The Diabetes Supply Chain During COVID-19

The Diabetes Supply Chain During COVID-19 - One Drop
Editor's Note: This article is reprinted with permission from Beyond Type 1, as part of their ongoing COVID-19 coverage.
Written by Todd Boudreaux

A lot of people are wondering how COVID-19 will affect the production of diabetes supplies and medications, including insulin. According to Beyond Type 1, who is communicating closely with diabetes drug and device manufacturers: 

  • All manufacturers are reporting that COVID-19 has not impacted the production or distribution of their products and that they do not anticipate shortages.
  • As a result of increased demand — and for some, a shift to a remote workforce — customers are being warned that there may be delays in processing orders.
  • Similar delays may occur in seeking technical support.
  • In some cases, patients have reported their local pharmacies are out of insulin or supplies, as a result of many patients refilling at the same time. Your pharmacy should be able to restock in a matter of days.
  • If possible, order your refills at least 1-2 weeks in advance. Also, order 90-day and mail-order refills when possible.

For a more in-depth look at how the supply chain works, check out Beyond Type 1’s interview with Wade Neucks of Lilly Diabetes here.

Insulin + Prescription Drugs

Lilly indicated in their latest press release:

“Lilly does not currently anticipate shortages for any of our medicines, including all forms of insulin…. Since the initial outbreak, Lilly has closely monitored our supply chain for potential impact to the supply of our medicines around the world. We continue to monitor the situation, and our insulin manufacturing sites in the U.S. and Europe remain operational, with increased precautions in place to protect the supply of medicine and the welfare of our employees. Lilly does not source active pharmaceutical ingredients (API) for any of our approved medicines from China… U.S. pharmacies that temporarily don’t have Lilly medicines in stock due to higher demand can order them from wholesalers, and generally they can be delivered in 1 to 2 days. Lilly has received a few reports of U.S. pharmacies stating that insulin orders are not being fulfilled due to “manufacturer backorder.” Lilly has informed wholesalers and others in the supply chain that we do not have any products on backorder, including insulin. Patients should ask their pharmacist to secure an order from their wholesaler.”
(Initial Response March 3rd, Last Updated April 7)

Sanofi’s response:

“We are working to maintain the supply of all of our medicines and vaccines through close collaboration with our suppliers throughout the world. Our global network of manufacturing plants is operational and the diversity of our global sourcing helps ensure business continuity across all our product lines. At this time, Sanofi does not anticipate shortages for patients resulting from the COVID-19 situation.”
(March 5, updated March 25)

Novo Nordisk in a press release:

“We have ample supplies of medicines, including insulin, and we expect to be able to fulfill orders and replenish pharmacies in the US throughout this pandemic. However, because of periodic increases in demand, there may be times when local pharmacies are temporarily out of stock of diabetes medicines. We are working with our distributors to ensure that there is enough inventory to fill prescriptions quickly. Updates available at NovoNordisk-US.com/covid19”
(March 11, last updated April 3)

Mannkind (Afrezza) response:

“MannKind sources critical raw materials from suppliers in the United States (US) and Europe, and our US manufacturing plant is fully operational; we are confident supplies for Afrezza will not be affected. As the global situation evolves, we will continue to take the steps necessary to safeguard the reliable supply of Afrezza.”
(Initial Response March 12, Reaffirmed March 20)

Xeris (Gvoke) indicated in a press release:

“Xeris has no business exposure to China. Regarding Gvoke PFS, the Company believes it has four to five months of finished goods on hand; four to five months of product currently being manufactured; and, an additional six to nine months of components and API. Therefore, the Company has commercial supply for the balance of 2020. In addition, the external components of Gvoke HypoPen™, Xeris’ liquid glucagon in an autoinjector, are being manufactured in Taiwan with the cartridges made in the U.S. and final assembly to be in the U.S. To date, there have been no work interruptions of manufacturing of Gvoke HypoPen components in Taiwan.”
(As of March 20)

Device Manufacturers

Abbott: “We are closely monitoring the coronavirus across our business operations. At this time, there has been no impact on availability of Abbott’s diabetes care products. We will continue to monitor the situation throughout our global manufacturing and distribution network as things continue to evolve.” (Initial Response March 13, Reaffirmed March 20)

Dexcom: “At this moment there are no interruptions to Dexcom’s ability to produce and supply product. However, we do anticipate near term delays in both customer service and tech support as we continue to transition to a remote work environment. Wait times on the phone will be much longer than usual. We ask that customers please only contact Dexcom support for urgent requests at this time. Dexcom is committed to communicating with our customers as the situation evolves. Customers should visit dexcom.com/coronavirus for the latest updates. We truly appreciate the patience being demonstrated by the diabetes community as we navigate these challenging times.” (Initial Response March 5, last updated March 23)

Insulet: “At this time, Insulet does not anticipate any product supply issues and will continue to deliver our Pods to those who depend on our product to manage their diabetes without any delays. We have systematic contingency plans in place and as part of our standard policy, we have built inventory and redundancy throughout our supply chain, all designed to mitigate against any supply shortages.” Click here for more information from Insulet on their coronavirus response. (Initial Response March 4, last updated March 23)

Insulet (Europe): “We are currently working hard to set-up our Customer Care team to work from home, this means that calls will take longer to be answered for the next few days and orders may be delayed by a day or so, do not be concerned, we have no supply issues and we will get your order to you there is no need to call or email to chase this. We are committed to get the service back to full strength to support you through this unprecedented time. Please utilise the website resources and email us with any non-urgent requests and contact your healthcare provider for any urgent medical queries.” (March 20)

Tandem: “As the global impact of the coronavirus (COVID‑19) continues to unfold, Tandem Diabetes Care has taken steps to protect the health, safety and well-being of our customers, employees and communities … Our manufacturing and warehouse facilities continue to operate as normal, as healthcare operations are deemed critical by the State … We are taking the current COVID-19 pandemic very seriously and are constantly monitoring the situation.If you are calling to speak with a member of our team in Product Technical Support, Sales Support, or Supplies Reordering, you may experience longer hold times or processing as a result of the actions we’ve taken in response to this uniquely challenging situation. We apologize if you do experience longer wait times and thank you for your patience and understanding.. For frequently asked questions and answers about accessing supplies during COVID-19, please click here.” (Initial Response March 11, Last updated March 24)

Medtronic: “Our top concern at Medtronic is the health and well-being of our employees across the globe and supporting our healthcare customers as they confront the COVID-19 virus. There is impact to our business as a result of COVID-19, but the duration and magnitude of that impact is difficult to quantify at this time because of the fluidity of the situation. At this time, we have realized no material impact from COVID-19 to our supply chain or product availability. This is a dynamic event and we will continue to monitor the situation and provide updates to our employees, customers and investors as the situation warrants.” Get the latest from Medtronic on their COVID-19 updates page. (Initial Response March 11, Updated March 17)

Roche: “Roche is working diligently to ensure the continuity of Accu-Chek products, and at this point, we do not expect supply chain disruptions related to the COVID-19 outbreak.” (Initial Response March 13, Reaffirmed March 20)

Senseonics (Eversense): On March 26, Senseonics suspended commercial sales of its Eversense CGM in an effort to reduce costs in light of COVID-19. The company will continue to distribute to current Eversense users.

General info

The FDA issued a statement on Feb 27 that they are “closely monitoring the situation,” and there have been no reports of direct impact to any diabetes products.

Be sure to renew and refill prescriptions well before you run out. If clinics and pharmacies become busy with sick people, or healthcare employees become ill, it may be harder to get routine care and supplies. A few actions you can take now:

  • Contact your physician and make sure all your prescriptions are current and have a maximal number of refills available. Consider back-up medications, like having long acting insulin on hand if you are a pump user.
  • You may be able to refill a prescription even if it is before the typical 30-day time window. Call your pharmacy to find out if your state and/or health insurance company has waived refill restrictions because of COVID-19.
  • Call your insurance company and find out if you can enroll to receive 90-day prescription refills via mail-order shipments.

For more information regarding your diabetes medications and health insurance during coronavirus, read this article.

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Mary Elizabeth Adams
Apr 20, 2020

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