Yes / Purpose The objective of this study was to advance our knowledge of pharmaceutical supply chain resilience using Complex Adaptive System theory (CAS). Design/methodology/approach 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 United Kingdom (UK). Findings 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, like 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. Originality/value 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.

<p> </p> <p><em>This study examines data-driven contract design in the small data regime and large data regime respectively, and the implications from contract pricing in the pharmaceutical supply chain. </em></p>

Yes / Purpose 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. Design/methodology/approach 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). Findings 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. Practical implications 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). Originality/value This study is the first to provide empirical evidence of the impact of resilience strategies in mitigating medicine shortages in the UK's PSC.

Falsified and substandard drugs are classified as a global problem and continue to increase as manufacturing becomes globalized and the complexity of distribution systems expands. The falsified and substandard drugs come with major health risks and socioeconomic consequences. The pharmaceutical supply chain is handled by several parties, making it harder to detect when falsified and substandard drugs end up in distribution. Since the rise of the cryptocurrency bitcoin, blockchain technology has been recognized for its transparency and security. Previous research describes blockchain as a decentralized database structure that preserves a chronological chain of blocks where each block contains a registered valid network activity verified by consensus of the participants in the network. The purpose of this study is to create a broader understanding of how blockchain can improve the transparency and traceability of the pharmaceutical supply chain in order to reduce the incidence of falsified and substandard drugs. The study is based on a qualitative method in the form of five semi-structured interviews with representatives from the pharmaceutical industry and two blockchain companies. In the study's discussion section, the literature study is set against the collected empirical material. Two tables also illustrate how the pharmaceutical industry is working with traceability and what effects blockchain can provide a supply chain. Finally, the study notes that regulations on the pharmaceutical industry primarily control which database structure is implemented on the supply chain. It is also stated that blockchain has characteristics that can improve transparency and traceability of a supply chain, but the technology is to some extent limited mainly by its large need for capacity

Rising Antimicrobial Resistance is a threat faced all over the world. Bacterial infections that were treatable with antibiotics only a few years ago can now lead to life-threatening conditions. This thesis is part of the work of a large platform, PLATINEA, trying to reduce the rate of new resistances occurring in Sweden by preventing non optimal treatment. Due to shortages of the right antibiotics, suboptimal antibiotics are prescribed, which has shown to be accelerating the resistances among the bacterial populations. This study proposes an information exchange database and a central storage model for critical antibiotics to circumvent stock outs and inconveniences resulting from shortages of medically valuable antibiotics. Through interviewing prominent actors in the Swedish pharmaceutical supply chain an inside into the procurement of antibiotic in Sweden and what concerns are faced by the organs involved was created. Literature studies on occurred shortages of antibiotics in Sweden and the world were examined and possible reasons for these were identified. Examination of governmental efforts and assignments created the context in which gaps were identified that this thesis work could fill. A focus on Benzylpenicillin and Rifampicin were kept throughout the study. The collected data led to the implementation recommendation of two models by this study. An information platform suggested to allow better, faster and more accurate information exchange between all involved actors of the supply chain as well as a centralized storage model for the storage of antibiotics with medically high value in Sweden.  Through the implementation of the model systems shortages of critical antibiotics can be circumvented and better availability of information leads to quicker reactions ability to stock outs of other antibiotics.

Logistics and Supply Chain Management has become a vital component in every industry in the globalised world. It is a key strategic tool for companies to deliver services and resources to stakeholders and a source of competitive advantage, consequently any failures to optimise or develop a supply chain can lead to a loss of customers, revenue and market share. The healthcare industry, specifically pharmaceuticals, is one such industry which is highly dependent on a stable and secure supply chain to deliver both products and services. However, on an extended level the pharmaceutical supply chain is often described as less mature than the automotive or aviation industry’s - both the part of the distribution channel connecting manufacturers to healthcare providers, as well as the one linking those to patients accessing medicine via authorised pharmacies. In several countries this was at least partly due to underdeveloped Information Technology (IT) infrastructure provided by the national health care providers. IT is often the driving force and backbone of any supply chain infrastructure - without the ability to compute vast amounts of data in real-time it becomes difficult for a supply chain to remain efficient and functional. Sweden is among the countries, which have upgraded their IT, adapted their law and thus allowed for the home delivery of sensitive prescription only (PO) medicine to patients which is, for example, already in use in England. To analyse the circumstances for an introduction of home delivery and its implications for the supply chain a dual case study adopting an abductive approach was carried out on both the corporate and retail level of PO medicine administration - namely, private pharmacy chains in Sweden, as well as a significant player in the pharmaceutical logistics industry. / Logistik och Supply Chain Management har blivit en viktig del i alla branscher i den globaliserade världen. Det är ett viktigt strategiskt verktyg för företag att leverera tjänster och resurser till berörda parter och en källa till konkurrensfördel, därför eventuella fel för att optimera eller utveckla en försörjningskedja kan leda till en förlust av kunder, intäkter och marknadsandelar. Hälso-och sjukvården, särskilt läkemedel, är en sådan bransch som är starkt beroende av en stabil och säker leveranskedja för att leverera både produkter och tjänster. Men på en utökad nivå läkemedelsleveranskedjan beskrivs ofta som mindre mogna än fordons-eller flygindustrin är - både den del av distributionskanal ansluter tillverkarna att vårdgivare, såväl som den som förbinder dem till patienter tillgång till läkemedel via auktoriserade apotek . I flera länder var detta åtminstone delvis på grund av underutvecklade informationsteknik (IT) infrastruktur som tillhandahålls av de nationella vårdgivare. Det är ofta den drivande kraften och ryggraden i alla försörjningskedjan infrastruktur - utan möjlighet att beräkna stora mängder data i realtid blir det svårt för en försörjningskedja för att förbli effektiv och funktionell. Sverige tillhör de länder som har uppgraderat sin IT, anpassat sin lagstiftning och därmed tillåtet för hemleverans av känsliga recept (PO) medicin till patienter som är, till exempel, som redan används i England. För att analysera de omständigheter för en introduktion av hemleverans och dess konsekvenser för leveranskedjan en dubbel fallstudie anta en abduktiv metod utfördes på både företags-och detaljistledet av PO medicin administration - nämligen privata apotekskedjor i Sverige, samt som en betydande aktör inom läkemedelslogistikbranschen.

Indian pharmaceutical companies spend one-third of their revenue from supply chain management (SCM) activities due to inherently poor transportation infrastructure. SCM is a vital function for many companies, as it is usually employed to lower expenses and increase sales for the company. SCM costs are higher in India than they are in other areas of the world, amounting to 13% of India's GDP. The purpose of this study was to explore SCM strategies Indian business leaders in the pharmaceutical industry have used to reduce the high costs associated with SCM. This study used a single case study research design and semistructured interviews to collect data from 3 SCM business leaders working in Indian pharmaceutical organizations and possessing successful experience in using SCM strategies to reduce high costs. Goldratt's (1990) theory of constraints was used as the conceptual framework for this study to identify challenges associated with SCM strategies. Data from semistructured interviews, observations, and company documents were processed and analyzed using data source triangulation, grouping the raw data into key themes. The following 3 themes emerged: distribution and logistics challenges, impact of SCM processes, and best practices and solutions. The implications for positive social change include the potential to reduce supply chain risk, which could lead to lower product prices for consumers, increased stakeholder satisfaction, and a higher standard of living.

Generic pharmaceutical supply chains are complex, interfacing humanitarian needs, industrial manufacturing, regulatory bodies and numerous other shareholders. This report gives a brief introduction to a current supply chain process within a company as well as a proposal to improve the supply chain financially, socially and environmentally. Data has been collected mainly through interviews and literature studies in order to conduct a case study. The project included an initial business case, calculations of necessary data in order to justify the work as well as to quantify the results. The main part of the proposal is to postpone the packing of medical products to a later stage as a way of improving the triple bottom line. Theoretically, this change results in lower ordering costs, lower volumes scrapped and thus lower scrapping costs and pollution, a decrease in order volumes further reducing costs and pollution and more. The study met the intended outcomes and would theoretically improve the company in line with the set targets. At the time of writing it is yet unclear whether it will lead to any action on behalf of the company. / Försörjningskedjorna inom farmaceutisk generika är komplexa med många externa beröringspunkter såsom mänskligt behov, industriell produktion, regulatoriska organisationer och andra intressenter. Den här rapporten erbjuder en kort introduktion till den befintliga försörjningsprocessen i ett företag i branschen samt ett förslag till hur företaget kan förbättra sin försörjningskedja ur ett ekonomiskt, socialt och miljömässigt perspektiv. Information har inhämtats främst genom intervjuer och litteraturstudier som har utgjort grund för en fallstudie. Projektet inkluderade framtagning av ett beslutsunderlag, datakalkyler för att ge stöd åt syftet med arbetet samt för att kvantifiera resultaten. Huvuddelen av förslaget utgörs av senareläggningen av packningsstadiet för medicinska produkter och effekten det får på det som på engelska kallas triple bottom line. Implementeringen av projektet ska teoretiskt leda till bland annat förbättrade vinstmarginaler, lägre andel kassationer och därmed en minskning av kostnader och utsläpp hänförliga till kassationer, lägre ordervolymer vilket i sin tur leder till sänkta kostnader och utsläpp. Studien har gett ett positivt utfall relativt målsättningen och implementeringen ska teoretiskt leda till en förbättring av verksamheten i linje med de uppsatta målen. I skrivande stund är det oklart huruvida företaget kommer att implementera förslaget.

Antimicrobial resistance (AMR) is the process where the bacteria develop resistance towards the treating effect of an antibiotic drug. AMR poses an alarming threat to human health causing around 700,000 deaths per year around the globe. If appropriate measures to combat the resistance are not taken, the number of deaths globally could increase to around 10 million by the year 2050. There are various factors driving the growth of AMR of which antibiotic shortages are common. A clear insight into the pharmaceutical supply chain is necessary to understand the reasons causing antibiotic unavailability. Ensuring access to medicines is one of the major objectives of pharmaceutical supply chains. Pharmaceutical firms compete in a volatile market to increase their profits. Antibiotics render slim profit margins to pharmaceutical firms; declining profits and increasing costs of production have led to firms outsourcing their operations to suppliers in different geographical locations. This in turn forms complex supply chain structures with various actors of a single drug chain being dispersed across the globe. The complexity in these supply chains lead to antibiotic supply interruptions. National drug shortages drive the risk of AMR, and these shortages are caused when pharmaceutical supply chains are weak or fragile. Therefore, the pharmaceutical supply chains need to be thoroughly analysed. This thesis aims to explore the different possible upstream supply chain structures that could exist in pharmaceutical supply chains. The study also highlights the factors that motivate the firms to choose different supply chain structures. This research is based on the existing literature on pharmaceutical supply chains. Qualitative semi-structured interviews, reports and existing research articles guided the authors in building a typology of upstream pharmaceutical supply chains based on: how different processes are handled by the MAH, the geographical location of operations in the chain, and the sourcing strategy of the Market Authorisation Holder (MAH) who owns the license for the drug. The findings of this study outline how a pharmaceutical firm could possibly structure the upstream supply chain based on its strategies. This study is limited to conceptualizing only the actors involved in the direct supply chain of the focal firm (MAH), further research including actors in the extended supply chain needs to be performed to get deeper insights into pharmaceutical supply chains.