Integrating New Brunswick’s Pharmaceutical Supply Chain | McKesson Canada - McKesson Canada

Case Study: Integrating New Brunswick’s Pharmaceutical Supply Chain

Better Care, Lower Cost, Fewer Errors

Better care, lower cost, fewer errors. It’s what every health system wants, and finally, it’s here.

New Brunswick is leading Canada with its recent rethink of how it distributes pharmaceuticals across the province. Pharmaceutical supply chains are rarely thought about when conducting health system planning, but when the two Regional Health Authorities in New Brunswick came together to explore how to make their provincial health system more efficient, the supply chain stood out as a clear opportunity.

New Brunswick was like many other jurisdictions across the country. It had a patchwork of pharmaceutical distribution centres, pharmacies, and some automated medication dispensers in select hospitals. However, without a clear network between these, they were missing out on the opportunity to make an even greater impact on health care in New Brunswick.

This is not to say that New Brunswick was without individual organizations driving their own innovative projects focused on greater efficiency and reducing errors, but there was an opportunity – and need – to connect these one-off efforts across the province. If these innovative efforts could be integrated across the province – from the moment medication is produced, to the moment it is taken by a patient – it would unlock system-wide improvement.

This required using a provincial perspective. The impact of both Regional Health Authorities co-creating this solution meant every patient would benefit, regardless of where they lived throughout the province.

Getting the right medication, to the right patient, at the right time

The goal was to create a province-wide, safe and reliable system; and one that would be self-funding, without major capital overlays.

Tactically, there was also an opportunity to focus on ‘the last mile.’ The existing pharmaceutical supply chain excelled at securely and reliably transporting pharmaceuticals from the point of production, to the hospital loading dock. But there was opportunity to vastly increase the ‘supply-chain’ within the four walls of the hospital. When it comes to pharmaceuticals, automation increases patient safety – getting the right medication to the right patient at the right time. Automation also holds the key to saving funds, and avoiding wastage and spoilage.

In reviewing the 22 hospitals in New Brunswick, an opportunity was identified: the timing of when medication was administered was a risk area for patients. Hospitals had already implemented a solution to this issue by installing an automated medication dispensation cabinet that helps resolve issues with timing, and helps avoid adverse drug reactions, due to each dispensation coming with a patient-specific barcode.

Dispensing Cabinets (ADU’s) automates the pharmaceutical compliance and ordering process, meaning less paperwork for staff, and a steady supply of medication that’s there when it’s needed – but not in over-supply, which can lead to spoilage and sunk costs.

Learning from the hospitals that were already using the ADU’s, the automated dispenser was then implemented across the 22 New Brunswick hospitals.

Reducing cost through distribution

With the ADU set up, they needed a steady supply of pharmaceuticals, which meant looking further back into the supply chain, beyond dispensation. The existing pharmaceutical distribution network was fragmented. Different producers were shipping different medication to different places, at different times. This fragmentation was exposing the province’s medication supply to unnecessary risk, while costing more than it needed to.

The first solution to these issues was to adopt a central-fill pharmacy model; a distribution centre for pharmaceuticals. Rather than each producer shipping individual medications to individual hospitals, all medications are sent to central facilities. These facilities were staffed with pharmacists who respond to orders from the 22 hospitals, 24/7, to ensure each hospital has the specific – and patient-specific – medications they need, when they need them.

The second solution involved moving to single-source distribution, which helped reduce cost through scale. By moving to this model, not only was a cost-neutral approach achieved, but the province saved $3 million while adding over 50 jobs.

This approach to rethinking the pharmaceutical supply chain is something that can be replicated across Canada, and is demonstrative of the impact that government and industry can have when they work together.

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