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Using the pharmaceutical sector as a microcosm of the health sector, we highlight the most prevalent structural and policy issues that make this sector susceptible to corruption and ways in which these vulnerabilities can be addressed. We conducted a literature review of publications from 2004 to 2015 that included books, peer-reviewed literature, as well as gray literature such as working papers, reports published by international organizations and donor agencies, and newspaper articles discussing this topic. We found that vulnerabilities to corruption in the pharmaceutical sector occur due to a lack of good governance, accountability, transparency, and proper oversight in each of the decision points of the pharmaceutical supply chain. What works best to limit corruption is context specific and linked to the complexity of the sector. At a global level, tackling corruption involves hard and soft international laws and the creation of international standards and guidelines for national governments and the pharmaceutical industry. At a national level, including civil society in decision-making and monitoring is also often cited as a positive mechanism against corruption. Anticorruption measures tend to be specific to the particular “site” of the pharmaceutical system and include improving institutional checks and balances like stronger and better implemented regulations and better oversight and protection for “whistle blowers,” financial incentives to refrain from engaging in corrupt behavior, and increasing the use of technology in processes to minimize human discretion. This chapter was adapted from a discussion piece published by Transparency International UK entitled Corruption in the Pharmaceutical Sector: Diagnosing the Challenges.

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.

Intentions of managers of pharmaceutical multinational enterprises (MNEs) to adopt business strategies, which will aid global health and wellbeing, are in some ways linked with their understanding of the returns that their company will receive from these investments. However, the MNE’s managers are unaware of business strategies that will allow them to link their business activities with the corporate objectives of contributing to Sustainable Development Goals (SDGs). Pharmaceutical companies are moving toward monopolistic practices by acquiring local companies for manufacturing purposes or by engaging local companies in contract manufacturing and directing the focus of these companies away from innovation and toward profit making. At the same time, pharmaceutical MNEs are promoting global health and wellbeing as their SDGs. This study uses knowledge from existing sources and expert insights to explain the returns that MNEs can get from their investments related to global health and wellbeing. One of the important recommendations from the ethical point of view is engaging local firms in the innovation process; from the marketing perspective, this study recommends the use of a corporate brand and not a product brand for offering generic medicines. The operations perspective explains how MNEs can incorporate the social agenda into their mainstream business strategies. Limitations of the study are discussed, and avenues for future research are explained.

The purpose of this paper is to investigate the influence of direct-to-physician promotion on physicians’ prescription behaviour. There were very few studies which have investigated to what extent the pharmaceutical promotion directed towards physicians influences physicians’ prescription behaviour in the Malaysian context.

A research framework has been developed based on the buyer behaviour stimulus-response model. A survey method has been used to collect data from 154 medical practitioners from private health-care facilities located at Klang valley in Malaysia. IBM SPSS and SmartPLS statistical programs have been used to analyse the data and validate the model.

This study found that personal selling is the most significant promotional tool for physicians’ prescription behaviour, whereas advertising is the least significant one. Sales promotion and public relations are the second and third most significant promotional tools. Direct marketing is found to be not significant.

This paper will help the pharmaceutical companies develop more effective plans to gain a competitive advantage for their business by having a guideline for pharmaceutical marketers as an input to the more efficient allocation of their promotional budgets.

This study has introduced a comprehensive understanding of all the factors in the pharmaceutical promotion that influence physicians’ prescription behaviour in Malaysia and how these factors are interrelated, influencing physicians’ prescribing medicines for patients.

Pharmaceutical donations are a practical approach to increase medicine availability during disasters such as disease outbreaks. However, often donated pharmaceuticals are inappropriate and unsuitable. This convergence of inappropriate pharmaceuticals is a severe operational challenge and results in environmental hazards. This study explores the pharmaceutical supply chains (PSCs) during a disease outbreak to relieve the negative impact of the material convergence problem (MCP).

This study adopts a situation-actors-process learning-action-performance (SAP-LAP) linkage framework to understand the PSC dynamics. The problem-solving component of the SAP-LAP analysis provides the strategies catering to MCP. The findings from the SAP-LAP helped to develop the causal loop diagram (CLD). This study conducts several experiments on the proposed strategies by integrating CLD into a stock and flow diagram. Later, a disease outbreak case study accessed the pharmaceutical donations effect on PSC performance.

The study synthesises and evaluates propositions and strategies to incorporate circular economy (CE) principles in PSC. This study proposed two strategies; one to sort and supply and the other to sort, supply and resell. The reuse policy improves humanitarian organisations' finances in the simulation study. This study verified the operational improvement of PSC by reducing the transport and storage burden due to MCP.

This study comprehensively approaches the issue of drug donation and uniquely produced several propositions for incorporating a CE perspective in PSC. The study also proposed a unique simulation approach to model the donation arrivals in response to a disease outbreak using susceptible, exposed, infectious and recovered modelling.

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.

Aims to evaluate the determinants of international pharmaceutical firms’ foreign direct investments (FDI) in the Chinese pharmaceutical manufacturing industry. Focuses on comparing the differences in FDIs between early entrants who started FDI before 1992 and the late entrants whose FDI started after 1992 in China. Field research was mainly conducted in China by personal interview as well as mail questionnaires over a period of three months in 1999 and 44 companies participated in total. The results of index of dissimilarity analysis, t‐test and Wilcoxon test consistently show that both early and late entrants are likely to agree that China’s huge market size played the most important role in motivating international pharmaceutical firms’ FDI in China. The results did not support the traditional FDI theories on domestic market imperfection and firm specific advantages.

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 purpose of this paper is to perform a worldwide survey on the opinion of over 1,000 stakeholders on the value of different approaches to improve global access to life‐saving medicines.

The research is based upon information gathered by triangulation of literature data, data from worldwide questionnaires and data from interviews originating from opinion leaders.

The findings revealed the main determinants, which contributed to the occurrence of drug pricing conflicts in some emerging markets in the past decade, and documented the preferred approaches to increase global access to life‐saving medicines for the next decade.

Limitations of the methodology are that some large countries were under‐represented in the questionnaire survey, and that the poorest stakeholders might have been under‐represented in the interviews.

The practical implication of this work is that it resulted in the formulation of an ethical policy or conceptual framework, referred to as the P3S3‐model, that the stakeholders, including policy makers, can use to work together in a setting of reduced conflict.

For pharmaceutical companies it is an ideal model to deploy their global social responsibility.

This is the first research that was designed to obtain and to build upon the in‐depth insights of key stakeholders and opinion leaders, on a comprehensive list of possible approaches to provide life‐saving medicines to poor people, at reasonable prices, globally. Therefore, the paper is of high originality/value.