MedSC 2014 Spring Meeting. Managing Field and Consignment Inventory. June 4, 2014

Transcription

1 MedSC 2014 Spring Meeting Managing Field and Consignment Inventory

2 Industry trends and drivers for transformation 1 Health Reform & 2 Growth Outside 3 Mergers & 4 Cost Pressures the U.S. Acquisitions Regulatory Scrutiny Reimbursement pressures on providers = pricing pressures on suppliers Value & service becoming more important as physician influence decreases Companies need to offset Med Device Excise Tax through cost efficiencies and pricing / bundling strategies U.S. & Western EU expected to grow less than rest of world Cent./East. Europe region expected to grow fastest Strong growth expected in Asia Pac with China leading Value of acquisitions by top 25 pure-play medical device co. s grew over 250% from 2008 to 2011 Additional deals and PE activity continue at a healthy pace Device related FDA inspections increased 18% between 2009 and 2011 Device related Warning Letters increased 86% between 2009 and 2011 FDA pursuing more robust inspection program on globalized supply chains Medical Device companies need to respond with new strategies, business models, and operational capabilities 2

3 Common challenges that create daily crises Region Rep 1 Rep 2 Rep 3 Rep 4 Rep 5 Once inventory or a set / kit leaves the main warehouse or forward stocking location, we lose visibility to the inventory and more importantly, control of the inventory and the ability to return it Need Set Find Set Move Set so when inventory is needed for a surgery, we employ a manual, reactive process to find and transfer the inventory if it s not available from the main / regional distribution point Use Set Return Set Why? 1. We rely on legacy practices not fact based decision making to manage the inventory dynamic in light of patient needs and strategic account management 2. We don t employ more analytical, data-based process for making crossfunctional decisions about where and why to deploy inventory 3

4 Challenges with the orthopedic supply chain Traditional orthopedic loaner kit and consignment models were established to: Provide the highest level of service to ensure no surgery is missed Allow sales reps to carry inventory directly into surgery theaters and hospital ORs Develop deep sense of trust in a device company s products and services Challenges Sales Reps and Distributors expect inventory to be widely available on relatively short notice Traditional supply chain planning techniques demand planning, inventory management are not robust Networks have evolved and not been strategically designed Visibility to inventory is limited once it leaves the warehouse Implications Significant investments in kit and loose inventory Expediting and crisis management is the norm for inventory supply management Network nodes don t have the capability or capacity required to support regional / local demands Field inventories are closely guarded Significant losses from obsolescence or write-offs 4

5 Guiding principles inform the strategy People, Process, Technology Alignment with Commercial Strategy; Enable top line revenue growth through access to strategic markets for existing product lines and new product launches Supply Chain Segmentation; Supply chain will be designed to meet the unique requirements of Markets, Customers, and Products (i.e. special handling, high demand) Distribution Network and Transport Design; Agile, lean, and responsive integrated delivery network that ensures customer delivery within 12 to 24 hours Minimize Investments; Leverage existing distribution capabilities to accelerate implementation time-lines, and minimize one-time start up expenses and on-going operational cost Mitigate Risk; Create network capabilities that improve regional / local responsiveness and optimize inventory investments Partner Capabilities; Leverage distributor and 3PL capabilities to optimize the balance between responsiveness and costs Performance Management and Metrics; Performance metrics for managing inventory, costs, quality, and delivery performance are jointly agree upon and enforced through SLAs Technology; Combine mobile apps and ERP to create and maintain visibility and accountability 5

6 NuVasive, Inc. A case study in creating inventory visibility, availability and accountability 6

7 Today s challenges are focused on 4 key areas 1. Lot Traceability - Once a kit or shipment of loose implants leaves the DC, lot traceability is either lost or very difficult to maintain - Lot traceability is not only important for field actions, but for maintaining traceability and accounting of inventory in the field 2. Field Transfers - It is common for kits / inventory to be transferred from Rep to Rep, Hospital to Hospital, etc. - Unless physical movements and transfers are mirrored in the system of record, lot traceability, consumption, billing and inventory reconciliation are all difficult to achieve / maintain 7

8 Today s challenges are focused on 4 key areas 3. Set Utilization - No standard benchmarks for minimum utilization; set utilization generally accepted as low - Need to segment customers / sets by high runners and strategic accounts and accept that utilization will be different 4. Inventory Control and Return - Once a kit or shipment of loose implants leaves the DC, it is very difficult to get that inventory back into the DC - Sales Reps and Distributors don t trust that they ll get the inventory back in time, and this creates a difficult inventory management cycle 8

9 Significant issues and impacts Starting in 2011, senior leadership sponsored a key initiative to understand and address significant inventory management issues and their related operational and financial impacts Issues Inventory traceability and accountability in the field was difficult Significant expense for expedited shipping to move inventory to where it was urgently needed Sales Reps were spending an increasing amount of time managing field inventory Impacts Significant expense for expiry, obsolescence and loss of inventory Sales Ops was constantly in daily crisis mode, spending too much time on expediting and not enough time on sales support / growth Sales Reps were increasingly unhappy with inventory management capabilities 9

10 Designing the Future State: Surgery to Settle Goals 1. Assume support of 100% of surgeries, and On-Time / In-Full inventory availability, will always be #1 priority 2. Create an end-to-end Surgery to Settle model Keys to Success 1. Develop mobile applications that allow Sales Reps to schedule surgeries, order inventory required to support surgeries, and submit surgery charge sheet information 2. Create ERP capabilities for sales order processing, inventory deployment, and postsurgery sales order and inventory reconciliation 3. Create tools that allow Sales Ops and Supply Chain to see where inventory is and deploy that inventory effectively, reducing expediting and crisis management 4. Obtain buy-in, early in the change journey, from Sales Reps and Sales Ops Achieving the Future State will require enterprise-wide change management, not a series of one-off fixes 10

11 Key Component #1: Loaner Kit Management Attribute Core Functionality Key Dependencies Operational Issues Addressed Inventory Issues Addressed Description Improvement of end-to-end loaner management processes: Set Build, Surgery Scheduling, Billing, Replenishment, Set Transfer, and Audit/Reconciliation Enable capture of set serial to provide link between set and implant inventory Improved set planning, surgery fulfillment, asset reconciliation process, field inventory recovery processes, consolidated returns processes, set usage, and controls Improved set inventory visibility, inventory accountability, set audit and reconciliation processes 11

12 Key Component #2: Loose Inventory Management Attribute Core Functionality Key Dependencies Operational Issues Addressed Inventory Issues Addressed Description End-to-end par level processes: Initial Fill-Up, Billing, Returns, Shelf Life Expiration, Replenishment, Cycle Counts Mobile Solutions and Tools, as well as data extraction, cleansing, and conversion are key elements More efficient planning and replenishment processes, as well as improved adherence to par levels Improved field inventory visibility and Sales Rep accountability 12

13 Key lessons learned 1. Increased inventory visibility, at multiple levels, and increased trust in the data is required 2. Increased inventory utilization in the field, and turnaround from DCs / Hubs, will be required to minimize incremental inventory investments 3. Sales Ops and Supply Chain must collaborate to balance daily priorities and streamline processes and communications 4. New metrics and reporting capabilities are just as important as new DCs / Hubs 5. Revision of SOPs and consistent enforcement of policies including incentives and penalties will be required to support new system 6. Sales order and replenishment process optimization should accompany network and inventory management system optimization 13

14 Questions? 14