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The pharmaceutical industry faces multiple risks that adversely affect its performance. Within these risks, some dependencies have been observed, which help in streamlining the mitigation efforts. Therefore, the present work identifies and categorizes various risks/sub-risks in cause–effect groups, considering uncertainty in the decision-making process.

An extensive literature review and experts' opinions were utilized to identify and finalize the risks faced by the pharmaceutical industry. For further analysis, data collection was done using a questionnaire focusing on finalized risks. Based on the data, the causal relation under uncertainty between various risks/sub-risks was identified using a multi-criteria decision making (MCDM) technique, i.e. intuitionistic fuzzy DEMATEL, in a pairwise manner.

The results show that the three most prominent risk categories are operational, demand/customer/market and financial. Also, out of the seven main risks, only supplier and operational are categorized within the effect group and the rest, i.e. financial, demand, logistics, political and technology within the cause group. The sub-risks within each category have also been categorized into cause–effect groups. The mitigation of cause group risks will help in economize the financial resources and improve the performance and resilience of the industry.

There is insufficient research on identifying the causality among the pharmaceutical industry risks. Additionally, an extensive discussion on the identified cause–effect groups is also missing in the literature. Therefore, in this work, efforts have been made to determine the prominent risks for the Indian pharmaceutical industry that will be helpful for channelizing the resources to mitigate risks for a resilient industry.

The purpose of the present work is to improve the industry performance by identifying and quantifying the risks faced by the Indian pharmaceutical industry (IPI). The risk values for the prominent risks and overall industry are determined based on the four risk parameters, which would help determine the most contributive risks for mitigation.

An extensive literature survey was done to identify the risks, which were also validated by industry experts. The finalized risks were then evaluated using the fuzzy synthetic evaluation (FSE) method, which is the most suitable approach for the risk assessment with parameters having a set of different risk levels.

The three most contributive sub-risks are counterfeit drugs, demand fluctuations and loss of customers due to partners' poor service performance, while the main risks obtained are demand, financial and logistics. Also, the overall risk value indicates that the industry faces medium to high risk.

The study identifies the critical risks which need to be mitigated for an efficient industry. The industry is most vulnerable to the demand risk category. Therefore, the managers should minimize this risk by mitigating its sub-risks, like demand fluctuations, bullwhip effect, etc. Another critical sub-risk, the counterfeit risk, should be managed by adopting advanced technologies like blockchain, artificial intelligence, etc.

There is insufficient literature focusing on risk quantification. Therefore, this work addresses this gap and obtains the industry's most critical risks. It also discusses suitable mitigation strategies for better industry performance.