Civica Rx expands roster of affordable generic drugs

COVID-19 Lessons needed to manage patients. At Henry Ford, the graduate medical education director repurposed all training staff to continued from page 1 care for COVID-19, which demonstrated quality and outcomes for the Health Hospitals had a lot of extended delays that health systems can be nimble. Alliance Plan, a nonprofit plan based for COVID-19 test results in the begin“As payors, we have to be very supin Michigan. Many areas within health ning of the pandemic. As a result, they portive of our health systems that are care systems struggled with the unexhad to act in a manner that presumed trying to react very quickly in these pected during the pandemic surge patients were positive and use personal situations,” Dr. Watson said. this spring; all can be looked at as protective equipment, and it was difHospitals also faced shortages of ceropportunities for improvement going ficult to group infected and noninfected tain equipment, such as ventilators and forward, said Dr. Watson, who also is patients because it was unclear who was infrared thermometers. “These are things an attending staff hospitalist at Henry who, he said. There also were issues all facilities are now rethinking, and as Ford Medical Group, in Michigan. with shortages of specialized providers health plans, we will have to partner with our facilities to make sure they have the resources they need to take care of our membership,” Dr. Watson said. In addition, health systems have been working to try to stay financially viable,

INTRODUCING INTRODUCING he said, continuing to provide needed care and working to make sure staff were paid and deployed properly. Many

FUNGITELL FUNGITELL STAT STAT ™ ™ had to make changes in their lines of credit or apply for government or other loans. Some hospital groups have since started working together to pool supplies and ensure they have enough inventory on hand for the next epidemic, including adequate supplies of low-cost generic medications (sidebar). The pandemic opened discussions

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Civica Rx Takes A Seat at Drug Supply Chain Table

Civica Rx has earned a key role in a new federally funded public–private partnership to maintain adequate supplies of essential medications during pandemics and other future public health emergencies. The collaboration was announced soon after the company relieved critical shortages of generic sterile injectables for more than 1,200 member hospitals during the COVID-19 pandemic’s crushing first wave.

At the Department of Health and Human Services (HHS), teams are involving Civica Rx in their build of “a 100% U.S.-owned and operated, endto-end domestic drug manufacturing infrastructure to secure essential sterile injectable drugs and prevent future shortages of these vital medicines,” said Martin VanTrieste, RPh, the president and CEO of the nonprofit company.

Already, Civica Rx has provided 1.6 million doses of critical medicines to the Strategic National Stockpile for the COVID-19 response. The neuromuscular blocking agents, pain relievers and sedatives for intubation, broad-spectrum antibiotics for secondary infections, and other drugs to treat comorbidities were supplied in partnership with the Phlow Corporation, in Richmond, Va.

Civica Rx’s role will be to make the finished dosage forms of essential medications, including vials and syringes, using its established network of manufacturing partners. Civica Rx also will build its own finished dosage-form

about fair allocation of resources, Dr. Watson said. While much of that had to do with ventilators, it opens the door for conversations about how COVID-19 vaccines should be distributed if and when they are approved and appropriate.

“Getting the vaccine is just one step,” he said. “Getting the vaccine to the people who need it will be an entirely different issue. As health plans, we will have to partner with health care organizations to make sure it’s done fairly and appropriately for our population.”

Multiple Points of Support

The virus shed light on other areas

manufacturing facility on the same site as Phlow’s other partners, Virginia Commonwealth University’s Medicines for All Institute and AMPAC Fine Chemicals.

The pandemic that exposed America’s medication supply vulnerabilities was Civica Rx’s toughest challenge in only its second full year of operation.

“Generics are treated like commodities, so there’s no real inventory in the pipeline. It was a big body blow to the supply chain when demand surged 300% during COVID-19 for some of the medications we deliver to members,” Mr. VanTrieste said. Yet “we were able to serve all of their day-to-day needs” because Civica Rx maintains a sixmonth inventory stockpile, has redundant suppliers and safety stock, had daily contact with hospital members in hot spot cities and manufacturer partners, and closely tracked FDA and ASHP drug shortage lists and IQVIA sales data and patterns, he noted.

Mr. VanTrieste said attuned “members can be the first ones to identify demand surges and also possible shortages, through something as simple as two orders in a row that weren’t full. By trying to connect the dots with them, we have a higher probability of understanding what’s going to happen.” Such a proactive approach is key, he noted, because “once a house is on fire, you can’t buy fire insurance. And you can’t develop robust supplies in a pandemic. Every day at Civica, we measure risk and manage our business model around the potential risk we see. We are preparing for ongoing COVID-19 waves.” health plans can be involved in, he said, including testing for their members and the broader community, and supporting member needs outside of clinical care, such as providing food benefits. It also highlighted opportunities for health plans to partner with clinical systems to address risky chronic conditions—such as obesity, hypertension and diabetes—that exacerbated COVID-19 clinical outcomes and deaths. “These should be areas of intense focus as we prepare for future epidemics,” Dr. Watson said. Health systems and plans also have to look at social determinants of health to identify at-risk populations ahead of time, and consider remote management or other technologies to detect epidemics before they happen, he noted.

The COVID-19 pandemic accelerated a trend in digital technologies, Dr. Watson said, and health plans need to be in a position to support their use. As the venue of care for more conditions shifts from hospital to home, devices will be a big piece of that, and more biometric data can be aggregated and segmented within populations to identify trends in geographic areas.

The pandemic will change the way we think about access to care, he added. “We have to think about how our members can access care through a variety of channels, with even social media as a clinical tool for those with lower-risk health care needs.”

—By Karen Blum

Dr. Watson reported no relevant fi nancial relationships.

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