Search results

A key feature of human rights in health is access to safe, effective and affordable medicines. Pharmacovigilance is advocated for monitoring intended/unintended effects of medicines to assure their safety. The purpose of this paper is to synthesize knowledge about supply chain impediments to safe medicines in developing nations and contribute to future development of research in this field.

This paper conducts a structured literature review based on Preferred Reporting Items for the Systematic Reviews and Meta-Analyses guidelines. It aims at profiling supply chain impediments to safe medicines in developing nations by reviewing 46 recent pharmacovigilance-specific papers published between 2005 and 2020.

Analysis of reviewed articles identified criticality of supply chain impediments that affect constituents across pharmaceutical in developing nations, which still struggle to maintain robust national pharmacovigilance systems due to lack of awareness, policy and practices.

Research results can be applied by pharmaceutical industry decision-makers and drug safety professionals in developing nations. Because the review is qualitative in nature, its implication ought to be tested after actual implementation.

This review can help identify underinvestigated impediments and methods to aid in developing new pharmacovigilance knowledge areas in developing nation context.

The review uncovers gaps in global health equity dialogue in developing nations. It also recognizes that macrolevel supply chain impediments exist due to unfair disease burden and health inequities in developing nations.

The paper examines supply chain impediments to safe medicines in developing nations with insights for future pharmacovigilance research. Identifying and classifying supply chain impediments through this review is the first step toward creating effective interventions for these impediments to safe medicines.

The purpose of the paper is to report on a study that investigated the critical success factors (CSFs) in the supply chain management of essential medicines in the public health-care delivery system in Malawi.

The exploratory and descriptive study followed a qualitative and quantitative research approach. Data were collected by means of semistructured interviews and a questionnaire administered to suppliers of essential medicines, regulators, donors and logistics companies in Malawi. Data was analyzed using SPSS.

The findings revealed that the significant CSFs are knowledge of disease patterns and prevalence, skills and experience of personnel, adequate financial resources, collaboration with supply chain partners and an efficient procurement and distribution system.

There were a number of limitations in this study. Although every effort was made to carefully and purposefully select the participants for the in-depth interviews in the first phase of the study and the respondents for the questionnaire in the second phase of the study, they were not randomly selected. As such, the findings cannot be generalised to all stakeholders in the pharmaceutical supply chain in Malawi. However, they can be used as a basis for further research on the topic.

No previous studies that deal with the identification of CSFs in the Malawi pharmaceutical supply chain were found. Therefore, this research makes a twofold contribution to the body of knowledge in the field. First, it identifies CSFs; second, it could assist stakeholders in the public health-care service delivery system in Malawi with regard to how they can improve the supply of essential medicines.

The purpose of this paper is to understand the role of resilience enablers in combating counterfeits in the medicine supply chain based on a Systematic Literature Review (SLR). The objective is also to help practitioners and scholars as the review revealed that little research has been conducted on selecting and implementing practices to improve resilience to counterfeiting.

Based on the literature review, a content analysis was performed for 84 selected papers to explore the potential relationship among resilience enablers and counterfeit anti-measures.

This paper contributes to Supply Chain Resilience (SCR) research by summarizing the highly fragmented literature concerning how to combat counterfeiting. The SLR indicated reengineering, collaboration, visibility, innovation, SCR culture and trust as six key enablers to combat counterfeit medicines and identified literature gaps. Moreover, the paper discusses other resilience enablers which have been less studied in the literature and shows new avenues of research.

This paper is limited in that it is an exploratory literature review and focuses only on three databases over the past 15 years. Furthermore, counterfeit is a rapidly evolving issue and anti-measure studies require frequent surveillance concerning new discoveries.

The main contribution of this paper is to provide a better understanding of enablers most often associated with counterfeit anti-measures, which, therefore, might help to increase resilience to counterfeit medicines. Moreover, research gaps involving enablers less associated with anti-measures are presented.

The purpose of this paper is to eliminate the medicine stock-out problem by building an optimum medicine stock in rural healthcare centers in India.

Data associated with inflow and outflow of a specific medicine (folic acid tablets) arer collected from all consecutive supply chain stages during the survey. While conducting the survey, it is found that several medicines are out of stock owing to uncertain lead time and demand. Integrating with quantity discount and min–max (s, S) inventory policy, two models are developed using system dynamics: one is Model 1 with constant lead time and uncertain demand, and the other is Model 2 with both uncertain lead time and demand.

Both models are simulated for a period of one year on Stella 9.1 platform. The results are compared with actual data, and the comparison shows significant improvement of the medicine stock at all downstream stages, while maintaining a certain safety stock. Further, Model 2 suggests a larger stock than Model 1 at each point of time.

Despite numerous issues, the stocks of medicine in rural healthcare systems can be improved as suggested by the models. The models depict the behavior of inventory stock at each stage of the supply chain and act as a function of time that could be used in the form of a prediction tool for the policymakers.

This paper is one of the first papers that had developed the model of the medicine supply chain in rural parts of a developing country. It provides a generic framework for the stock assessment and improvement throughout the supply chain.

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.

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.

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.

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 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.

Artemisinin-based combination therapies (ACTs) have been developed to treat uncomplicated malaria. However, scanty studies exist to inform the role of macro factors in explaining the nonavailability of ACT in developing countries. Therefore, this paper aims to evaluate the different macro-environment factors affecting the availability of ACTs in the public hospital setting.

This study applied a quantitative methodological approach and structural equation modeling (SEM) to test hypotheses statistically. SEM examines linear causal relationships among variables while accounting for measurement error. Confirmatory factor analysis (CFA) was used to assess model reliability. CFA and SEM were used to determine the shared variance-covariance of variables, define the latent construct and provide a more precise way to account for the error variances associated with the variables, which, if untested, could lead to biased parameter estimates. This was guided by the data collected from 40 general public hospitals with 283 respondents.

This study’s results support a model for promoting social-cultural, technological and legal factors. The availability of ACTs is significantly affected by legal factors. Improving legal aspects by a unit can enhance ACT availability by 0.59. Political factors scored the least, and they do not influence the availability of malaria drugs.

The design was quantitative and cross-sectional. Future research could be longitudinal with a mixed-method approach and consider other external stakeholders.

Reducing the impact of the nonavailability of antimalarial drugs in general public hospitals requires a holistic concerted and coordinated supply chain approach that tackles the political, economic, social-cultural norms, technological and legal factors.

The authors develop and test a model using macro factors: political, economic, social, cultural, technological and legal factors. This model is relevant for many developing countries to supply chain coordination perpetually experiencing medicine shortages.