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An investigation into the aspects of innovation within the downstream domain of the pharmaceutical supply chain This research evaluates the implementation of innovative programmes within the downstream domain of the Pharmaceutical Supply Chain (PSC). Pharmacies are considered as key links between healthcare services and patients because they are responsible for dispensing and managing pharmaceuticals in order to prolong life. Considering the healthcare organisations‘ crucial role and that they face the challenge of minimising the cost of healthcare services while enhancing service quality, healthcare organisations tend to try improvement approaches and innovative interventions to enhance their efficiency and effectiveness. Specifically, they tend to focus on improving their Supply Chain Management (SCM) in order to reduce waste, in particular with regards to their medicine expenditure, and to provide improved services. However, implementing innovation within the Pharmaceutical Supply Chain (PSC) is not yet adequate; at present there appears to be a lack of experience and knowledge of how such initiatives should be undertaken. Research that examines potential innovative contributions might therefore make a defined contribution to the sector. This research, therefore, aims to assess the current medicine delivery process and identify the issues responsible for weak process performances and the factors that influence pharmacies‘ innovativeness within two diverse European contexts, the UK and Greece. An exploratory research design, embracing a mixed-methods approach, was used to analyse the issues associated with PSC inefficiency and assess to what extent innovation could be adopted by hospital and community pharmacies to improve the delivery process of pharmaceutical products. The qualitative data was gathered through 30 interviews with key professionals working within the downstream domain of the PSC in the two selected geographical areas. A total of 21 in-depth interviews in the UK and 9 in Greece were conducted to examine the elements preventing the effective and efficient delivery of medicines. Simultaneously, an online survey was developed to collect the quantitative data. The final sample (N=130) consisted of specialists working within the down stream domain of the PSC in Greece and the UK. The quantitative data analysis aimed to identify the factors that support or prevent innovation within this specific and complex environment. The analysis and combination of these two sets of data enabled the researcher to gain a comprehensive understanding and recommend innovative solutions that are suitable to the system under investigation, leading to continuous improvement. This research contriputes to academic literature as it adds more theoritical insights to innovative delively processes, especially those that have been characterised as highly complex. The results led to the generation of the Innovative Pharmaceutical Supply Chain Framework (IPSCF) that provides guidelines to healthcare organisations about how the identified problems can be overcome by implementing suitable innovative techniques. The implementation of Lean and Reverse Logistics practices, which are supported by integrated Information Technology (IT) systems, are suggested as a means for healthcare organisations to enhance their delivery system in terms of quality (products and service quality), visibility (knowledge and information sharing), speed (respond to customers and suppliers needs) and cost (minimisation of cost and waste) and therefore generate a competitive edge. The study‘s recommendations have important implications for pharmacies, as they provide guidance regards suitable innovative programmes that can be adopted. The outputs of this research are specifically relevant to the pharmacy sectors of the UK and Greece, but may have also relevance for European healthcare organisations.