during the COVID-19 pandemic and preparedness planning for the future

Abstract

Coronavirus disease 2019 (COVID-19) has posed unprecedented challenges for nations worldwide, among which medication shortages can cause a devastatingly negative impact on global health. Using Taiwan as an example, this report describes the sources of potential medication shortages, discusses the preparedness and contingency strategies to address medication shortages, and outlines the evidence-based recommendations on ensuring a stable medication supply and improving the quality and security of medicines. Many drug shortages have focused on shortfalls of overseas manufacturing, but the effect of the COVID-19 crisis on misallocation of medications within the nation's internal supply chains is also a great concern. A wide range of stakeholders are involved in pharmaceutical supply chains, including government regulators, health care insurers, pharmaceutical companies, frontline physicians and pharmacists, patients and families, professional and patient associations or unions, and even individuals who acquire medications from abroad. Collaborative inputs and efforts from all these interdependent stakeholders are critical for establishing transparent preparedness and contingency plans to address drug shortages affected by disruptions of overseas manufacturing or stockouts in pharmacies owing to medication misallocation. Strategies have been documented and recommended in Taiwan and the United States to mitigate drug shortages and ensure the long-term quality and security of medicines. Barriers to accessing medicines are nothing new, but the COVID-19 pandemic poses urgent and even novel challenges to the stability and integrity of medication supply, which urges for a need to reconsider and reinforce effective management strategies for pharmaceuticals. Active management, transparent information, and timely communications are essential to ensure a stable supply of key therapeutic medications, especially during a pandemic.

Pharmacists’ role, work practices, and safety measures against COVID-19: A comparative study

“…Both countries faced operational crises during the first few weeks of the pandemic regarding medicines, PPE supply, and the collapse of delivery of remunerated prescription medicines, which was similar to other countries. [18][19][20] Recent studies by Shrestha Pharmacist's role in COVID-19 management SCIENCE AND PRACTICE et al, 3 Hussain et al, 4 Bahlol and Dewey, 5 and Kasahun et al, 6 described good preparedness and response of pharmacists to pandemic, similar to our results.…”

Medicines and vaccines supply chains challenges in Nigeria: a scoping review

“…Other countries that reported a disruption in medicine and vaccine supplies were due to natural disasters and pandemics such as COVID-19 [ 40 ]. It is important to note that the challenges in Nigeria and other countries like Taiwan have been further complicated by the COVID-19 pandemic [ 46 , 47 ]. Financial challenges, corruption and lack of human resources which are other challenges identified in this review have also been reported in Uganda [ 48 ].…”

Drug shortages in a state-owned academic hospital during the COVID-19 pandemic in Ecuador

“…A better understanding of how different countries managed the shortages during the COVID-19 pandemic represents an opportunity for learning and improving interdisciplinary collaboration between pharmacists, physicians, and healthcare managers. [17][18][19][20][21] To avoid abusive drug prices, Ecuador implemented a price regulation system with three regimes: a regulated regime for strategic medicines, a controlled regime for non-strategic medicines, and a direct price setting or emergency regime. The price of medicines is under the regulation of an ad-hoc council that sets and reviews medicines' prices.…”