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The purpose of this paper is to examine the pharmaceutical supply chain for artemisinin‐based combination therapies (ACT) in Ghana.

This study employed an inductive approach in examining the dynamics of the pharmaceutical supply chain. The study also used analytical hierarchical process in identifying factors that are detrimental to the ACT supply chain.

The study revealed that there are basically two main supply channels through which ACT enters the Ghanaian pharmaceutical system – private and public. The ACT network depicts a strong evidence of actor interdependence and long‐term relationships. However, the key supply chain enabler – the use of information technology – was found to be lacking, leading to delays and disruptions in the supply chain system. Disruption was found to be the main detrimental factor to the supply chain although delay was found to be occurring more frequently. Price increases indicated a low effect on the supply network at the pharmacy level, but the general price of the highly subsidised effective ACT (Coartem) remains very high.

Owing to constraints in accessibility, it was challenging to contact all the actors in the network individually, especially the consumer. Drugs considered in the study were the WHO approved ACT, even though efforts were made to compile available anti‐malarial drugs on the market.

This study has provided insights into the supply chain for ACT. The findings of the study are relevant in improving the supply chain system.

The paper brings to the fore the need for a proper pharmaceutical supply chain management in the health sector with regards to one of the world's most infectious and deadly diseases – malaria.

This paper aims to describe relationships between constructs adapted to the pharmaceutical field with respect to the measurement of the supply chains strategic and operational performance in private pharmacies, relating it to the quality of service perceived by users.

Relationships among the indicated constructs were validated through the use of structural equation models. This study includes the use of questionnaires adapted and applied to suppliers (pharmaceutical chemists and supply staff), operational managers (pharmacy assistants) and users (patients and clients) who visit different segments of pharmacies, such as chain businesses and independents located in the region of Valparaíso, Chile. The sample collected information from 128 establishments and 601 people, through which different relationships between segments were compared.

A structural model was validated on the basis of statistical principles. Furthermore, positive relationships were observed in the constructs studied where pharmacy chains had a statistical significance of less than 5 per cent between the responsibility of the supply process and the experience of the users, whereas independent pharmacies had a very significant causal relationship between operational managers and users.

The proposal can help predict the quality of service perceived by the user based on the behavior of sales and supply staff, which may be similar in other markets with similar characteristics.

The structural model proposed is original and adapts measurement scales validated from previous studies to be able to apply them in the pharmaceutical retail market.

After discussing this case, students will be able to understand the challenges faced by social entrepreneurs in starting a health-tech start-up in Africa; create and evaluate lean business models of health-tech companies as a social enterprise; evaluate how health-tech start-ups were developing innovative business models and supply chain networks to make prescription drugs accessible and available in Africa; understand how inorganic growth strategies can help health-tech start-ups scale up; and evaluate what promises investors were seeing while investing in social enterprises in the health-care sector in Africa and what social wealth they were creating.

In August 2022, Gregory Rockson (Rockson), social entrepreneur and founder of for-profit health technology (health-tech) social enterprise in Ghana, mPharma, stated that he had plans to replicate the company’s business model, which provided people access to drugs and at affordable prices, to other African nations, beyond the company’s existing footprint. However, analysts pointed out that the fragmented drug supply chain and poor regulation in the health-care market across Africa could act as a challenge for mPharma to replicate its business model successfully across the African continent. People in Africa were forced to pay higher prices to buy life-saving drugs due to the continent’s fragmented drug supply chain. To add to their woes, pharmacies struggled to keep life-saving and life-sustaining medicines in stock. Often, patients traveled miles to a pharmacy only to find out that the drugs they needed were not in stock. In addition to this, the markets were flooded with counterfeit drugs. And the Covid-19 pandemic only exacerbated the situation. mPharma managed the prescription drug inventory for pharmacies and drug suppliers using its proprietary vendor management information system. By using the technology infrastructure it had built, the company connected patients, pharmacies and hospitals through a cloud-based software. The system enabled doctors to track in real-time which drugs were available and at which location, thus giving patients reliable access to medicines. Patients registering with mPharma with their prescriptions and medical history received an alert on their mobile phones notifying them where the drugs they needed were available. mPharma bought drugs from major drug manufacturers such as Novartis International AG, Pfizer Inc. (Pfizer) and Bayer AG, on behalf of the pharmacies. This enabled the pharmacies to save on the up-front costs of stocking the drugs, reduced supply constraints and ensured availability of drugs to consumers in these underserved markets. The company had a consignment model wherein member pharmacies had to pay only for what they sold. Most pharmacies forecast the number of drugs they needed and purchased them from mPharma at pre-agreed rates. The company took the inventory liability to prevent pharmacies from going out of stock. As mPharma used its purchasing power to buy drugs in large quantities from drug manufacturers and suppliers, it was able to help patients realize cost savings of 30% to 60% in the purchase of medicines. mPharma was focusing on achieving its ambitious goal of dominating the health-care market in Africa in future. However, analysts felt that the company would face challenges related to poor regulation in the health-care market, high prices of drugs and the fragmented pharmacy retail market in the continent.

This case is intended for use in MBA/MS level programs as part of a course on Social Entrepreneurship, Sustainability, Business Model Innovation, Disruptive Business Models, and Supply Chain Management in the Drug Industry.

Teaching notes are available for educators only.

CSS 3: Entrepreneurship.

The purpose of this study is to understand the antecedents that influence supply chain coordination in the pharmaceutical supply chain using the transaction cost analysis framework.

Data from 156 retail pharmacies on their relationship with the pharmaceutical wholesalers are used to test the hypotheses.

The findings of this paper show the importance of antecedents that are based on the transactional cost theory, such as asset specificity and environmental uncertainty. These antecedents impact the supply chain process coordination at different levels – transactional, operational and strategic.

Future research may investigate additional antecedents using other theoretical lenses.

Pharmaceutical wholesalers are dependent on pharmaceutical manufacturers for the supply of products and face intense competition that results in lower profit margins. Given that the pharmaceutical industry is strictly regulated, the wholesaler facilitates regulatory compliance of the manufacturers in the distribution process by coordinating with them. But the wholesalers do also face a constant threat from the manufacturers, who could potentially bypass the wholesalers (disintermediation) and go directly to the pharmacies. To counterbalance the dependence, the wholesalers strive to achieve loyalty with the retail pharmacies. Through supply chain coordination, the wholesalers achieve efficiency in procurement for the pharmacies, thus reducing cost and improving their competitive advantage.

Supply chain coordination in the pharmaceutical supply chain improves the safety and security of the pharmaceutical distribution system.

This paper contributes to the supply chain coordination stream of literature. To the best of the authors’ knowledge, this is the first study to develop the three levels of process coordination in the pharmaceutical supply chain context. This paper shows how process coordination can be achieved between the dyad without vertical integration.

The community pharmacy industry is an increasingly competitive sector, where independent pharmacies must compete with national and multinational chains for market share. Each pharmacy seeks to differentiate and earn customer trust. The purpose of this paper is to seek to better understand the effectiveness of differentiating via developing a unique corporate brand personality in the pursuit of customer trust.

A survey was conducted in a small city in Western Canada. Patients who have recently filled a prescription were asked to assess their perceptions about the brand personality of the pharmacy they last visited, and evaluate how much they trust the pharmacy. Data were analyzed using SPSS and structural equation modeling (SEM).

The results indicated that significant brand personality differences exist among various types of pharmacies. Customers rated independent pharmacies slightly more trustworthy than multinational mass merchandise and national chain pharmacies. SEM analysis revealed that sincerity and competence have the most significant impact on building customer trust.

The findings suggest that independent pharmacies may be able to differentiate themselves by developing a brand personality that is competent and sincere, whereby they earn the trust from their customers. The authors' findings also suggest that a sophisticated appearance might be an expensive option that does not provide satisfactory return on the investment.

The purpose of this study is to understand how Amazon’s threat may impact the Pharmacy Industry as a whole and whether traditional drugstore chains such as consumer value stores (CVS) Pharmacy will need to re-think their business strategy, especially in the digital space, to account for potential disruption.

This is a hypothetical case study used as a teaching exercise to guide the learner through a decision-making process. The case starts by presenting a disruption in the retail pharmacy business that the main character must navigate by using real-world data and insights, provided in the case, to formulate a recommendation.

In an extremely competitive and consolidated pharmacy market, Amazon has the potential to change the business entirely. CVS Health will potentially face strong headwinds from Amazon’s PillPack and a downward trend in prescription sales. Regardless of the new competition, CVS Health continues to be innovative in the space. Instead of being a one-trick pony, CVS has encompassed the mentality of becoming a one-stop-shop by expanding into areas such as specialty pharmacy, health clinics, pharmacy benefits management and innovative digital capabilities.

This paper provides the reader with existing and known information about the evolving retail pharmacy business and allows the reader to interpret the new information to make their own decision on how a digital business strategy team can account for potential disruption.

The aim of this paper is to report on the findings of a systematic literature review‐seeking to elicit existing evidence of the nature of organisational culture in community pharmacy organisations.

This review takes a novel approach to systematically identifying and synthesising the peer‐reviewed research literature pertaining to organisational culture in this setting, its antecedents and outcomes.

The review provides an overview of the scope of and research methods used in the identified literature, together with a narrative synthesis of its findings, framed within five dimensions of organisational culture: the professional‐business role dichotomy; workload, management style, social support and autonomy; professional culture; attitudes to change and innovation; and entrepreneurial orientation.

There is a need for more detailed and holistic exploration of organisational culture in community pharmacy, using a greater diversity of research methods and a greater focus on patient‐related outcomes.

This paper demonstrates that, whilst little research has explicitly investigated organisational culture in this context, there exists a range of evidence describing aspects of that culture, some of the environmental and organisational factors helping to shape it, and its impact on the pharmacy workforce, services delivered and business outcomes. It highlights the importance of the business‐professional role dichotomy in community pharmacy; the influence of individual pharmacists' characteristics and organisational setting; and the impact on pharmacists' wellbeing and job satisfaction and the services delivered. It provides less evidence of the impact of organisational culture on the quality and safety of service provision.

Competition and cooperation co‐exist in various sub‐fields of organizational strategies, while a research gap remains in the links between how managers perceive their cognitive relations with rival partners and how they choose a strategy. The purpose of this paper is to investigate how different focuses of competition and cooperation are put in core and supportive strategic importance based on business manager's individual perception toward a particular rivalling cognition.

A conceptual model is developed composed by several hypotheses. An empirical study is conducted by analysing data collected from 89 pharmacies, including public hospital pharmacies and community service, private chain retailing pharmacy, and independent pharmacies, out of hundreds of outlets in a capital city in China to test hypotheses. By using factor analysis and correlation analysis, several hypotheses are supported in linking competitive cognition with either core marketing strategies or supportive marketing strategies.

Observational results indicate that large and small pharmacies, motivated by relational perceptions among competitors, tend to rely selectively on some strategic tools of competition and cooperation in terms of their different business nature.

These results are valuable for business managers in the healthcare industry, enabling them to rethink their relations with strategic partners and their strategies.

The paper's findings enrich understanding of how a competing environment influences strategic orientation of competition and cooperation under a collaborative marketing framework.

The ecosystem concept has attracted attention in information system research to explain business competition, innovation and many other emerging phenomena. Existing studies focus more on a single ecosystem type or a single ecosystem goal and pay little attention to the ecosystem’s evolution. The objective of the study is to investigate the factors that impact the evolution of the information ecosystem (IE) to gain a better understanding of strategic thinking.

The IE involves many actors, so the multi-case study approach is conducted with purposeful sampling to recruit all the significant ecosystem actors. The collected qualitative data are analyzed by coding data, exploring data relationships and structuring pattern steps; institutional theory is used as a theoretical framework.

The results demonstrate that industry practices, laws and regulations, new actors and the mimetic pressure of outsourcers drive the growth of the ecosystem. Strategy intention, cost pressure and normative pressure all contribute to the IE’s evolution.

The concept of ecosystems has attracted attention in information system research. The study investigates the factors contributing to the evolution of the IE from an institutional theory perspective. Our suggestion is that new players can find a niche in offering information technology (IT)/ information services (IS)-related solutions to survive in the ecosystem; however, they need to pay attention to the normative pressure.

Scholarship in the entrepreneurship and marketing literatures has helped advance thinking about how health care organizations create value for companies and consumers. However, there is an ongoing need for empirical research; hence, the purpose of this paper is to examine how entrepreneurial orientation and customer orientation influence healthcare (retail pharmacy) industry performance.

Using a sample of the US retail pharmacies, the study applies partial least squares structural equation modeling to identify the direct and indirect effects of the entrepreneurial orientation constructs on company performance. The study also includes importance–performance analyses to prioritize for managers which orientations, dimensions and respective manifest items merit the most critical attention as contributors to pharmacy performance.

We find that the entrepreneurial orientation has a significant impact on customer orientation and company effectiveness. We also find that three dimensions – innovation, risk-taking, and proactiveness – exhibit stronger importance and performance than autonomy and competitive aggressiveness.

While the present study employs data from firms of various sizes, it is limited to firms in the pharmacy industry. Although this study included established EO measures, one of the risk taking items was dropped from the final analysis. In certain research contexts, this result may or may not be consequential. Finally, this study employed nonfinancial measures for measuring performance. Using such measures is not uncommon and can offer insightful linkages to long-term organizational strategies in ways not afforded by conventional financial measures (Ittner and Larcker 2000); however, future research should, if possible, aim to capture financial and nonfinancial data.

In the dynamic healthcare environment, entrepreneurial pharmacies that have the ability to innovate, take risks and be proactive can provide superior customer orientation and hence better performance.

Health care industry in general and pharmacies in particular have to be entrepreneurial to meet customer needs and hence the wellbeing of the society With the aging population and growth of complex diseases, pharmacies can provide better access to care delivery if they have entrepreneurial orientation.

In this study, partial least square modeling technique along with importance performance analysis was adopted for first time in this literature to identify key factors that contribute to EO. The findings will aid pharmacy managers to focus their initiatives on the three key dimensions to succeed in their retail pharmacy business.