Status of the Medical / Healthcare Supply Chain

The supply chain has calmed down since the height of the pandemic; however, smart manufacturers are thinking ahead to changing conditions. Geopolitical risks are at an all-time high. The Russia-Ukraine war rages on and Israel and Hamas are at war which has spilled over to the Iran-backed Houthis rebels attacking container ships in the Suez Canal, disrupting a major shipping lane.

Additionally, China continues to threaten Taiwan which produces 90% of the advanced computer chips for the world and an important component in medical devices. China is also being very aggressive in the region which could impact shipping lanes through the South China Seas, manufacturing in China and manufacturing in countries in the region. Since China dominates the medical device supply chain, this is concerning. Thus, proactive manufacturers are moving towards regional manufacturing. This trend started following the pandemic (refer to our quote in a MPO Medical Products Outsourcing article) and has been picking up steam.

Reshoring & Expanding Manufacturing Capabilities

According to Xometry’s Medical Industry Survey, medical device manufacturers are rapidly reshoring operations to strengthen their domestic supply chains. In fact, 67% of medical device manufacturers are in the process of reshoring operations within the next 12 months. There is a focused effort in rethinking supply chain strategies.

Although many companies are reshoring, executives remain concerned about the cost impact of expanding production in the USA. The good news is that labor costs have decreased as a percentage of total cost dramatically since the offshoring craze while other costs have increased, making reshoring more attractive. For example, transportation costs were heightened during the pandemic and have been impacted by the Panama Canal drought, the diversions of the Suez Canal, and other supply chain disruptions. The cost of capital has increased significantly with the increase in interest rates which has made the cost of carrying inventory much higher. And there are many other costs to consider in the total cost to produce. In fact, the total cost of product can be equivalent or even less in the USA in some non-commodity situations.

Many advancements have been made in manufacturing and technology. Companies are automating and digitizing their manufacturing and supply chain. For example, they are using 3D printing/ additive manufacturing, robotics, artificial intelligence with IoT, and other advanced technologies to improve efficiencies and enhance visibility. As manufacturers expand their manufacturing footprint, source new regional suppliers and reshore production, these advanced technologies maximize operational performance and minimize cost while maintaining and improving customer service levels with lower inventory levels. Thus, margin concerns are mitigated depending on the upgrades and improvements to the manufacturing process.

In the medical device industry, companies are starting to expand regional manufacturing in the USA. For example, Ascential Medical & Life Sciences is reshoring to Minnesota. Their new state-of-the-art facility has highly innovative automation solutions, making reshoring financially viable. Certainly, they are not alone. Companies are expanding operations in the USA.

Manufacturers are also nearshoring to the region. Mexico has expertise in medical devices and the ability to scale. Since customer requirements are significant in North America, the ability to scale in the US and Mexico is a relevant factor. The availability of advanced manufacturing and technical skills is also an important factor. Medical grade material supply can be sourced nearby, and the USA is ramping up computer chip manufacturing capabilities. For high labor component products, Mexico provides an excellent option because their labor rates are lower than China, and they benefit from the USMCA agreement between the two countries.

Although the USA and Mexico are great options with scale, there are additional medical device manufacturing hubs in other nearby countries. For example, Costa Rica has advanced skills, computer chip manufacturing, and therefore a thriving medical device manufacturing concentration. The Dominican Republic has medical device manufacturing, and Puerto Rico is known for pharmaceutical manufacturing.

Manufacturing Resurgence

There is no doubt that the successful companies will mitigate risk and manufacture regionally. Thus, the USA, Mexico and business friendly countries will experience a resurgence in manufacturing in the next decade. It will require investments in manufacturing, tooling, and other resources although there are opportunities to keep costs intact or even reduce total product cost.

The most successful companies will upgrade their processes, ERP systems, utilize advanced technologies, maximize customer and product profitability and proactively manage these opportunities with a SIOP (Sales Inventory Operations Planning) process. Assess your supply chain to learn how you stack up. Take our complimentary supply chain assessment. Upgrade, innovative, get ahead of the competition, and thrive.

If you are interested in reading more on this topic:
Why Manufacturing Matters and Will Thrive in the Next Decade

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Manufacturing Matters – Safety & Security

Manufacturing promotes safety and security and mitigates risk. Controlling your supply chain and mitigating geopolitical risk can become paramount overnight as geopolitical events occur, natural disasters emerge, and supply chain challenges arise (strikes, disruptions, shortages). These types of issues have been increasingly concerning with recent events.

For example, the war in the Middle East has caused disruptions in the Suez Canal. Container ships are being diverted and traveling around the southern tip of Africa, adding 10,000 miles and 7-10 days. This situation delays critical supplies and causes further inflation with increased costs. Additionally, the reason China has been threatening Taiwan is partially to gain control over 90% of the world’s advanced computer chips that go into everything from medical devices to critical infrastructure.

During the pandemic, the U.S. discovered it was dependent on China for critical supplies and everyday necessities. Not only can a worldwide pandemic cause disruptions of these supplies, but country specific policies can dictate whether your supply will be cut off. For example, China rolled out zero COVID policies, directly impacting production and shipping to the U.S. China could prioritize who received limited supplies.

China also wants to control the Red Sea and could decide to cut off supplies produced in other Asian countries in the region. Clearly China thinks manufacturing is essential to national security. For example, their shipbuilding capabilities are over 200 times greater than the U.S. According to the Maritime Executive, China produces more than half of all new tonnage in the world. These types of statistics are gravely concerning and the proactive will build capabilities.

Manufacturing Will Thrive in the Next Decade

As companies realize they must gain control over their supply chain to better support customers, reshoring and regional expansion of manufacturing capabilities will soar. Additionally, the cost has come into alignment for non-commodity products if you evaluate the total cost to produce, ship, store, protect, etc., China won’t have the advantage. Piles of inventory tying up cash unnecessarily are no longer acceptable, especially as customer needs change rapidly, increasing the risk of obsolescence. As interest rates soar, this situation is untenable.

Customers are not willing to accept prolonged periods of delays and stock outs. Thus, they are taking control of their supply chain and focusing on manufacturing capabilities. In addition, companies must prioritize customers and address proactively with strategic pricing and capacity decisions. Thus, smart companies are utilizing a SIOP (Sales Inventory Operations Planning) process to proactively navigate these changing circumstances to maintain high levels of customer service, profitability, and working capital results. SIOP will bring visibility to customer and product profitability, sourcing decisions, make vs buy alternatives, capacity bottlenecks and more.

The proactive will thrive and have more opportunities than ever expected. In fact, they will be in the catbird seat. The rest will continually struggle and weaken. With the significant skills gap (refer to our recent article on where the talent has gone), the proactive executives are hoarding the “best of the best” (employees, trusted advisors, suppliers, etc.). Are you prepared to thrive?

If you are interested in reading more on this topic:
SIOP/ S&OP: Proactive Approach to Maximizing Production Output and Capacity

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With sustainability increasing in popularity and the carbon footprints of end-to-end supply chains evaluated, innovation and manufacturing will skyrocket.

Top manufacturers are prioritizing common-sense sustainability solutions to drive triple-bottom-line results. In fact, there is a significant opportunity for U.S. manufacturers to expand capacity and gain business with a significant advantage in sustainability over China and other manufacturing options. As sustainability continues to increase in popularity and end-to-end supply chain carbon footprints are evaluated, U.S. manufacturing will skyrocket. Technological advances and innovation drive sustainable manufacturing, and, according to the WIPO Index, the United States is one of the top countries in innovation.

Manufacturers are making significant strides in sustainability. There is a focus on sustainability in materials, manufacturing, product life cycle, and logistics. There are countless ideas for improving performance. For example, manufacturers are building sustainability into product design and partnering with suppliers to reduce materials, minimize waste, design for low-impact materials, and transport with a sustainable supply chain. In manufacturing, they can optimize processes to consume less materials and conserve energy and natural resources. There are a host of logistics programs rolling out across the board as well. For example, as regional manufacturing occurs, the distances travelled will be reduced, and as cleaner, energy-efficient modes and options are pursued, sustainability improves.

Pertinent Examples

According to GE, it launched the CFM RISE (Revolutionary Innovation for Sustainable Engines) Program as a part of its commitment to achieve aggressive goals for a sustainable future, including reducing fuel consumption and CO2 emissions by more than 20%. P&G is focused on water usage. Its goal is to increase water efficiency by 35% per unit of production and to recycle five billion liters in its facilities worldwide. Tesla is continually focused on sustainable manufacturing. For example, Tesla recently announced its goal to reduce the use of silicon carbide by 75%, significantly reducing its use of rare earth metals. Instead, the use of a permanent magnet motor will allow the company to scale production more efficiently.

Similarly, a healthcare products manufacturer put together a program to partner with suppliers to redesign materials to decrease usage without impacting product quality and manufacturability. Additionally, the manufacturer brought in the equipment supplier and raw-material supplier to assess how to best utilize its machine to minimize usage and waste, and installed visual inspection equipment to minimize waste due to quality defects. And finally, the manufacturer also brought its customers into the process to assess packaging to minimize plastic and packaging materials while ensuring that the product met the customer requirements, which positively impacted the sustainability of transportation as well.

Regional Manufacturing and Logistics Examples

For a multitude of reasons stemming from the pandemic, including supply chain risk and political risk, the transition to regional manufacturing clusters and reshoring/nearshoring of manufacturing is rapidly increasing in the United States and Europe. China is far less sustainable. For example, China is using the least efficient energy source that emits twice the amount of greenhouse gas than natural gas. According to NPR, China permitted two coal plants a week in the last year, which is six times more than the rest of the world combined. On the other hand, the United States uses mainly natural gas and has advanced manufacturing practices, frequently producing with the lowest emissions in the world.

The logistics arena has also made vast improvements. For example, according to PMSA, the San Pedro Bay Ports together saw steep and dramatic emissions reductions in 2022. The combined numbers reveal drops of 90% for diesel particulate matter (DPM), 97% for sulfur oxides (SOx), 63% for nitrogen oxides (NOx), and equally remarkable declines for other emission categories, compared to the baseline year of 2005. Cleaner, smarter transportation is also a high priority with a multitude of sustainability initiatives being pursued across all modes of transportation including rail, truck, pipeline, and air.

Innovative organizations are partnering with their end-to-end supply chain to create sustainable supply chains. The best-in-class companies are driving the triple bottom line with benefits to people, profit, and the planet. As sustainability gains momentum and end-to-end supply chain visibility is achieved, a manufacturing resurgence will follow.

If you are interested in reading more on this topic:
Sustainability Gains but the Technology Isn’t Always Ready

Originally published in Adhesives & Sealants Industry, November 2023

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Manufacturing appears to be turning the corner. According to the ISM, the Purchasing Managers Index (PMI) recorded a contraction but at the slowest pace of the recent cycle. In fact, this is the third straight month of improvement. The expansion of the PMI is indicating a recovery on the horizon for manufacturing.

S&P Global also surveys the economy, and their statistic shows that manufacturing is near stabilization. Their Purchasing Managers’ Index came in at 49.8 with production increasing at a marginal pace. Thus, the most respected surveys align and are trending positive for manufacturing.

Manufacturing Expansion Beyond the Statistics

Beyond the economy’s signals, manufacturing has the potential to surge. Whether reading surveys, talking with clients or collaborating with colleagues, it is clear that smart executives are expanding manufacturing footprints, reshoring from Asia, and finding regional partners to increase manufacturing. According to a poll conducted by Forbes, Xometry, and John Zogby Strategies, 82% of CEOs have already implemented — or are actively pursuing — reshoring strategies.

These expansion and reshoring activities will accelerate the manufacturing resurgence. The bottom line is that manufacturers are realizing that the risks associated with China, manufacturing long distances from key customers, and other geopolitical conflicts and wars such as the Russia-Ukraine war are simply too high. Forward-thinking executives are taking control of their ability to serve customers. To read more on this topic, read our article “Take Control of Manufacturing to Wrestle Volatility to the Ground.”

Where Should Manufacturers Focus?

There will be more opportunities than ever before as prepared, innovative, and resilient manufacturers will have the opportunity to take market share as they can service customers with ever increasing expectations in a scalable, profitable manner. Unfortunately, the rest that rest on their laurels, reacting as events unfold will not be able to keep up with key customer needs and gain traction quick enough to succeed in today’s volatile environment where customers expect customized products, personalized service, with rapid execution and innovative solutions.

Thus, during manufacturing month, we should be thinking five steps ahead of the competition. Don’t just bring manufacturing back; instead, think about expanding manufacturing in a new way. Automate where it makes sense (starting with repetitive tasks), digitize so that there is supply chain visibility and resiliency, utilize 3D printing and additive manufacturing to slash product development lead times and produce custom products on demand, analyze what if scenarios with digital twins, leap forward with AI and predictive analytics, and ensure your foundational processes, ERP system and related technologies are on solid footing.

Become passionate about talent and leadership. Our most successful clients retain top talent. There are no exceptions. Without your #1 asset, there will be no business. With the rate of retirement and the future of the workforce, there is a large gap to sustain business, let alone thrive in the next decade. Fundamental topics are arising at clients at a quick pace. Inventory accuracy, order fulfillment, and other bedrock topics can be much more challenging than they appear.

Only those who invest in proactive processes such as SIOP (Sales Inventory Operations Planning), dedicate the time to training, education, and development, and prioritize proactive organizational development and supply chain partner relationship building efforts will succeed. Yet this is still not enough. Innovation and resilience will be required to succeed during these turbulent times.

The Bottom Line

A manufacturing resurgence is underway. The only question is whether you will jump in and take control of your destiny or observe from the sidelines.

If you are interested in reading more on this topic:
Taking Control: Reshoring, Nearshoring, Friendly Shoring & Manufacturing Expansion

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Manufacturing is making a resurgence in the U.S. and other countries around the world. According to the U.S. Bureau of Labor Statistics, there is a shortage of 550,000 stable manufacturing jobs to be filled in manufacturing businesses nationwide. There is no doubt the Skills Gap is in full force if you observe manufacturers offloading, prioritizing customers, and struggling to fulfill demand because of a lack of people. In union industries, employees are threatening strikes and across the board, wages are increasing which leads to intense inflationary pressures. It is a tricky time to navigate yet the best will figure out how to scale successfully.

The Resurgence Will Continue

The manufacturing resurgence will continue as businesses address extreme supply chain risk, unpredictable costs, the need to meet changing customer needs, and U.S. incentives ramp up. For example, Joseph P. Quinlan, head of CIO Market Strategy at Merrill and Bank of America Private Bank has described the current environment in the U.S. in a June 2023 market outlook report, as “the early stages of a manufacturing supercycle pivoting around renewable energy, electrical vehicles and batteries/charging stations, and semiconductors, in addition to rising spending in more traditional areas like ports, highways, grids, airports and the like.” As of April, spending on manufacturing construction — new factories was tracking at a $189 billion annual rate, triple the average rate in the 2010s ($63 billion).

In consulting with manufacturers how to leverage SIOP (Sales Inventory Operations Planning), supply chain management, and ERP to scale successfully, it is clear that there is plenty of scrutiny on make vs buy decisions (reshoring, nearshoring, offloading, expanding capabilities), customer and product profitability analyses, and strategies to scale successfully to meet customers’ requests and expansion plans. The resurgence will continue yet talent remains scarce.

Fulfilling the the Need for Expansion & Scale

There are several strategies smart manufacturers are pursuing to fulfill the need for expansion and scale as it relates to talent. The most successful include the following:

• Training & development: There is a renewed interest in training and developing employees to expand their skills and learn about new and advanced methods to perform their roles.
• Mentoring: One of the best ways to accelerate the learning process is to find a mentor. Mentors bring experience to the table and provide insights that cannot be found in a book. Exemplars can show the way forward. If you can entice experienced employees and retired employees to provide guidance, progress will be robust.
• Apprenticeship programs: Manufacturing thrives on apprenticeship type programs with on-the-job training with immediate feedback and corrective information.
• Automation, robotics & digitization of the supply chain: Only the successful will look for ways to automate whatever is repetitive, use robots for those tasks that can run through the night without interaction, and digitize the end-to-end supply chain to bring efficiency and to more quickly meet customer needs.
• 3D printing / additive manufacturing: Why produce what you can print upon demand? If an aerospace engine and a miniature house can be printed, what’s holding you back?
• ERP & related technologies: Every client can better use their ERP system to achieve results and automate mundane tasks. Prioritize utilizing this already-existing asset and expand the use with related technologies such as artificial intelligence (AI), IoT (internet of things), digital twins, AV/VR (audio visual/ virtual reality), and much more.
• Retention: Often, the most successful clients are simply those that retain key talent. It sounds easy, but it requires effective leadership, flexibility, investment into employees (training, cross-training, experiences, etc.), and competitive compensation. People follow people. People do not follow companies.
• Supplement your employees: We are not the typical supply chain consultants as we will jump into the details with a client and partner with key resources to bring results to fruition. More and more clients are pursuing this type of strategy to supplement their workforce by providing support to key talent while advancing their capabilities and ensuring results. To learn how to select a supply chain consultant, read our article.

As the manufacturing resurgence accelerates, the need for talent will increase. Employ key strategies to fulfill this demand for talent and address the Skills Gap. Please contact us with your success stories and your questions for how to succeed during these volatile times. And, please keep us in the loop of your situation and how we can help your organization get in a position to thrive for years to come. Learn more about these topics in our blog and download your complimentary copy of our recently released special report: The Road Ahead: Business, Supply Chain & The World Order

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According to the National Association of Manufacturers (NAM), 82% of manufacturers remain at least somewhat positive about their company’s outlook. This statistic is especially interesting since 59% thought continued inflation would make a recession more likely in the next 12 months.

Perhaps manufacturing should be even more positive as reshoring ramps up as companies realize they need to take control of their production. Are you getting ahead of this trend?

Reshoring Rises Rapidly

Reshoring and foreign direct investments (FDI) job announcements hit a record in 2021, according to the Reshoring Initiative’s 2021 Data Report. According to the report, the year-over-year increase is almost exclusively due to companies filling the supply chain gaps of essential products including electronic batteries, semiconductors, PPE, pharmaceuticals, rare earths, and renewable energy. At least 63% of the projects reshored were from Asia with the South being the most popular region for reshoring. Texas and Tennessee were the top two states for the number of jobs announced.

Opportunities Abound

Even though reshoring is rising rapidly, it is not fast enough. Manufacturing will have to run faster to keep up with the demand. Companies have realized the lengthy lead times from Asia are unacceptable. Most certainly, the inability to pivot rapidly to changing conditions is unacceptable. Customers change their mind. Having a minimum of 13 weeks of inventory in the extended supply chain while easily double that amount during times of supply chain chaos is unacceptable. Being dependent on suppliers that can triple container shipping prices with extended delays is unacceptable. Running out of warehouse space to store the “wrong” products in the “wrong” place is unacceptable. Thus, companies are taking control and expanding manufacturing capabilities, whether internally or through partnerships.

For example, there is a vast need to expand the manufacturing of computer chips. Even though Intel and Taiwan Semiconductor are expanding in Arizona and Samsung and Texas Instruments are expanding in Texas, it is a drop in the bucket in comparison to U.S. demand since they are used in everything from cars to medical devices to electronics. There will be more opportunities for manufacturing in the next few years than ever before. Similarly, there will be vast opportunity for companies to secure their market position for decades to come. Will you be prepared to grow during inflation, deflation, supply chain disruption and whatever else is thrown your way?

Please keep us in the loop of your situation and how we can help your organization thrive during these times of volatility and disruption. There will be more winners created than at any other time than since emerging from the Great Depression. To gain additional ideas and insights on how to best navigate these volatile times and thrive, read our new eBook Thriving in 2022. Learning from Supply Chain Chaos. Download your complimentary copy.

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There will a resounding resurgence of manufacturing near-term. According to a new report from The Reshoring Initiative®, reshoring broke records in 2020 and exceeded foreign direct investment (FDI) for the first time since 2013. Not only did it beat FDI, but it beat it by nearly 100%! Also, according to the National Association of Manufacturers (NAM), the vast majority (88%) expect sales, production, and prices to increase next year despite the supply challenges. Clients across the board are experiencing these same trends. Thus, there will be organic growth as well as reshoring growth. Why has this resurgence taken off by leaps and bounds?

During COVID, clients and colleagues realized there was far too much risk in their supply chain. For example, a client in Europe thought they had a backup source of supply to their China supplier because they had a secondary source in India; however, when COVID hit, neither supplier could deliver the requested materials. Another client had identified a backup source; however, they did not utilize the backup source on an ongoing basis. Thus, when COVID created disruption in the supply chain, the backup source was busy and had to prioritize current clients. Additionally, even those with backup sources realized the length, complexity, and critical risk (IP, political, etc.) of their end-to-end supply chain. Thus, clients are reevaluating their supply chain and reshoring/ near-shoring at least a portion of their supply chain.

On the other hand, companies already manufacturing in the U.S. gained an advantage. Not only were the majority considered essential and so could continue producing during lockdown, but they were able to take advantage of opportunities to support companies that couldn’t get enough supply to satisfy their customers. Customers realized the importance of suppliers that were able to meet their needs and those that used creativity, innovation and unique partnerships to meet changing needs, and they rewarded them with increased sales. Additionally, as is occurring with a plastic injection molding client, volumes are increasing even further as companies decide they prefer a regional source of supply and want to make the transition rapidly. This plastic injection molder has more business than it can handle even though the company has continued to expand capacity.

Last but not least, the pandemic is separating the weak from the strong. The businesses with minimal cash reserves are going out of business or struggling mightily. Customers still want product and are shopping elsewhere. Additionally, COVID has spurred the early retirement and/or change of career and lifestyle of countless leaders. This is especially true with family-owned businesses. Multiple clients have sold and/or are in the process of selling so that they can enjoy retirement and slow down. Unfortunately, the personalized service is often not as robust with the company that takes over, transitioning additional volume to the proactive manufacturers willing to treat customers as they have become accustomed.   

The business will be there if you jump into action, prepare to scale, and look for opportunities. You don’t have time to take the continuous improvement path if you want to leverage the opportunity. Instead, you must take on risk and pursue an aggressive path to grow and scale. Start with a rapid assessment of your market and differentiators, reconfigure your manufacturing footprint and extended supply chain to best support your future customer and market needs, and prioritize what’s essential to scale rapidly. Beyond these strategic priorities, the most successful clients are focusing attention on supply chain resilience, talent, and digitization/ data. Those that focus on these priorities will gain ground rapidly and will pull quickly ahead of the competition. There will not be another opportunity of this magnitude during our lifetime, similar to the period immediately following the Great Depression. Are you prepared to thrive?

Lisa Anderson

As originally published in Brushware Magazine on November-December 2021

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According to a recent National Association of Manufacturers (NAM) survey, the vast majority (88%) expect sales, production and prices to increase next year despite the supply challenges. In working with clients across multiple industries such as biotech, building and construction products, and food and beverage, there is no doubt that sales continue to rise (with a few fits and starts due to the extended supply chain disruption) and the focus and concern is on how to expand capacity and scale up successfully to serve customers while not losing control of EBITDA performance.

In addition, there is VAST concern about the risks exposed during the pandemic. This has been further heightened with the changing political landscape. There will be a rush to reshore, nearshore and reconfigure the end-to-end supply chain. Additionally, I expect there to be a transformation with the strongest thriving and growing and the weakest transitioning out. Are you ready for a resurgence?

What Should We Consider and/or What Impacts Could Arise?

• Think 3 steps ahead: How are you positioned to take advantage of this opportunity? Start thinking as if you were playing chess and think 3 steps ahead.
• Reconfigure your supply chain: Plan for what you need to leverage the opportunities successfully.
• Shore up your down-the-line weaknesses: As this transformation takes place, where will your weaknesses show up? Start overcoming them immediately and ignore what won’t become a bottleneck.
• Implement SIOP (Sales, Inventory, & Operations Planning): You must have a process in place to improve the predictability of your revenue plan and integrate the core processes within your business to scale and achieve financial results. See a client video on the impact of SIOP.
• Hoard talent: The most successful clients are hoarding talent. There is a severe shortage of talent. People have choices. Is your company compelling people to work for you?
• Digitize the supply chain: To thrive in the new world with the resurgence of manufacturing, you must digitize your supply chain. Start immediately. Ramp up even faster. Yet maintain a common sense view.

Please keep us in the loop of your situation and how we can help your organization successfully navigate the current volatility and emerge above and beyond. Several of these types of topics are included in our eBooks such as The Road Ahead: Business, Supply Chain & the World Order.

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