Before medicine reaches the hands of patients, there’s a complex, secure and reliable pharmaceutical supply chain driven by teams working around the clock to get it there. The pharmaceutical distribution industry is crucial in this process, linking approximately 1,400 manufacturers to over 330,000 care sites and facilitating the delivery of around 11 million products each day.
While the United States and Canadian pharmaceutical supply chains are currently the global gold standard, we must continuously work to strengthen the infrastructure, security, and scalability of our pharmaceutical supply chain to be “future-ready.” Stubborn challenges like drug shortages while relatively uncommon (impacting less than 1% of prescriptions), can have significant impact on patient health. And increasingly, many specialty products on the forefront of bio-medical innovation require innovation and investment in the supply chain, including specialized handling and storage.
Understanding the Challenges
The healthcare supply chain is under pressure from multiple fronts. Drug shortages, driven by increased patient demand, challenging economics, sourcing challenges for active pharmaceutical ingredients, and manufacturing disruptions, further exacerbate the situation. Natural disasters, like hurricanes, can incapacitate manufacturing facilities. While rapid advancements in cell and gene therapies, mRNA vaccines, and GLP-1 drugs are revolutionizing patient care, they also require innovative distribution solutions to meet specialized handling needs.
Taking a Collaborative Approach
Tackling these challenges requires a united front from federal, state, and local governments, nonprofits, the private sector, and the public. By strengthening the healthcare supply chain, we help ensure that critical supplies and medications continue to reach patients and healthcare providers in need. Public-private partnerships are vital for building resilience, particularly in managing supplies and emergency response.
McKesson partners with pivotal industry organizations and nonprofits such as the Healthcare Distribution Alliance (HDA), Duke-Margolis ReVAMP Consortium, Angels for Change and End Drug Shortages Alliance (ESDA) to sustain a resilient supply chain that benefits patients, healthcare providers, and customers.
Our business leaders maintain an active role within the ESDA, serving on both its board and committees, thereby fostering a robust partnership and collaboration. A notable instance of this collaboration occurred during the IV fluid shortage, where we sought to support the EDSA and its diverse supply chain members in better informing the industry around this situation for customers and their patients. We remain active in the various EDSA projects across supply readiness, quality and transparency.
Modernizing Operations and Embracing Digital Enablement
The development of rare disease drugs and specialty therapies have revolutionized patient care, yet they often demand specialized handling conditions, requiring the healthcare supply chain to modernize and keep up with such innovations. Many of these new medicines have shorter shelf lives and require precise inventory management, including tracking, temperature control and light protection. In some cases, these shorter shelf lives can even be patient-specific, necessitating tailored handling and storage solutions to ensure the efficacy and safety of the medications for individual patients.
To help meet the demand for emerging therapies, McKesson has invested in enhanced cold chain storage and quality controls. In 2023, we opened a new distribution center dedicated to specialty medications, with over 80,000 square feet for refrigerated, frozen, and ultra-low temperature products. This expansion allows us to handle the specialized requirements of these therapies safely and efficiently.
Another consideration is the integration of artificial intelligence (AI) and machine learning to optimize logistics, reduce costs, and improve efficiency. Predictive analytics using extensive datasets and algorithms also help us to make informed inventory management decisions, maintaining product availability and proactively addressing potential shortages.
Additionally, we have seen the opportunity to use automation technologies to replace redundant tasks, allowing our team members to focus on more complex, purposeful work, ultimately helping to boost productivity and job satisfaction.
Ensuring Supply Chain Security and Compliance
Another important factor that remains at the forefront is strengthening supply chain security and safety. A secure supply chain is crucial for patient safety, requiring strict chain of custody standards from manufacturer to patient. The Drug Supply Chain Security Act (DSCSA) aims to protect U.S. consumers by securing the supply chain from counterfeit or harmful drugs through electronic traceability mandates.
Over the past seven years, McKesson has prepared for DSCSA serialization compliance by implementing track and trace technologies. These include serialization, data capture, centralized data management, real-time tracking, verification tools, reporting, analytics, interoperability, and robust security measures, providing better visibility and control over the pharmaceutical supply chain.
The significant reduction in the risk posed by counterfeit medications serves as a testament to the improvements and collaboration within the industry. Through proactive measures such as Authorized Distributor of Record (ADR) designations and stringent regulations like the DSCSA, stakeholders have worked together to enhance the integrity of the pharmaceutical supply chain, ensuring greater patient safety.
Advancing Health Outcomes for All
Strengthening the healthcare supply chain is essential to face the challenges and rapid advancements in the industry. By modernizing infrastructure, embracing digital enablement, fostering collaboration and prioritizing security and compliance, we can provide safe and timely delivery of medications and treatments. McKesson remains dedicated to working with partners and stakeholders to build a resilient supply chain that meets the evolving needs of patients and healthcare providers, unlocking the full potential of our healthcare system and helping to advance health outcomes for all.

Gene Cavacini
Gene Cavacini is the Senior Vice President and Chief Operating Officer for McKesson’s U.S. Pharmaceutical segment. Gene oversees pharmaceutical sales, distribution, and customer service operations in the United States, leading more than 7,500 employees tasked with delivering one-third of America’s medicines.
About McKesson Corporation
McKesson Corporation is a diversified healthcare services leader dedicated to advancing health outcomes for patients everywhere. Our teams partner with biopharma companies, care providers, pharmacies, manufacturers, governments, and others to deliver insights, products, and services to help make quality care more accessible and affordable.