Cell therapies represent some of the most logistically complex treatments ever created, with quality and viability dependent on seamless coordination across multiple steps. With the first CAR-T therapies now approved, and more companies entering this new terrain, managing the cell therapy supply chain has become a mission-critical industry skill. We asked two supply chain experts from our parent company, the National Marrow Donor Program® (NMDP)/Be The Match®, how they manage inevitable interruptions when lives are on the line.
Q: Why is contingency planning important in the cell supply chain?
Cullen Case, senior manager, Logistics and Emergency Preparedness: Successfully delivering cells from a donor or patient to a hospital or manufacturing site is a complex, multi-step process. Because cells must often travel long distances to reach their ultimate destination, interruptions are inevitable, whether it’s a delayed flight or a major incident such as a hurricane that shuts down air transportation in the region or political unrest in a recipient’s home country. Our job is to manage these issues proactively because any unforeseen incident has the potential to disrupt the supply chain.
Ray Hornung, manager, Logistics and Business Continuity: About half of the 20,000 cell and blood sample shipments we oversee each year are shipped internationally. We conduct a constantly playing orchestra to ensure that all the pieces that are needed to support a delivery are always in place. We have team members on call 24 hours a day, so the couriers responsible for transporting our products always have the support of the organization behind them.
Q: How does your team respond to challenges that threaten to interrupt the cell therapy supply chain?
Cullen: When we are alerted to an incident that might disrupt operations, we bring together a collaborative, multi-departmental team to assess what the potential impact might be, then develop an action plan to ensure safe delivery of cells.
Ray: Our ability to respond quickly in a crisis is due in large part to the relationships we have with people and organizations across the supply chain, including hospitals, apheresis centers and cord blood banks. In addition, our personal affiliations within the national and international emergency management communities provide a myriad of contacts to tap when external resources are needed. We rely on a deep network of partnerships developed by NMDP/Be The Match, which has more than 30 years of experience managing more than 80,000 hematopoietic cell transplants across the world. We tap into these personal relationships when we need to enact a contingency plan.
Q: What kinds of disruptions have the organization responded to in the past?
Cullen: In 2010, the eruption of the Icelandic volcano (Eyjafjallajökull) prevented most commercial aircraft from crossing the Atlantic. We called in our contingency planning team, and partnered with other European companies who urgently needed to move products in the U.S. Together, we chartered an aircraft and diverted all our products through Portugal to safely bring them to patients in need.
More recently, during Hurricane Harvey, our team kept a close eye on the storm, and rerouted a number of couriers to ensure they would not be in the hurricane’s path. We had one patient awaiting a transplant in Houston, and a courier lined up to go, but all flights were cancelled. The courier had to fly to San Antonio first, then was rerouted at the last minute to Dallas where he would need to be driven to Houston. Then the emergency manager at Texas Children’s hospital stepped up to help. Although not affiliated with the receiving transplant center in any way, he arranged to have a high-water vehicle standing by (pictured above) if the car transporting the courier ran into issues with flooded roads. Luckily, the car driving the courier was able to make it through and arrived at the transplant center shortly after midnight. The product was successfully infused.
Q: What are you most proud of in your work?
Ray: The cells we collect, transport and deliver are irreplaceable. We use the phrase “one product, one patient” to emphasize just how critical our role within the organization is. Our team is a well-oiled machine. We’re scalable and flexible. We put great care into ensuring that we deliver products safely from the donor to their ultimate destination.