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Increased outsourcing and importation of drugs from different parts of the world to the Latin America and the Caribbean (LAC) region result in the proliferation of substandard and fake medicines, posing a threat to public health. The presence of substandard and fake medications in LAC regions is a source of public health concern and causes an economic burden to the governments in these regions. Whereas testing and detecting medication quality can easily be achieved in developed countries, the situation is different in developing countries such as LAC. This paper aims to examine the public health challenges faced by LAC regarding substandard, fake and counterfeit medicines and how the region can tackle these challenges.

Databases such as Scopus, PubMed, ScienceDirect, Embase, HINARI, EBSCOhost, Google Scholar, unpublished data, conference abstracts and papers from World Health Organization, Pan-American Health Organization and electronic newspapers were searched concerning medicine quality and in LAC.

Drug treatment improves the quality of life while decreasing morbidity and mortality among diseased populations. Absence of or inadequate testing laboratories, old and ineffective legislature, lack of enforcement or willpower and lack of effective surveillance are challenges in LAC for the proliferation of substandard and falsified medicines (SFMs).

The most significant limitation of this study was the need for the reviewers to have used articles written in other languages besides English. The LAC region has a large population in non-English-speaking countries, and many articles are written using local languages. Hence, excluding those articles is a limitation worthy of note in this review. The articles accessed needed to provide adequate information on SFM markets and illegal pharmacies or hospitals but did not. Future reviews may focus on providing illegal substandard and falsified medicines markets in the region and how they can be minimized or eliminated.

This review highlights the challenges faced by LAC countries regarding substandard, fake and counterfeit medicines. The sources, prevalence and consequences of substandard and falsified drugs were identified to suggest the measures needed to curb the infiltration of low-quality medicines in LAC.

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.

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.

Product counterfeiting has been ubiquitously observed in various segments of the supply chain. The intrinsic values of brands create more opportunities for counterfeiting. The damaging reputation of such brands leaves them to deal with the fallouts of counterfeits. Hence, such companies address them mainly through legal action, price and quality strategy. However, consumer characteristics and the random distribution of counterfeit products to the consumer types affect the effectiveness of a counter strategy. This paper aims to generate insights on how to leverage digital technology to curb counterfeit entities with consideration of consumer characteristics and the random distribution of counterfeits to them.

The authors used game theory and vertical differentiation model to understand and encounter deceptive counterfeiting of brand products. The study understands the economic relationship between a brand product manufacturer and consumer types based on their awareness. Further, the authors have considered different cases in the model to gain useful insights.

The results reveal that when the consumers are proactive, informed and value-conscious brand product manufacturers take digital technology counterstrategy to earn the maximum revenue. Hence, this analysis highlights that the effectiveness of a counterstrategy critically depends on the consumer characteristics, whether they are proactive, informed or unaware.

The study outlines that brand product manufacturers must emphasize on the digital supply chain, product redesign and product tracking facility to empower informed and value-conscious and proactive consumers. Moreover, the government should take steps to create awareness among uninformed consumers via information campaigns.

This paper incorporates the role of consumers and brand product manufacturers to understand and address the deceptive counterfeiting issue.

The purpose of this research is to study and analyze the literature that integrates Lean Six Sigma (LSS) approach with blockchain technology in different sectors for improved quality management.

This study presents a scoping review on the application of integrated LSS and blockchain technology in the manufacturing and healthcare sector. Further, the authors examined existing blockchain-based solutions on a variety of dimensions, including application area, technical approach, methodology, application scenario, various blockchain platforms, purpose, and monitoring parameters. The authors study LSS approaches in detail, as well as the key benefits that blockchain technology can enable. Finally, the authors discuss significant research problems to be addressed in order to develop a highly efficient, resilient, and secure quality management framework using blockchain technology.

It has been observed that the adoption of blockchain technology for quality management and assurance is influenced by several factors such as transaction execution speed, throughput, latency. Also, prior blockchain-based solutions have neglected to leverage the benefits of LSS methodologies for effective quality management.

This is the first study to explores the influence of blockchain technology on quality management and assurance in manufacturing and healthcare industry. Furthermore, prior research has not examined how integrating the LSS methodology with blockchain technology can aid in the control of product quality management.

This study aims to explore the effect of power-based behaviours on pharmaceutical supply chain (PSC) resilience.

This study used a mixed-method approach to explore the role of power-based behaviours in PSC resilience. Qualitative interviews from 23 key PSC stakeholders, followed by thematic analysis, revealed the underlying perceptions regarding PSC resilience. Quantitative propositions were then developed based on the themes adopted from PSC resilience literature and the qualitative findings. These were tested via a survey questionnaire administered to 106 key stakeholders across the various levels in the PSC. Structural equation modelling with partial least squares was used to analyse the data.

The data analysed identified proactive and reactive strategies as resilience strategies in the PSC. However, power-based behaviours represented by quota systems, information and price control influenced these resilience strategies. From a complex adaptive system (CAS) perspective, the authors found that when power-based behaviours were exhibited, the interactions between PSC actors were mixed. There was a negative influence on reactive strategies and a positive influence on proactive strategies. The analysis also showed that PSC complexities measured by stringent regulations, long lead times and complex production moderated the effect of power-based behaviour on reactive strategies. Thus, the negative impact of power-based behaviours on reactive strategies stemmed from PSC complexities.

This research particularly reveals the role of power-based behaviours in building PSC resilience. By evaluating the nexus from a CAS perspective, the analysis considered power-based behaviours and the moderating role of PSC complexities in developing resilience strategies. This study considers the interactions of PSC actors. This study shows that power asymmetry is a relational concept that inhibits the efficacy of reactive strategies. This study thus advocates the importance of power in achieving a more resilient PSC from a holistic perspective by highlighting the importance of the decision-making process among supply chain (SC) partners. The findings are particularly relevant if PSC resilience is viewed as a CAS. All the interactions and decision-making processes affect outcomes because of their inherent complexities. Although this study focused on the PSC, its implications could be extended to other SCs.

The authors identified that power-based behaviours influenced resilience strategies. It was detrimental to reactive strategies because of the complexities of the PSC but beneficial to proactive strategies through resource-sharing. PSC actors are therefore encouraged to pursue proactive strategies as this may aid in mitigating the impact of disruptions. However, power-based behaviours bred partner dissatisfaction. This dissatisfaction may occur even within strategic alliances indicating that power could be detrimental to proactive strategies. Therefore, it is pertinent to identify conditions that lead to dissatisfaction when pursuing strategic partnerships. This study provides insight into actual behaviours influencing resilience and quantifies their effects on the PSC. These insights will be valuable for all SC partners wanting to improve their resilience strategies.

Previous PSC management and resilience studies have not examined the role of power in building resilience in the PSC. This paper thus provides a unique contribution by identifying the role of power in PSC resilience, offers empirical evidence and a novel theoretical perspective for future practice and research in building PSC resilience strategies.

Pharmaceutical supply chains (PSCs) need a well-operating and faultless logistics system to successfully store and distribute their medicines. Hospitals, health institutes, and pharmacies must maintain extra stock to respond requirements of the patients. Nevertheless, there is an inverse correlation between the level of medicine stock and logistics service level. The high stock level held by health institutions indicates that we have not sufficiently excellent logistics systems presently. As such, selecting appropriate logistics service providers (drug distributors) is crucial and strategic for PSCs. However, this is difficult for decision-makers, as highly complex situations and conflicting criteria influence such evaluation processes. So, a robust, applicable, and strong methodological frame is required to solve these decision-making problems.

To achieve this challenging issue, the authors develop and apply an integrated entropy-WASPAS methodology with Fermatean fuzzy sets for the first time in the literature. The evaluation process takes place in two stages, as in traditional multi-criteria problems. In the first stage, the importance levels of the criteria are determined by the FF-entropy method. Afterwards, the FF-WASPAS approach ranks the alternatives.

The feasibility of the proposed model is also supported by a case study where six companies are evaluated comprehensively regarding ten criteria. Herewith, total warehouse capacity, number of refrigerated vehicles, and personnel are the top three criteria that significantly influence the evaluation of pharmaceutical distribution and warehousing companies. Further, a comprehensive sensitivity analysis proves the robustness and effectiveness of the proposed approach.

The proposed multi-attribute decision model quantitatively aids managers in selecting logistics service providers considering imprecisions in the multi-criteria decision-making process.

A new model has been developed to present a sound mathematical model for selecting logistics service providers consisting of Fermatean fuzzy entropy and WASPAS methods. The paper's main contribution is presenting a comprehensive and more robust model for the ex ante evaluation and ranking of providers.

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.

Illicit trade is pervasive in many nations and may be influenced by the level of national IQ. The current interdisciplinary paper aims to study the association between national intelligence and illicit trade across nations.

The illicit trade index scores for 84 countries, developed by the Economics Intelligence Unit, are used to measure the dependent variable. The independent variable is national intelligence, while economic development, unemployment and Hofstede’s cultural dimensions are the control variables. Two-level hierarchical linear models (HLMs) are used to empirically test the above-mentioned association.

The empirical results suggest that the higher the degree of national intelligence, the lower is the degree of illicit trade across nations. In addition, economic development, unemployment and national culture play an important role in explaining cross-country differences in illicit trade.

Regulatory authorities should find the results of this cross-national research useful in evaluating the likelihood of illicit trade from a cognitive perspective, and in implementing reforms to curb this type of economic crimes.

This interdisciplinary study makes novel contributions to the literature on economic and financial crimes. First, for the first time to the best of the authors’ knowledge, an association between national intelligence and illicit trade is examined. A second original contribution of this study compared to earlier research is related to the use of two-level HLMs. Third, the investigation of the association between intelligence and illicit trade takes a new control variable into consideration, i.e. unemployment, a variable which is found to have a significant effect on illicit trade and that has not been used directly in relationship with illicit trade so far.

Adopting new technologies to improve supply chain activities and processes is essential due to increasingly complex and dynamic business environments. Particularly in the pharmaceutical industry, high-quality standards must be met, requiring transparency and visibility in the supply chain. This research aims at investigating the implementation of blockchain technology in the supply chain of an Egyptian pharmaceutical company.

The research applies a single case-study approach building on the theoretical underpinnings of transaction cost economics. Twenty-five semistructured interviews were conducted with pharmacies and employees of the case company to identify the blockchain technologies' potential for pharmaceutical supply in Egypt. Further analyzing the frequencies of the codes, the authors elaborate on specific relationships between the observed practices.

The research revealed the potential benefits of adopting blockchain technology. Transaction costs are indeed positively impacted by reduced contracting costs, processing costs and lead times, also ensuring the safe delivery of medications. However, the findings also highlight obstacles related to running costs, awareness and company culture. Regarding supply chain governance, blockchain technology can enhance collaboration within the supply chain as well as with important stakeholders.

Insufficient management of pharmaceutical supply chains (PSC) may affect a company's reputation but also disrupt the patient's healing process due to temperature damage and counterfeit medicines. Blockchain governance, in this vein, can ensure a safer and more reliable supply of pharmaceutical products. For intraorganizational purposes, however, cloud solutions, barcoding and generally digital platforms are rated more frequently than blockchain solutions.

The present study contributes to an advanced understanding how blockchain technology supports PSC, particularly in an emerging country context like Egypt. It thereby confirms and extends previous research as well as adds to the theoretical underpinnings of digitalized supply chains.