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So far Dan Rosen has created 3 blog entries.
7:02 am 7:02 am

Can you predict a medicine shortage before it happens?

By |2021-04-09T07:03:47-08:00April 9th, 2021|Uncategorized|0 Comments

Maisha Meds believes it is possible to use systematically collected data from across the medicine supply chain to detect shortages in countries before they start to affect patients. In 2020, our organisation built an initial prototype of just such a system that, while imperfect, could inform future attempts to design early warning systems for the medicine supply chain. The attached paper describes the methodology, results, caveats and implications of this attempt. Introduction and background The COVID-19 pandemic has triggered a number of health commodity supply chain challenges that have led to healthcare commodity shortages and price hikes. Maisha Meds has internally published a paper that aims to describe how we have used a combination of international customs trade data and retailer point of sale (POS) data to develop and test a prototype of a medicine shortage flagging tool, to identify potential essential medicine shortages across sub-Saharan Africa. Maisha Meds used export data from India, import data from Kenya and Point of Sale data from Kenyan pharmacies to identify anomalies in the supply of medicines, view price changes and look for leading indicators of potential national level medicine shortages across sub-Saharan Africa. Results Analysis 1: Using an ARIMA forecast model Maisha Meds identified 116 out of 525 finished pharmaceutical products that experienced a significant drop in exports from India to all of Sub-Saharan Africa ex. South Africa after Feb 2020. This was an increase from 34 / 525 products experiencing a significant drop in exports indicative of a shortage from October 2019 – Feb 2020, before Covid-19’s impact on supply chains. Wholesaler interviews identified 39 molecules as being in shortage in at least one country, of these Maisha Meds had sufficient data to analyse 37. The Maisha Meds ARIMA forecast model was able to flag 18/37 molecules as at risk of shortage to a 95% confidence interval. In the instances where there was sufficient API data the ARIMA model successfully flagged 11/13 products as at risk of shortage that were confirmed by local wholesalers (or 15/18 including the products highlighted as in shortage not included on the original list of tracer molecules). Analysis 2: Maisha Meds also conducted an analysis to link historic drops in Indian exports to major price increases in Kenyan pharmacy prices, in an effort to prove a link between change in exports and change in prices for patients in Africa. In 8/15 molecules, Maisha Meds was able to identify a statistically significant change in the value of exports from India to Kenya, using an 80% confidence interval, prior to a trend break price increase in Kenya. Looking at the products that exhibited a relationship between exports and price increase in Kenya, a negative correlation between price and export value was observed with a lag of 4-5 months in half of the cases, in particular for products with a higher import dependence on India. This would indicate that with refinement and improved data inputs it might be possible to identify a shortage before it affects medicine supply in [...]

7:00 am 7:00 am

Understanding the Impact Of COVID-19 On Essential Medicine Supply Chains

By |2020-07-18T11:46:48-08:00June 22nd, 2020|Uncategorized|0 Comments

Authors: Anthony McDonnell, Kalipso Chalkidou, Prashant Yadav and Dan Rosen (Maisha Meds Head of Data Insights) This blog was written in partnership with the Centre for Global Development who published the following blog first here. We are grateful for contributions from IQVIA for this piece. The COVID-19 pandemic has triggered unprecedented measures by national governments around the world, trade disruptions, and a deep and global economic crisis. All of these factors are, in turn, threatening the supply of essential medicines and other commodities. This is felt most acutely in developing countries (for example, early discussions highlight how Kenya is exposed to medicine shortages), but also in wealthy nations. The widespread nature of these problems reflects a highly complex and highly globalised supply chain for medicines and healthcare commodities. In this blog we outline some of the challenges in the global supply of medicines and introduce a methodology that will enable countries to spot early challenges in supply, allowing them as well as global development partners and industry to plan ahead and pre-empt falling short. The COVID-19 pandemic has triggered a number of challenges that have led to shortages and price hikes, and could potentially fuel an epidemic of fake and substandard medicines, including: severe supply chain blocks caused by significant decreases in air cargo capacity, sea freight, and transport logistics; export restrictions by supplier countries related to both COVID-specific commodities, but also non COVID ones (for example India has banned a number of essential active pharmaceutical ingredients (APIs) and finished products, though some of these bans have since been reversed, the UK has banned parallel exports, and EU has restricted exports of protective equipment.) the slowdown in production of medicines in affected countries. This began in China with API production (which has now all but resumed there) but also in India, and other key manufacturing bases. Drawing on the work of the international Decision Support Initiative (iDSI) and CGD’s earlier procurement work, in partnership with colleagues from IQVIA, MaishaMeds, and other in-country partners, a we have set out to better understand the current supply chain crisis. We are working to identify solutions to current pressing problems in order to make the global system more resilient in the future. We are collaborating closely with inter-agency groups focussed on medicines procurement to ensure our analytical work is strongly embedded in the policy context. Key: 1,3 social distancing measures have impacted manufacturing 2,5,7 Export bans have impacted the flow of goods across borders. 2,5,7,9 Logistical problems and disruptions have disrupted transportation of goods. 4,6 delays at ports Scoping the extent of the problem For medicines financed and/or procured by global agencies (including medicines for HIV/AIDS, TB, and malaria, or contraception) there are multiple efforts underway by agencies such as the Global Fund, USAID, and Global Drug Facility to manage global supply chain risks from COVID-19. However, for essential medicines which are procured by countries using domestic resources, there is relatively little in terms of globally coordinated efforts to understand and mitigate shortages. In order to understand the extent and nature of the problem, we are looking at non-COVID products that fall into the category of very essential [...]

12:18 am 12:18 am

COVID consequences: How to spot a drug shortage

By |2020-07-18T11:46:57-08:00April 28th, 2020|Uncategorized|0 Comments

Summary : Maisha Meds is a healthcare technology firm based in Kenya. We have been working to identify potential medicine shortages in the country to help support the response to COVID-19 in Africa. Based on our initial findings we have identified four major types of medicine shortage that are likely to affect the Kenyan market and have supplied thoughts on how to map these shortages, and possible responses to moderate the impact of shortages. Preparing for the impact of COVID-19 on Kenya’s health commodity supply chain Kenya’s coronavirus case tally as of April 20 hit 281, with 14 deaths, and the addition of 11 new cases. Kenya has East Africa and the Horn of Africa’s third highest tally currently.[1] That Kenya has not yet seen the same scale of outbreak as other countries is good news, we hope that it remains that way. But regardless of the size of the outbreak the health of Kenyan citizens is already under threat by challenges to the health commodity supply chain. COVID-19 has led to a slowdown in the manufacture of active pharmaceutical ingredients (API) in China that will have repercussions for the supply of essential medicines across the world.[2] China is the world’s leading producer and exporter of API (the chemicals used to make medicines) by volume, accounting for 20%-40% of total global API output, including 26% of organic chemical exports to Kenya.[3],[4] China produces over 2,000 API drug products, with annual production capacity exceeding 2 million tons. Chinese API producers also supply a good part of the Indian pharmaceutical market.[5] In addition to concerns about Chinese supply, local manufacturers in Kenya have reported that there are currently issues in the Indian pharmaceutical supply chain; while factories are still operational it’s becoming harder to obtain finished pharmaceuticals and API as a result of the virus’ impact on logistics. India supplies 37% of Kenya’s finished pharmaceuticals by value and a greater proportion of sales volume.[6] India implemented a social distancing shutdown on March 24th, as well as a ban on the exports of 26 health commodities on March 3rd. Though these export bans were subsequently relaxed for all molecules except for paracetamol on April 6th.[7] Kenya is exposed to medicine shortages At the time of writing this blog Kenya has reported relatively few confirmed coronavirus cases compared to the global burden, though the number of cases continues to rise. However, the country is at a high risk of health commodity shortages due to price sensitivity of patients paying cash for their healthcare and the likelihood of procurement departments being outbid for essential commodities by more developed, richer countries. In addition, the relatively small local manufacturing industry does not make API, and private wholesalers and manufacturers are unlikely to have stockpiled health commodity reserves beyond a 3-4 month time horizon due to capital constraints. To ensure that patients do not die from the economic and healthcare related consequences of the virus it is important to understand where there are likely to be health commodity shortages, [...]

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