Article

Novaplus Mitigates the Challenge of Drug Shortages

February 22, 2021
needles surrounding vial

In 2019, a shortage of Vincristine, which is a chemotherapy medication used to treat children with cancer, left doctors in a bind. The manufacturer Teva exited the Vincristine market, leaving Pfizer as the sole supplier. With no appropriate substitute, demand for Pfizer’s medication was increasing.

On Oct. 14, 2019, the New York Times ran an article about the short supply of Vincristine, highlighting the alarm in the pediatric community and the impact to patients. Almost immediately, the only available Vincristine product on the market was the Novaplus® labeled medication, which had been meeting a 98% fill rate. This is a common scenario for Novaplus.

“We can visually see that when we log into the wholesaler ordering platform … the only product left for a particular molecule is the Novaplus product. That often happens,” says an associate director of Pharmacy at a major academic medical center.

As pharmacists know, the most costly and dangerous drug shortages are usually due to an inability to get drugs that are no longer under patent protection. The loss of patent protection leads to a decreased price and a reluctance of manufacturers to get into a market with declining profitability, which leads to shortages.

Most non-acute healthcare providers, including ambulatory surgery centers, physicians performing procedures in their offices, infusion centers and home infusion pharmacies, face shortages of essential pharmaceuticals. One proven solution to mitigate the problem is the Provista Pharmacy Program, which offers pharmaceuticals through the private label Novaplus. Novaplus provides exclusive access to the nation’s most protected inventory of shortage-prone drugs.

Unique in the industry, Novaplus features a mostly injectable portfolio, which has been increasing by about two dozen new drugs each year since 2012. Fill rates average 92%, which is significantly higher than the 79% average by other group purchasing organizations (GPOs).

For example, Novaplus offers fill rates of:

  • 98% on Vancomycin HCL; 71% other GPOs.
  • 98% on Heparin sodium; 63% other GPOs.
  • 90% Metoclopramide HLC; 0% other GPOs.
  • 90% Ketorolac tromethamine; 50% other GPOs.
  • 90% Piperacillin-tazobactam; 38% other GPOs.

In addition, Novaplus offers nearly 200 drugs representing approximately 790 national drug codes (NDCs), including antibiotics, anesthesia and oncology pharmaceuticals. This makes it the largest private label and dedicated inventory in the industry.

NOVAPLUS PROVIDES ACCESS TO PRODUCTS ON THE DRUG SHORTAGE LIST

Provista’s private label program can play a strategic role in helping pharmacists manage drug shortages. The top 25% of drugs on the American Society of Health-System Pharmacists (ASHP) drug shortage list are not an issue for Novaplus members–the program has fill rates of over 90% on these drugs. In addition, 87% of NDC drugs are available through the Novaplus label.

Relationships with manufacturers help drive drug availability. For instance, leveraging committed spend for Novaplus products allows Provista to predict demand for manufacturers of generics. In return, manufacturers ensure higher fill rates.

A first-of-its-kind risk-sharing initiative with manufacturers leads to greater production commitments. This results in increased production of short- and critical-assess drugs for Provista members.

Further enhancing the program is a newly announced initiative that takes drug fulfillment to the next level and provides incentives for manufacturers to participate. It offers:

  • A seven-year commitment versus three years for other agreements.
  • Manufacturer extended production planning ability.
  • Higher market share, backed by auto-substitution, compliance requirements and targeted marketing.
  • Promotion by over 150 alliance dedicated field service teams.
  • Suppliers the ability to offer unique, differentiating value to alliance members.
  • Preferred stocking.

Although labels on Novaplus pharmaceuticals are different from the manufacturers’ brand name products, the drugs are identical. They are from the same manufacturers and are the same products. Oftentimes, the Novaplus-labeled product is the only drug available with the wholesale distributor or the manufacturer.

INCREASED PRODUCTION MITIGATES DRUG SHORTAGES

Ensuring medications are available where and when they are needed has never been simple. Many drugs are in short supply, with more than 100 NDCs experiencing greater market demand than existing supply. Provista explores all options to stimulate consistent production while providing manufacturers with predictable demand.

Provista offers drug sourcing and business intelligence strategies, too. The purpose is to identify and implement innovative, member-centric contracting approaches to drive a sustainable pharmaceutical product supply. The Novaplus Enhanced Supply Program, which was launched Jan. 1, 2020, targets the enhancement of more than 90 critical, lifesaving and essential medications.

The program offers an approach to address market needs:

Market Need                                   Novaplus Approach
More pharmaceutical supply          Significantly increased supply. inventory.

More accountability.                       
Increased rigor for supplier.

More demand predictability.           
Longer contract duration.

More sustainability.                          
Incentive to produce less. 

Profitable drugs.


More transparency.                         
Production detail disclosure.

More resiliency.                               
Mandated resiliency.

Redundancy/contingency.

Novaplus supports a sustainable supply by anticipating drug supply demand to better meet patient needs. Provista members gain the advantage of convenient access and more supply, with no additional forms, steps, cost or commitment.

PROVISTA PLAYS AN ACTIVE ROLE IN IMPROVING SUPPLY RESILIENCY

For years, Provista has played an active role in improving supply resiliency. The GPO has built a long-term solution with a singular goal: to outmaneuver uncertainty.
Provista is currently focused on expanding the highly successful Novaplus program to provide supply assurance for essential medical products during times of increased utilization by:

  • Growing and enhancing supply with both products and suppliers.
  • Exploring new bid approaches (e.g., volume segments).
  • Enhancing the business intelligence platform.
  • Monitoring and anticipating supply interruptions.
  • Establishing contingency (backup) contracts.
  • Elevating quality and sustainability in bid scorecard.

Along with improved protections, additional inventory will also be available going forward. This equates to many months of inventory and several million additional vials of medicine. The months of inventory is based on current run rates, including historical purchases. 

However, life-saving procedures often depend on the availability of these generic injectables. If a provider does not have the needed drug the day the patient is scheduled for treatment, the patient may go somewhere else and never come back to that provider. The Novaplus program avoids drug shortage problems by ensuring facilities have access to the drugs they need, when they’re needed.

About the Author

Walter Geba, PharmD, is the Vice President of Pharmacy Operations at Provista in New York.

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