Demand planning in an evolving pharmaceutical supply chain

On the face of it, product availability is a binary situation. Either a drug is in stock or it isn’t.

But there’s more to it than that. “In stock” doesn’t tell healthcare providers whether there’s enough supply to start and complete therapy, especially for antibiotics, chemotherapy, or maintenance medications. Neither does it clarify whether the right dosage and formulation are available, or account for constraints like patient cost and regulatory quotas

In practice, providers don’t experience availability in terms of what exists. They experience it through access, an important distinction in an environment where supply chain resilience has become a top priority.

Traditional demand planning doesn’t fully address this need. It focuses on forecasting volume and aligning supply, but these don’t necessarily answer the questions healthcare providers are asking.

To providers, availability and accessibility mean two different things. A product can be technically available, meaning somewhere in the network, but still inaccessible if the provider can’t obtain it in time with a reasonable level of effort. Said differently, availability is a supply-side condition, while accessibility is a patient-level outcome shaped by a range of factors in the business environment.

A range of healthcare supply chain challenges affect drug access. Key factors include:

Financial and payer dynamics

• Payer coverage. Coverage can determine whether a product is even considered a viable option.
• Tiered cost-sharing. Formularies use tiers to influence choices, putting brand-name and specialty drugs out of reach for many patients.
• Utilization management. Payers may further restrict access via prior authorization, step therapy, and quantity limits.
• Patient out-of-pocket costs. High costs may prompt patients to skip doses or abandon treatment altogether.

Market and evidence dynamics

• Clinical and economic evidence. Weak or evolving evidence can result in conditional access or slower uptake across the market.
• Competition from generics and biosimilars. While lower-cost alternatives can expand overall access, they may also limit use of branded products or reduce incentives to manufacture them.
• Timing of market access decisions. The gap between regulatory approval and final reimbursement can affect how quickly a product becomes usable.

Supply and operational factors

• Shortages. Drug shortages are among the most visible sources of biopharma supply chain risk. The supply of drugs—especially generic prescription items—is a persistent challenge, with between 8,000 and 10,000 individual national drug codes (NDCs) in some state of shortage at any given time.
• Manufacturing and quality oversight. Temporary production slowdowns or facility closures can occur as manufacturers respond to evolving quality standards and increased inspections by regulatory agencies. These measures play a critical role in protecting patient safety and maintaining confidence in the pharmaceutical supply. Disruptions tied to packaging, finishing, or remediation efforts can influence short-term availability, even as they strengthen long-term system reliability.

Policy and geopolitical factors

• Policy and regulatory changes. Evolving trade agreements, new regulatory frameworks, and other actions could impact sourcing and availability of products crucial to the pharmaceutical supply chain.
• Patient support and access programs. These programs can improve access, but long processing times may delay treatment.
• Global conflicts and geopolitical instability. Disruptions in certain regions can impact manufacturing inputs, financial flows, or transportation routes, potentially creating access challenges.

Demand planning works best when providers and healthcare entities work in close partnership with their distributors. Clear communication around patient populations, anticipated treatment needs, and expected utilization is foundational to predicting demand accurately and supporting access at the point of care.

With that shared visibility, demand planning can move beyond historical volume. Planning can begin at the drug family or therapeutic level and be translated into the specific formulations, dosages, and NDCs needed based on formulary and access considerations.

This shared approach changes demand planning in several important ways:

• Planning for real-world use. Demand planning expands beyond forecasting volume to where and how products will be used, enabling better inventory positioning to meet patient needs.
• Emphasis on actionable timing. Earlier, clearer signals help providers anticipate potential constraints and plan accordingly.
• Designing to reduce friction. Planning accounts for access barriers and works to simplify ordering and substitution complexity.
• Coordinated execution across functions. Demand planning aligns with allocation, communication, and access support so providers receive consistent, usable guidance.

Cencora’s C.O.R.E. (Commercial, Operational, and Relationship Excellence) investment reflects a broader shift in how availability and access are managed.

This effort is grounded in customer feedback. Across care settings, providers described many of the same challenges in their day-to-day workflows. C.O.R.E. addresses those challenges by bringing commercial insight, operational execution, and customer relationships into a more unified approach.

This helps supply decisions reflect real-time demand and gives providers greater insight into what’s happening across the network.

Within that context, C.O.R.E. applies advanced demand planning capabilities to improve resilience and responsiveness. AI-powered forecasting integrates customer, order, and market signals to deliver more reliable projections, even in volatile conditions. Machine learning models detect demand spikes and risks earlier, while explainable AI and scenario modeling show what’s changing and why. Together, these tools help Cencora teams evaluate trade-offs and take action before service levels are affected.

To understand what next-generation demand planning looks like in practice, consider vaccine seasons, which put added pressure on supply chains. In response, Cencora introduced enhanced preorder functionality, refined inventory positioning, and clearer contract and ordering standards. These changes enable inventory to be placed earlier and more accurately, reducing last-minute shortages and order backlogs. For customers, this means faster initial shipments and more predictable delivery timelines.

C.O.R.E. is supported by ongoing investment in infrastructure, data, and automation. Cencora has committed about $1 billion to upgrade its U.S. distribution network. These upgrades expand capacity, improve resilience, and support more complex therapies. They also enable better inventory visibility and more responsive fulfillment.

Availability will continue to be shaped by uncertainty. Although distributors can’t eliminate all sources of disruption, they can make disruption more manageable through better signals, tighter coordination, and systems designed around how healthcare providers actually experience access.