A systematic literature review of healthcare supply chain and implications of future research

Public sector pharmaceutical distribution system and its challenges: a case of a central Ethiopian Pharmaceuticals Supply Service and selected branches

BACKGROUND

The purpose of pharmaceutical distribution is to ensure a consistent supply of quality-assured pharmaceuticals to service delivery points to avoid stock outs and/or overstocks. However, choosing a resource-efficient method is difficult because of the two competing interests of lowering distribution costs and improving service level. This study aimed to assess the public sector pharmaceutical distribution system and its challenges in central Ethiopian Pharmaceuticals Supply Service and selected branches.

METHODS

This study was conducted at the Central Ethiopian Pharmaceuticals Supply Service and four regional branches between December 2021 and February 2022, utilizing a concurrent parallel mixed-methods design. The quantitative component involved 104 respondents, with data analyzed using SPSS 23 through descriptive statistics. For the qualitative component, 17 key informants participated, and the data were manually analyzed through thematic analysis using an inductive approach.

RESULTS

Warehouse management was performed relatively well compared to inventory management and delivery practices, with overall mean scores of 3.22, 3.14, and 3.08, respectively. The qualitative study highlighted key challenges, including insufficient stock, off-schedule deliveries, the provision of near-expiry products, and vehicle constraints.

CONCLUSIONS

This study demonstrated that improving warehousing, inventory management, and delivery practices, while addressing key challenges, could significantly improve the effectiveness of pharmaceutical distribution.

Leagility in the healthcare research: a systematic review

BACKGROUND

Expenditure of healthcare services has been growing over the past decades. Lean and agile are two popular paradigms that could potentially contain cost and improve proficiency of the healthcare system. However no systematic review was found on leagilty in the healthcare research. This study aims at synthesizing the extant literature of leagility in the healthcare area to consolidate its potential and identify research gaps for future study in the field.

METHODS

A systematic literature review is conducted following the PRISMA checklist approach. Studies were searched in multiple databases. The selection of articles was executed by dual-scanning of two researchers to ensure quality of data and relevance to the topic. Scientific articles published between January 1999 and November 2023 concerning leagile healthcare are analysed using Microsoft Excel and VOSviewer (version 1.6.18).

RESULTS

Out of 270 articles identified from the inclusion and exclusion criteria, 24 were included in the review. A total of 11 target areas were identified in leagility applications in healthcare. Success and limiting factors of leagile healthcare were classified into macro and micro aspects and further categorized into six dimensions: policy, organization, human resources, marketing, operation management and technology. Moreover, four research gaps were revealed and suggestions were provided for future study.

CONCLUSION

Leagility in the healthcare context is still being in its infancy. Few empirical validation was found in leagile healthcare literature. Further exploration into the application of theory in various sectors under the scope of healthcare is appealed for. Standardization and modularization, leadership support, skillfulness of professionals and staff training are the factors most frequently mentioned for a successful implementation of leagility in the healthcare sector.

TrackChain: Hyperledger based pharmaceutical supply chain - Resource utilization perspective

A distributed and decentralised ledger system shared by a variety of users in a peer-to-peer network is defined as a blockchain. Through its decentralised approach, it makes pharmaceutical products more accessible and secure for vendors, while they can maintain and access their inventories themselves. Between a company and its suppliers, a supply chain is used to produce and distribute a specific product or service, whose efficiency is increased with its integration in the supply chain. For efficient and transparent tracking of products, blockchain will be the right choice. In view of blockchain being incorporated into the supply chain system, it solves many logistical issues that supply chains face, such as appropriate data access, ensuring data quality, and many more. This can increase the traceability of the material supply chain and improve the maintenance of the list when there are several products to be supplied. Therefore, the concept of supply chain was developed in two platforms namely, Hyperledger Fabric and Hyperledger Sawtooth. Finally, Hyperledger Sawtooth was found to be well suited for creating decentralised apps or platforms with respect to resource utilization It enables developers to separate their application domain from the core system so that business rules for apps can exist without requiring knowledge of the primary platform's underlying architecture. The proposed system shows that Hyperledger Sawtooth framework consumes lower CPU than Fabric which helps in increasing the number of transactions.

Labor markets for health supply chain management in Rwanda: a qualitative study of stakeholder perspectives

BACKGROUND

Effective supply chains for health products require an adequate, skilled workforce for supply chain management (SCM). Rwanda faces challenges in human resources for SCM, including limited capacity for SCM at different levels. Understanding of the factors influencing the supply of and demand for SCM professionals in Rwanda is necessary to ensure the labor market contains an adequate workforce. This study identifies the perspectives of key stakeholders in the supply chain management sector about the factors influencing the supply of and demand for SCM professionals.

METHODS

Data were collected in semi-structured group and one-on-one interviews with 39 key stakeholders involved in the supply chain management labor market between March and April 2019. Interviewees were categorized according to their role in the labor market as system actors, functional actors involved in the supply of SCM workers, and functional actors involved in the demand for SCM workers. Interviewees were asked open-ended questions about factors influencing the demand for and the supply of SCM workers, and recommendations for improvement. Interviews were analyzed thematically. One validation focus group was held and the results were also reviewed by the Ministry of Health in Rwanda.

RESULTS

Stakeholders agreed that skills mismatch between SCM workers' skills and the competencies jobs require impacts the supply of workers. A lack of career structure for SCM, lack of professional definitions for health supply chain management, and SCM curricula that do not match the needs of the workplace contribute to this gap. The demand for SCM professionals is poorly defined in terms of the numbers of professionals needed and the skills workers require. Financial limitations hinder demand for health SCM professionals.

CONCLUSIONS

This study adds to the understanding of factors influencing the SCM labor market in Rwanda by documenting perspectives from government ministries, professional organizations, universities, and employers from SCM organizations. Improving the SCM labor market in Rwanda and the availability of the skilled cadres required for the effective management of health supply chains in Rwanda requires a coordinated effort by the Ministry of Health in Rwanda, private SCM companies, professional associations, education sector, and policy makers.

Supply chain planning of vaccine and pharmaceutical clusters under uncertainty: The case of COVID-19

As an abrupt epidemic occurs, healthcare systems are shocked by the surge in the number of susceptible patients' demands, and decision-makers mostly rely on their frame of reference for urgent decision-making. Many reports have declared the COVID-19 impediments to trading and global economic growth. This study aims to provide a mathematical model to support pharmaceutical supply chain planning during the COVID-19 epidemic. Additionally, it aims to offer new insights into hospital supply chain problems by unifying cold and non-cold chains and considering a wide range of pharmaceuticals and vaccines. This approach is unprecedented and includes an analysis of various pharmaceutical features such as temperature, shelf life, priority, and clustering. To propose a model for planning the pharmaceutical supply chains, a mixed-integer linear programming (MILP) model is used for a four-echelon supply chain design. This model aims to minimize the costs involved in the pharmaceutical supply chain by maintaining an acceptable service level. Also, this paper considers uncertainty as an intrinsic part of the problem and addresses it through the wait-and-see method. Furthermore, an unexplored unsupervised learning method in the realm of supply chain planning has been used to cluster the pharmaceuticals and the vaccines and its merits and drawbacks are proposed. A case of Tehran hospitals with real data has been used to show the model's capabilities, as well. Based on the obtained results, the proposed approach is able to reach the optimum service level in the COVID conditions while maintaining a reduced cost. The experiment illustrates that the hospitals' adjacency and emergency orders alleviated the service level significantly. The proposed MILP model has proven to be efficient in providing a practical intuition for decision-makers. The clustering technique reduced the size of the problem and the time required to solve the model considerably.

Development of the information quality scale for health information supply chain type 2 diabetes mellitus management using exploratory factor analysis

Background

Research on the quality scale of the healthcare supply chain is still limited. This study aimed to assess the information quality of the supply chain model with a focus on construct validity. Studies related to information quality measurement generally focus on measuring the dimensions of the completeness of medical records and consumer perspectives. We intended to assess the scale based on doctors needed as care coordinators on type 2 diabetes mellitus or the Non-Insulin-Dependent-Diabetes-Mellitus (NIDDM) program in primary healthcare.

Methods

Sixty-four primary healthcare doctors with an age range of 24-51 years were involved in this research. The scale obtained was formed from the assessment of the point of view of a panel of experts through the content validity index (CVI). The exploratory factor analysis (EFA) method was used to explore the scale of information quality in the information supply chain model for the NIDDM chronic disease management program.

Result

The data analysis results indicated three main factors that affected the quality of the information supply chain model of NIDDM, namely accessibility, safety, and efficiency of information related to NIDDM. The results of the validity and reliability of the data showed that the scale used in this research was valid and reliable with a Cronbach alpha coefficient of 0.861.

Conclusion

The scale developed in this research could be used to explore the quality of the information supply chain of NIDDM management in primary healthcare. Each item on the scale could explain the variables according to their respective groups.

Factors Affecting Inventory Management Performance of Tracer Medicines Across Primary Health Care Units, Gamo Zone, Southern Nations Nationalities and People's Region, Ethiopia

Background

Inventory management ensures access to tracer medicines (TMs) for priority health-care needs. Factors that impede its performance across primary health-care units (PHCUs) are less explored in Ethiopia. The current study assessed factors affecting the inventory management performance of TMs across PHCUs, Gamo zone.

Methods

A cross-sectional survey was conducted in 46 PHCUs between April 1 and May 30, 2021. The data were collected using document review and physical observation. A stratified simple random sampling was employed. The data were analyzed by SPSS version 20. The results were summarized as mean and percentage. Pearson's product-moment coefficient and ANOVA were employed at a 95% CI. The correlation test established the relationships between dependent and independent variables. ANOVA test compared the performance between PHCUs.

Results

The inventory management performance of TMs across PHCUs is below the standard. On average stock according to the plan is 18%, the stock-out rate is 43%, the inventory accuracy rate is 78.5%, and availability across PHCUs is 78%. 72.3% of visited PHCUs fulfill storage condition criteria. Inventory management performance decreases downward the levels of PHCUs. There is a positive correlation between the availability of TMs and supplier order fill rate, r = 0.82, p < 0.01; between the availability of TMs and report accuracy, r = 0.54, p < 0.001; and between TMs stocked according to the plan and supplier order fill rate, r = 0.46, p < 0.01. The inventory accuracy was significantly different between primary hospitals and health posts (p = 0.009, 95% C.I = [7.57, 60.93]); and health centers and health posts (p = 0.016, 95% CI = [2.32, 25.97]).

Conclusion

The inventory management performance of TMs is below the standard. It is attributable to supplier performance, the quality of the report, and performance variation across PHCUs. These result in the interruption of TMs in PHCUs.

Creating a marketing mix model for the marketing of medical devices through public procurement

The purpose of the paper is to contribute to the knowledge in the field of marketing of medical devices in the public sector. The research problem is based on verifying the correlations between the elements of the 4P marketing mix, after-sales activities and their influence on the preparation of tender documentation in the marketing of medical devices to social welfare institutions. In the process of marketing products through public procurement, the same attention is devoted to the after-sales activities as marketing mix elements (4P). We created a marketing mix model for the marketing of medical devices through public procurement.

Design and implementation of an online tool for managing the availability of high-cost perishable medicines

Introduction

Due to their impact on healthcare systems, the sustainability and optimization of high-cost drugs is an issue of concern for several countries. Different strategies have been implemented such as centralized purchasing to optimize budgetary resources. However, there is still a need for a mechanism to optimize these drugs further.

Methods

We conducted this prospective multicenter intervention study in five hospitals in the Andalusian Public Health System of Cádiz (Spain) between July 2019 and September 2021. We developed an online website (Farmastock) and implemented it to determine the availability of high-cost, low-use, and near-expiry medicines in each hospital. We used a simple analysis using operational variables to assess the project intervention's savings impact on managing these high-cost drugs.

Results

The implementation of Farmastock in Cádiz resulted in savings of 675,757.52 € for the Andalusian Public Health System, with 238 medicines transferred out of the 373 available. Of these medicines offered, the most considerable percentage were medicines used for pathologies with high clinical instability and accounted for nearly 80% of the medicines optimized by the tool.

Conclusions

Farmastock allowed the Andalusian Public Health System to make substantial financial savings by not making new purchases of high-cost drugs available in other centers of this health network that were not being used. Therefore, this tool is a very efficient measure to contribute to the sustainability of the APHS and could be implemented in more hospitals soon.

The Impact of Two-Invoice System on Pharmaceutical Manufacturers' Selling Expenses in China: A Difference-in-Differences Approach

A perennial question for the pharmaceutical industry has been excessive drug prices. To alleviate patients’ burden of expensive medical bills and increase the affordability of medicines, China adopted the Two-Invoice System (TIS) in drug procurement for public medical institutions in 2017. In this paper, we study the impact of the TIS on pharmaceutical manufacturers’ selling expenses. Using a Difference-in-Differences (DID) methodology and a sample of the A-share pharmaceutical manufacturing firms listed on the Shanghai Stock Exchange and Shenzhen Stock Exchange from the years 2014 to 2020, we find that the TIS leads to a significant increase in pharmaceutical manufacturers’ selling expenses but gradually weakens over time. In addition, we further explore whether the impact of the TIS on pharmaceutical manufacturers’ selling expenses is affected by the pharmaceutical manufacturers’ previous drug circulation mode. The results indicate that the TIS could significantly increase the pharmaceutical manufacturers’ selling expenses in the agency mode group. However, there is no evidence to support the TIS having the same effect in the direct sales office model group.

Healthcare Supply Chain Reliability: The Case of Medical Air Transport

The principal task of national healthcare systems is to provide health services that are safe, accessible, high-quality and people-oriented. To ensure the continuity of healthcare, support activities related to patient transfer and logistics are necessary. Effective implementation of transport processes is a factor affecting the possibility of medical intervention, in terms of both planned and life-saving care. The reliability of the healthcare supply chain is a key factor in patient health. In our research, we have used the method of a single case study of a public regional hospital in Poland providing comprehensive medical services. The aim of the research is to identify the factors that affect the reliability of the healthcare supply chain in relation to the interhospital air transport of patients. Our qualitative research using process mapping reveals what factors affect the reliability of interhospital medical air transport. The analysis of 100 interhospital medical air transport cases has allowed us to create a general procedure related to the movement of patients between the facilities of the healthcare system in Poland. Our research shows that the key factor of reliability is the coherent and integrated cooperation of institutions involved in transport processes.

Supply chain integration as a strategy to strengthen pandemic responsiveness in Nova Scotia

This provincial case study, one of seven conducted as part of a national research program on healthcare supply chain management during COVID-19, focuses on Nova Scotia. During the first wave of the pandemic, Nova Scotia faced the massive destabilization of its traditional supply channels and had to grapple with role clarity and communication in its emergency response structure. Nova Scotia was able to centralize its pandemic sourcing, procurement, and management efforts to its provincial health authority. Healthcare supply chain teams were able to rapidly modify their sourcing and procurement processes in order to compensate for the destabilization of their standard supply channels and assume responsibility for the province-wide management and distribution of pandemic supplies. The Nova Scotia case findings make clear both the value of a centralized and dedicated healthcare supply chain response-that integrates all provincial care delivery organizations-and the diversification of the healthcare supply chain.

Digitally enabled supply chain as a strategic asset for the COVID-19 response in Alberta

This provincial case study, one of seven conducted as part of a national research program on healthcare supply chain management during COVID-19, focuses on Alberta. With a history of emergency preparedness, Alberta’s unique context, one that includes having an already established, centralized, and digital healthcare supply chain strategy, sets this case apart from the others in terms of pandemic responses. A key challenge navigated by Alberta was the inadequacies of traditional sourcing and procurement approaches to meet surges in product demand, which was overcome by the implementation of unique procurement strategies. Opportunities for Alberta included the integration of supply chain teams into senior leadership structures, which enabled access to data to inform public health decision-making. This case demonstrated how Alberta’s healthcare supply chain assets—its supply chain infrastructure, data, and leadership expertise, especially—contributed to resilient supply chain capacity across the province.

Institutional change and stability in strategic networks in the Brazilian pharmaceutical industry

Purpose

This study aims to analyze the dynamics of the institutional change and institutional stability undergone by strategic networks (SNs) in the pharmaceutical industry.

Design/methodology/approach

The authors performed a case study with four Brazilian SNs which followed different patterns of institutional change and institutional stability. Twenty network managers and network members from the pharmaceutical industry were interviewed, and documents were analyzed.

Findings

The results show how and why institutions changed or remained the same. More specifically, exogenous shocks can negatively impact the competitive environment influencing institutional change in SNs. Moreover, endogenous shocks may prevent institutional change and stimulate institutional stability. Continuous interaction between institutions and SNs is the key to institutional change, especially if public and private policies are considered a source of political institutions.

Originality/value

Research has highlighted the endogenous influence of SNs on firms in selecting their partners and arranging their positions in the SNs, but little attention has been paid to how SNs themselves respond to institutions or promote institutional change. This study explains how and why change fails at the network level, additionally pinpointing the main sources of the institutional change and inertia in SNs. As such, network members may use different strategies to stimulate institutional change or stability according to their interests.

Supply chain capacity to respond to COVID-19 in Newfoundland and Labrador: An integrated leadership strategy

This provincial case study, one of seven conducted as part of a national research program on healthcare supply chain management during COVID-19, focuses on Newfoundland and Labrador (NL). Faced with the destabilization of its traditional supply chain, NL leveraged an existing centralized healthcare supply chain structure to organize its supply chain response to the pandemic. To overcome product shortages, health leaders collaborated with their local business community and industries to source and procure personal protective equipment and create domestic manufacturing capacity for critical supplies. The healthcare supply chain response in NL demonstrates the value of a highly integrated and centralized healthcare supply chain management strategy. It also makes clear the value of a diversified healthcare supply chain, one which draws on local manufacturing capacity to create a domestic source of critical supplies and overcome shortages from global suppliers.

Improving resilience of the healthcare supply chain in a pandemic: Evidence from Europe during the COVID-19 crisis

The severe scarcity of critical medical supplies caused by the COVID-19 pandemic led to considerable procurement challenges in the healthcare supply chain (HCSC). As ensuring the availability of such supplies during disruptions is critical, the debate on how to increase supply chain resilience in healthcare has gained new momentum. We present empirical evidence from a multi-tier case study spanning nine European medical supplies manufacturers and hospital groups. Based on the resource dependence theory, we investigated procurement-related strategies to improve medical supplies availability. We conducted semi-structured interviews with 39 procurement and supply chain management experts and derived seven propositions on buffering and bridging approaches for managing evolving resource dependencies and thereby strengthening supply chain resilience in a pandemic. Overall, we confirm the resource dependence theory's applicability for explaining companies' mitigation measures in a pandemic disruption. We find that bridging measures within the healthcare supply base, such as offering procurement support for suppliers or leveraging long-term buyer-supplier relationships, are more effective for securing medical supplies than buffering measures. Complementing bridging with buffering, such as extended upstream procurement or resource sharing among hospitals, can lead to superior risk mitigation as capacities of the present supplier base may not suffice. Furthermore, we extend the resource dependence theory by showing that the severity of disruptions caused by a pandemic triggers new forms of buffering external to the HCSC. Both traditional and new buffering measures establish novel flows of medical supplies in the HCSC that can enable higher supply security in a pandemic.

A structural equation model for big data adoption in the healthcare supply chain

Purpose

The purpose of this study is to examine the barriers to the implementation of big data (BD) in the healthcare supply chain (HSC).

Design/methodology/approach

First, the barriers concerning BD adoption in the HSC were found by conducting a detailed literature survey and with the expert's opinion. Then the exploratory factor analysis (EFA) was employed to categorize the barriers. The obtained results are verified using the confirmatory factor analysis (CFA). Structural equation modeling (SEM) analysis gives the path diagram representing the interrelationship between latent variables and observed variables.

Findings

The segregation of 13 barriers into three categories, namely “data governance perspective,” “technological and expertise perspective,” and “organizational and social perspective,” is performed using EFA. Three hypotheses are tested, and all are accepted. It can be concluded that the “data governance perspective” is positively related to “technological and expertise perspective” and “organizational and social perspective” factors. Also, the “technological and expertise perspective” is positively related to “organizational and social perspective.”

Research limitations/implications

In literature, very few studies have been performed on finding the barriers to BD adoption in the HSC. The systematic methodology and statistical verification applied in this study empowers the healthcare organizations and policymakers in further decision-making.

Originality/value

This paper is first of its kind to adopt an approach to classify barriers to BD implementation in the HSC into three distinct perspectives.

Evaluating Supply Chain Collaboration Barriers in Small- and Medium-Sized Enterprises

The disruption has a significant impact on supply chain collaboration (SCC) which is an important task to improve performance for many enterprises. This is especially critical for small- and medium-sized enterprises (SMEs). We developed a decision-modeling framework for analyzing SCC barriers in SMEs for the emerging economy in Bangladesh. Through literature review and expert opinion survey, we have identified a comprehensive list of SCC barriers under four main categories, namely, information-related, communication-related, intra-organizational, and inter-organizational barriers. Then we applied the Grey DEMATEL and Fuzzy Best-Worst methods to evaluate these SCC barriers and compared the results. We also conducted a sensitivity analysis to assess the robustness of the proposed approach. The study reveals that lack of communication is the most crucial barrier in SCC, providing a model for assessing barriers in other emerging economies. This study contributes to the literature by analyzing SCC barriers and by comparing the results obtained from two different MCDM methods. The findings of this study can help decision-makers to plan for overcoming the most prioritized SCC barriers which ultimately contribute to improving the resilience and sustainability performances of SMEs.

Analyzing the operational barriers of government-supported healthcare supply chain

Purpose

The purpose of this study is to develop a methodology for the identification, categorization and prioritization of operational government-supported healthcare supply chain barriers (GHSCBs).

Design/methodology/approach

This study develops a theoretical background for identifying and segregating relevant GHSCBs and proposes a 5W2H (a Toyota production system) with fuzzy DEcision MAking Trial and Evaluation Laboratory (DEMATEL) embedded approach to quantify the causal–effect relationships among the identified operational GHSCBs.

Findings

Seven GHSCBs (i.e. uncertainty of demand management, lack of continuous improvement and learning, lack of deadline management, lack of social audit, warehousing equipment unavailability, human resource shortage and inadequate top level monitoring) were identified as significant cause group where the government, top management and decision-makers of government-supported healthcare supply chain (GHSC) have to put efforts.

Research limitations/implications

The results obtained are specific to the GHSC of Indian perspective, which could be extended to global context. However, the proposed approach can be a base and provide a platform to understand and analyze the interactions among GHSCBs.

Practical implications

The proposed methodology will show the appropriate areas for allocating efforts and resources to mitigate the impact of GHSCBs for successful implementation of healthcare supply chain.

Originality/value

According to best of the authors' knowledge, this is the first study of operational barrier for GHSC in India in specific. The use of 5W2H embedded fuzzy DEMATEL approach for the development and analysis of the theoretical framework of Indian GHSCBs is unique in barrier literature.

Opportunities and challenges for contactless healthcare services in the post-COVID-19 Era

This study examines the opportunities and challenges involved with contactless healthcare services in the post-COVID-19 pandemic era. First, we reviewed the literature to analyze contactless or contact-free healthcare services that have been utilized in pre-and during the COVID-19 pandemic periods. Then, we interviewed medical experts and hospital administrators to gain knowledge about how healthcare providers are currently working to mitigate the spread of COVID and preparing for the post-pandemic period. Thus, we analyzed the evolution and utilization of contactless services during the three different time periods: pre-, during-, and post-COVID-19. The results indicated that in the post-COVID-19 era, a new normal of hybrid healthcare services would emerge. While some of the contactless services that have been practiced during the pandemic may revert to the traditional face-to-face services, those innovative contactless healthcare services that have been proven effective during the pandemic would be practiced or even advanced in the post-pandemic period due to the accelerating technological developments. This study suggests many potential opportunities and daunting challenges for healthcare institutions, policymakers, and consumers regarding the implementation of contactless services in the post-COVID-19 era.

A collaborative approach to maintaining optimal inventory and mitigating stockout risks during a pandemic: capabilities for enabling health-care supply chain resilience

Purpose

Inventory management systems in health-care supply chains (HCSC) have been pushed to breaking point by the COVID-19 pandemic. Unanticipated demand shocks due to stockpiling of medical supplies caused stockouts, and the stockouts triggered systematic supply chain (SC) disruptions inconceivable for risk managers working individually with limited information about the pandemic. The purpose of this paper is to respond to calls from the United Nations (UN) and World Health Organization (WHO) for coordinated global action by proposing a research agenda based on a review of current knowledge and knowledge gaps on the role of collaboration in HCSCs in maintaining optimal stock levels and reinforcing resilience against stockout disruptions during pandemics.

Design/methodology/approach

A systematic review was conducted, and a total of 752 articles were analyzed.

Findings

Collaborative planning, forecasting and replenishment practices are under-researched in the HCSC literature. Similarly, a fragmented application of extant SC collaborative risk management capabilities undermines efforts to enhance resilience against systematic disruptions from medical stockouts. The paucity of HCSC articles in humanitarian logistics and SC journals indicates a need for more research interlinking two interdependent yet critical fields in responding to pandemics.

Research limitations/implications

Although based on an exhaustive search of academic articles addressing HCSCs, there is a possibility of having overlooked other studies due to search variations in language controls, differences in publication cycle time and database search engines.

Originality/value

The paper relies on COVID-19's uniqueness to highlight the limitations in optimization and individualistic approaches to managing medical inventory and stockout risks in HCSCs. The paper proposes a shift from a fragmented to holistic application of relevant collaboration practices and capabilities to enhance the resilience of HCSCs against stockout ripple effects during future pandemics. The study propositions and suggestion for an SC learning curve provide an interdisciplinary research agenda to trigger early preparation of a coordinated HCSC and humanitarian logistics response to future pandemics.

Antecedents to buyer-supplier coordination in the pharmaceutical supply chain

Purpose

The purpose of this study is to understand the antecedents that influence supply chain coordination in the pharmaceutical supply chain using the transaction cost analysis framework.

Design/methodology/approach

Data from 156 retail pharmacies on their relationship with the pharmaceutical wholesalers are used to test the hypotheses.

Findings

The findings of this paper show the importance of antecedents that are based on the transactional cost theory, such as asset specificity and environmental uncertainty. These antecedents impact the supply chain process coordination at different levels – transactional, operational and strategic.

Research limitations/implications

Future research may investigate additional antecedents using other theoretical lenses.

Practical implications

Pharmaceutical wholesalers are dependent on pharmaceutical manufacturers for the supply of products and face intense competition that results in lower profit margins. Given that the pharmaceutical industry is strictly regulated, the wholesaler facilitates regulatory compliance of the manufacturers in the distribution process by coordinating with them. But the wholesalers do also face a constant threat from the manufacturers, who could potentially bypass the wholesalers (disintermediation) and go directly to the pharmacies. To counterbalance the dependence, the wholesalers strive to achieve loyalty with the retail pharmacies. Through supply chain coordination, the wholesalers achieve efficiency in procurement for the pharmacies, thus reducing cost and improving their competitive advantage.

Social implications

Supply chain coordination in the pharmaceutical supply chain improves the safety and security of the pharmaceutical distribution system.

Originality/value

This paper contributes to the supply chain coordination stream of literature. To the best of the authors’ knowledge, this is the first study to develop the three levels of process coordination in the pharmaceutical supply chain context. This paper shows how process coordination can be achieved between the dyad without vertical integration.