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Medicine shortages have a detrimental impact on stakeholders in the pharmaceutical supply chain (PSC). Existing studies suggest that building resilience strategies can mitigate the effects of these shortages. As such, this research aims to examine whether resilience strategies can reduce the impact of medicine shortages in the United Kingdom's (UK) PSC.

A sequential mixed-methods approach that involved qualitative and quantitative research enquiry was employed in this study. The data were collected using semi-structured interviews with 23 key UK PSC actors at the qualitative stage. During the quantitative phase, 106 respondents completed the survey questionnaires. The data were analysed using partial least square-structural equation modelling (PLS-SEM).

The results revealed that reactive and proactive elements of resilience strategies helped tackle medicine shortages. Reactive strategies increased relational issues such as behavioural uncertainty, whilst proactive strategies mitigated them.

The findings suggest that PSC managers and decision-makers can benefit from adopting structural flexibility and proactive strategies, which are cost-effective measures to tackle medicine shortages. Also engaging in strategic alliances as a proactive strategy mitigates relational issues that may arise in a complex supply chain (SC).

This study is the first to provide empirical evidence of the impact of resilience strategies in mitigating medicine shortages in the UK's PSC.

This paper links supply chain risk management to medicine supply chains to explore the role of policymakers in employing supply chain risk management strategies (SCRMS) to reduce generic medicine shortages.

Using secondary data supplemented with primary data, the authors map and compare seven countries' SCRMS for handling shortage risks in their paracetamol supply chains before and during the first two waves of the COVID-19 pandemic.

Consistent with recent research, the study finds that policymakers had implemented few SCRMS specifically for responding to disruptions caused by COVID-19. However, shortages were largely avoided since multiple strategies for coping with business-as-usual disruptions had been implemented prior to the pandemic. The authors did find that SCRMS implemented during COVID-19 were not always aligned with those implemented pre-pandemic. The authors also found that policymakers played both direct and indirect roles.

Combining longitudinal secondary data with interviews sheds light on how, regardless of the level of preparedness during normal times, SCRMS can be leveraged to avert shortages in abnormal times. However, the problem is highly complex, which warrants further research.

Supply chain professionals and policymakers in the healthcare sector can use the findings when developing preparedness and response plans.

The insights developed can help policymakers improve the availability of high-volume generic medicines in (ab)normal times.

The authors contribute to prior SCRM research in two ways. First, the authors operationalize SCRMS in the medicine supply chain context in (ab)normal times, thereby opening avenues for future research on SCRM in this context. Second, the authors develop insights on the role policymakers play and how they directly implement and indirectly influence the adoption of SCRMS. Based on the study findings, the authors develop a framework that captures the diverse roles of policymakers in SCRM.

Disruptions and shortages of drugs have become severe problems in recent years, which has triggered strong media and public interest in the topic. However, little is known about the factors that can be associated with the increased frequency of shortages. In this paper, the authors analyze the drivers of drug shortages using empirical data for Germany, the fourth largest pharmaceutical market.

The authors use a dataset provided by the German Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte [BfArM]) with 425 reported shortages for drug substances (DSs) in the 24-month period between May 2017 and April 2019 and enrich the data with information from additional sources. Using logistic and negative binomial regression models, the authors analyze the impact of (1) market characteristics, (2) drug substance characteristics and (3) regulatory characteristics on the likelihood of a shortage.

The authors find that factors like market concentration, patent situation, manufacturing processes or dosage form are significantly associated with the odds of a shortage. The authors discuss the implications of these findings to reduce the frequency and severity of shortages.

The authors contribute to the empirical research on drug shortages by analyzing the impact of market characteristics, DS characteristics and regulatory characteristics on the reported shortages. The authors’ analysis provides a starting point for better prioritizing efforts to strengthen drug supply as it is currently intensely discussed healthcare authorities.

One of the most important components of healthcare is the timely delivery of pharmaceutical products, such as life-saving medicines. However, disruptions like COVID-19 bring new challenges and risks to the pharmaceutical supply chain (PSC) and healthcare organizations that impact their operational performance. This study focuses on mitigating risks in India's generic medicine supply chain (GMSC) as a result of various disruptions, which can assist policymakers develop appropriate plans and strategies to build resilience in the Jan Aushadhi Scheme (JAS) of micro, small and medium enterprises (MSMEs) in order to improve their overall performance.

Risk-causing vulnerabilities and resilience capabilities are identified from the literature review and expert's opinions. Following that, the vulnerabilities are classified into cause-and-effect vulnerabilities, and supply chain resilient capabilities (SCRCs) are measured using a hybrid fuzzy DEMATEL and best worst method (FDEMATEL-BMW) framework.

The outcome of the study reveals that transportation breakdown, loss of human resources and loss of suppliers are the potential risk-causing vulnerabilities that lead to vulnerabilities like shortages of medicines, loss of in-hand stock qualities and loss of sales/revenue. In addition, the analysis suggests that the sustainability of an organization with maximum weightage is the critical factor for building resilience in GMSC followed by flexibility, agility and visibility.

The integration of resilience into Jan Aushadhi GMSC can help in managing disruptions efficiently and effectively to mitigate risk and optimize MSMEs overall performance.

To the best of the authors’ knowledge, this work will be the first of its kind to model resilience in GMSC of MSMEs using a hybrid framework.

Antibiotics shortages have become an increasingly common problem in Europe because of several reasons, including the offshoring of the production of active pharmaceutical ingredients for many of these products to low production cost countries, such as China and India. The problem has deteriorated because of the Covid-19 crisis that has put most global value chains (GVCs) under great stress. This situation has boosted extensive discussions among academics, practitioners and policymakers on possible changes to the configuration of GVCs. This paper aims to focus specifically on antibiotics supply chains from the perspective of a small country (Sweden), and analyse the pros and cons of backshoring and nearshoring alternatives, as a means to reduce drug shortages.

This work adopts a systemic perspective to capture the implications of reshoring for the different stakeholders involved in the antibiotics field. The present meso-analysis, focusing at the industry level, is based on multiple sources of primary data collected between 2014 and 2021, including participation in policy-related projects and interviews with over 100 representatives of key stakeholders in the antibiotics field.

This paper shows how reshoring can address the problems of drug shortages and reduce availability risk in antibiotics’ GVCs. However, the authors show that no simple and best solution exists because both alternatives of reshoring, i.e. backshoring and nearshoring, entail pros and cons for different stakeholders. The authors conclude with implications for policymakers and managers.

The analysis of pros and cons of both backshoring and nearshoring for various stakeholders offers relevant implications for research on operations and supply management, international business and economics/political science.

This paper looks at reshoring as a policy-driven decision and provides an innovative systemic perspective to analyse the implications for different stakeholders of two reshoring options concerning the antibiotics supply chain.

This “impact pathways” paper argues that operations and supply chain management (OSCM) could help address the worsening drug shortage problem in high-income countries. This significant societal problem poses difficult challenges to stakeholders given the complex and dynamic nature of drug supply chains. OSCM scholars are well positioned to provide answers, introducing new research directions for OSCM in the process.

To substantiate this, the authors carried out a review of stakeholder reports from six European countries and the academic literature.

There is little academic research and no fundamental agreement among stakeholders about causes of shortages. Stakeholders have suggested many government measures, but little evidence exists on their comparative cost-effectiveness.

The authors discuss three pathways of impactful research on drug shortages to which OSCM could contribute: (1) Developing an evidence-based system view of drug shortages; (2) Studying the comparative cost-effectiveness of key government interventions; (3) Bringing supply chain risk management into the government and economics perspectives and vice versa. Our study provides a baseline for future COVID-19-related research on this topic.

The purpose of this study was to advance the knowledge of pharmaceutical supply chain (PSC) resilience using complex adaptive system theory (CAS).

An exploratory research design, which adopted a qualitative approach was used to achieve the study’s research objective. Qualitative data were gathered through 23 semi-structured interviews with key supply chain actors across the PSC in the UK.

The findings demonstrate that CAS, as a theory, provides a systemic approach to understanding PSC resilience by taking into consideration the various elements (environment, PSC characteristics, vulnerabilities and resilience strategies) that make up the entire system. It also provides explanations for key findings, such as the impact of power, conflict and complexity in the PSC, which are influenced by the interactions between supply chain actors and as such increase its susceptibility to the negative impact of disruption. Furthermore, the antecedents for building resilience strategies were the outcome of the decision-making process referred to as co-evolution from a CAS perspective.

Based on the data collected, the study was able to reflect on the relationships, interactions and interfaces between actors in the PSC using the CAS theory, which supports the proposition that resilience strategies can be adopted by supply chain actors to enhance this service supply chain. This is a novel empirical study of resilience across multiple levels of the PSC and as such adds valuable new knowledge about the phenomenon and the use of CAS theory as a vehicle for exploration and knowledge construction in other supply chains.

The Indian pharmaceutical industry has contributed significantly to global healthcare by securing superior-quality, inexpensive and reachable medicines worldwide. However, supply chain management (SCM) has been challenging due to constantly shifting requirements for short lifecycles of products, the convergence of industry and changeable realities on the ground. This study aims to identify, assess and prioritize the strengths, weaknesses and opportunities of the pharmaceutical SCM environment in India.

The paper employs a Strength, Weakness, Opportunity, Threat (SWOT) analysis and recognizes strategies to utilize the advantages of the strengths and opportunities, rectify weaknesses and resolve threats.

A variety of strategies that could have a positive effect on the Indian pharmaceutical business are presented. Findings and suggested strategies can significantly advance knowledge, enhance understanding and contribute to the growth of a successful SCM for the Indian pharmaceutical sector.

This paper would act as a roadmap to greater comprehension of the market leaders and market leaders' operating climate. The findings from this study will offer academic scholars and business practitioners deeper insights into the environment of SCM.

Integrated supply chain in pharmaceutical industry requires organized planning and modeling of each strategic element of pharmaceutical supply chain (PSC). The aim is to coordinate each activity of PSC and design a robust strategy to make the system hassle-free. Each activity of industry is interdependent and follows certain co-relations with each other. The paper focuses on the four most significant identified issues in PSC and analyses the weightages of these issues and their sub issues with respect to cost incurred and time taken to manage whole chain of supply.

Fuzzy analytical hierarchy process methodology has been applied to rank the issues which consume maximum time and/or costs.

The derived result shows that warehouse design and management (WDM) consumes more than one third of the total time and around half of the total cost. Other than WDM, process of supplier selection for procurement is second most time and cost consuming issue. The derived results are discussed and provided to the field experts of the area. The analysis will be useful for decision makers to economize PSC.

The study is limited to PSC; hence, result may vary with other practical situations.

This generated scope for further research on how to minimize the weightage of WDM for cost and time in PSC industry so that decision-makers can optimize the economic system of PSC.

The research is based on the field survey of India’s largest generic medicine distributing company in the government sector; hence, analysis has been performed on real situation.

The pandemic induced lockdown lead to supply and manufacturing disruptions that were swiftly dealt with by the Indian Pharma Industry through successful industry-government collaboration. By May 2020 production was back to normal and exports were higher than the same period in May 2019. The case deals with the processes that enabled this to happen, the policy responses and the changes that happened in the period from March 2020 to August 2020.