The traditional debate around central depots vs domestic supply is now giving way to more flexible models, helping sponsors navigate complexity better while controlling costs, according to Sharp Clinical’s Mike MacNeir and Lindsay Moir.
The design of depot strategy has long been framed as a fundamental trade-off within the clinical trial supply chain. Sponsors historically balanced regional hub models, optimized for cost and operational efficiency, against domestic depot strategies, designed to deliver speed, control, and regulatory compliance.
But for years, the decision was binary: regional versus domestic, or efficiency versus responsiveness.
Regional hubs offered clear advantages through centralized inventory, reduced infrastructure, and scalability across multiple countries, whilst domestic depots, by contrast, enabled faster resupply, stronger alignment with local regulations, and improved responsiveness to site demand.
However, this once binary trade-off is now breaking down as a broader set of factors comes into play.
Advances in forecasting, pooled supply strategies, IRT-driven resupply, and real-time supply chain visibility—alongside the growing adoption of just-in-time and direct-to-patient models—are reshaping how clinical trial supply networks are designed and operated.
As a result, the paradigm is shifting from one of compromise to one of optimisation. Rather than choosing between regional efficiency and local responsiveness, organizations must adopt a more integrated mindset. One that leverages regional hubs for cost efficiency, scale and flexibility of supply whilst using domestic depots to deliver speed, compliance, and risk mitigation, and local distribution channels to support patient-centric delivery and broader accessibility. This evolution requires a deliberate redesign of supply strategies, where each component is orchestrated to complement the others, rather than acting as trade-offs in isolation.
Rather than choosing one model, many of Sharp’s customers are combining these approaches and asking Sharp to design supply chains that are fit-for-purpose at each phase of a study.
At the core of this request is flexibility.
What does a flexible supply model look like?
Modern clinical trials require supply strategies that adapt in real time, that can respond to to shifting enrolment patterns, protocol changes, and geographic expansion. Flexible supply models allow sponsors to locate inventory dynamically, adjust distribution routes, and tailor approaches by region – moving away from fixed designs towards responsive, data-driven networks.
This adaptability is critical when evaluating the true cost of traditional supply chain models. While a single regional depot may reduce the upfront infrastructure and depot spend, the downstream impact can be significant and often is overlooked.
For example, positioning Singapore as a central hub for the APAC region may appear cost-effective on paper. However, requirements such as single use import licenses, local regulatory processes, or repeated release activities also need to be considered. These factors can not only introduce additional administrative burden but can drive incremental costs through repeated handling, documentation and compliance activities. Beyond the direct costs, these hidden factors may result in longer lead times, increased risk of delay and reduce responsiveness to site demand. In practice, what appears to be a cost-efficient centralized model on paper might lead to higher total operational costs, greater complexity, and potential disruption to trial timelines.
A flexible model addresses this by balancing centralized efficiency with local responsiveness. Rather than relying on a single structure, it uses a combination of regional hubs, local depots, and adaptive distribution pathways—allowing supply strategies to evolve as study needs change.
Flexible depot strategies are particularly valuable when drug supply is constrained. By limiting the number of depots that require inventory, sponsors can reduce overall stock requirements and avoid tying up limited drug inventory across multiple locations, maintaining greater flexibility to redirect supply based on demand.
The rise of decentralized and patient-centric trials has accelerated the shift even further, often requiring more localized or hybrid infrastructure where supply chains are designed not just for efficiency but for accessibility and reliability at the point of care. Local dispensing models, direct-to-patient (DtP) delivery, and home healthcare are increasing the focus on proximity to the patient. As a result, a flexible supply model is not defined by a specific footprint, but by its ability to respond—integrating central scale, local compliance, and patient-level delivery into a cohesive, adaptive network.
This represents a fundamental shift in mindset: from designing static supply chains around cost, to orchestrating dynamic ecosystems built around patients, risk, and performance.
Sponsors that embrace hybrid, adaptive depot strategies leveraging central hubs for efficiency while deploying localized capabilities where needed, are better positioned to navigate complexity, control costs, and deliver for patients.
In summary, the question is no longer “central versus local.” The real differentiator is how effectively these models are when combined. Success lies in early, deliberate design, underpinned by data, flexibility, and a clear focus on outcomes.
About the authors
Michael MacNeir is Vice President of Business Development at Sharp Clinical, where he brings two decades of experience supporting pharma and biotech companies in finding solutions to complex global clinical trials. In his business development role, he is focused on helping sponsors optimize clinical supply chains through innovative packaging, labeling, distribution, storage, and supply management strategies. Michael is a frequent contributor to industry discussions on clinical supply resilience, risk management, patient-centric trial design, and the integration of technology-driven solutions that enhance trial performance and accelerate development timelines. He serves on the ISPE Steering Committee, ISP DTP Task team, and ISPE Digital Display Label (DDL) Task team.
As Global Pricing Director at Sharp Clinical, Lindsay Moir leads the strategic pricing approach for the company’s global clinical supply solutions, helping customers balance cost, efficiency, and supply chain performance. Lindsay has deep expertise in pricing strategies and alternative model development, and commercial due diligence and she is passionate about value-added solutions that enhance patient access, retention, and adherence, and support the advancement of clinical research and healthcare.
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