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Operations and Supply Chain Management (OSCM) has continually evolved, incorporating a broad array of strategies, frameworks, and technologies to address complex challenges across industries. This encyclopedic article provides a comprehensive overview of contemporary strategies, tools, methods, principles, and best practices that define the field’s cutting-edge advancements. It also explores the diverse environments where OSCM principles have been effectively implemented. The article is meant to be read in a nonlinear fashion. It should be used as a point of reference or first-port-of-call for a diverse pool of readers: academics, researchers, students, and practitioners.
Antibiotic resistance is one of the most urgent threats to public health. The development of antibiotic resistance can be reduced by the use of narrow-spectrum antibiotics that target specific bacteria, meaning that fewer non-harmful bacteria are killed and other harmful bacteria are not exposed to selection pressure. However, many narrow-spectrum antibiotics were introduced decades ago and therefore lack regulatory documentation in line with current standards. An additional problem for a reliable supply is that of market fragmentation, where countries with similar resistance patterns and prescribing cultures (e.g. Norway and Sweden) prioritize different formulations and strengths. For example, over half of Sweden’s highest priority paediatric antibiotics are not marketed in Denmark or Norway in the same formulations or dosages. Such market fragmentation, which can result in the annual demand of a country being smaller than batch production sizes, means that specific strengths and formulations may no longer be economical to supply. Further, once an antibiotic has been withdrawn from the market, it is difficult to attract a new supplier because of the cost of the clinical trials required to update approval of the drug. However, as resistance to antibiotics increases among populations, clinicians need access to the maximum possible range of antibiotics. Regional collaboration, that is, the harmonization of essential medicines lists (including strengths and formulations for older antibiotics) between countries, is a recommended first step towards reliable access to the necessary range of antibiotics.
The purpose of this study is to advance knowledge of the effects of using environmental criteria in the tendering and procurement of pharmaceuticals. In cooperation with the Norwegian Hospital Procurement Trust, we conducted a longitudinal case study of how environmental criteria in the tendering of generic antibiotics were implemented. This case is one of the first attempts to use environmental criteria in generic pharmaceuticals procurement. Qualitative and quantitative data were collected based on interviews, workshops, meetings and secondary sources, followed by iterative analysis, including a case narrative and causal loop diagramming. We found that rewarding environmental criteria fulfilment at the expense of price seems to have multiple effects. Firstly, higher prices increase public spending in the short-term but also help maintain the supply base, which can reduce shortages. Secondly, this increased focus gives more transparency into supplier risks. It is this latter unexpected effect of introducing environmental tendering criteria that makes the case and our analysis particularly interesting. Additionally, in the long term, interviewees expect that increased focus on environmental criteria for specific antibiotics will have the intended effect of reducing transmission of resistant bacteria through improving suppliers’ production processes. Our findings also suggest that increased focus on environmental criteria does not necessarily increase shortages of narrow-spectrum antibiotics, which could unintendedly increase transmission of resistant bacteria. Data from our case study suggest that these two effects are likely to have a positive influence on public health, thereby potentially reducing future healthcare costs.
Background: The COVID-19 pandemic exposed vulnerabilities in global supply chains, including those for essential medicines like paracetamol. This study aimed to assess the resilience and adaptability of Ethiopia’s paracetamol supply chain during the pandemic. Methods: A mixed-methods approach was employed, combining semi-structured interviews with key stakeholders and analysis of secondary data on paracetamol availability and supply chain disruptions. The study employed systems thinking and supply chain resilience frameworks, utilizing causal loop diagrams to visualize system dynamics. Results: Eighteen stakeholders, representing seven pharmaceutical manufacturers, five import companies, and five wholesalers, participated in the study. These participants had between three and fourteen years of experience in their respective roles. The study revealed complex interactions within the paracetamol supply chain, highlighting both challenges and adaptive responses. While 500 mg paracetamol tablets were readily available, shortages of other formulations were observed due to a range of factors, including limited product diversification, political instability, inflation, and reduced production efficiency. Conclusions: The resilience and adaptability of stakeholders, particularly manufacturers and importers, were crucial in maintaining the supply of 500 mg paracetamol tablets. Key strategies included regional sourcing, increased production, and improved partnerships. Understanding the interconnectedness of factors within the supply chain is essential for developing effective strategies to enhance its resilience and ensure sustained access to paracetamol in the future.
We investigate how organizations embedded in a supply system collectively respond to risks and seize opportunities arising from crisis events under shifting forms of uncertainty. Using the United Kingdom (UK) medicine supply system as the research context, we explore how decision-makers navigated the effects of an event with knowable implications (UK's European Union exit, 2016–2020) followed by an event with unknowable implications (COVID-19 global pandemic, 2020–2021). We adopt a longitudinal case research design that incorporates causal loop diagramming, to understand the system's responses. We find that learning evolves as crisis events unfold, changing from surface (know-what) to deep (know-why and -how) and at the highest level, it is transcendent. Transcendent learning entails understanding system effects into the future (i.e., beyond the past and present) and in relation to other supply systems (i.e., beyond the UK system). Capabilities to absorb, avoid, and accelerate away from shocks are developed sequentially as learning changes. We contribute to prior research by developing a theory of system-level strategic agility and the adaptation processes that underpin it. The latter hinge on dynamic resource (re)allocation and the continuous (re)configuration of processes, protocols, regulations, and structures.
Objectives Lockdowns and border closures impacted medicine availability during the COVID-19 pandemic. This study aimed to assess the availability of essential, generic medicines for chronic diseases at public pharmaceutical supply agencies in Ethiopia. Design Comparative cross-sectional study. Setting The availability of essential, generic medicines for chronic diseases was assessed at two public pharmaceutical supply agency hubs. Participants The current study included public supply agency hub managers, warehouse managers and forecasting officers at the study setting. Outcomes The assessment encompassed the availability of chronic medicines on the day of data collection, as well as records spanning 8 months before the outbreak and 1 year during the pandemic. A total of 22 medicines were selected based on their inclusion in the national essential drug list for public health facilities, including 17 medicines for cardiovascular disease and 5 for diabetes mellitus. Results The results of the study indicate that the mean availability of the selected basket medicines was 43.3% (95% CI: 37.1 to 49.5) during COVID-19, which was significantly lower than the availability of 67.4% (95% CI: 62.2 to 72.6) before the outbreak (p<0.001). Prior to COVID-19, the overall average line-item fill rate for the selected products was 78%, but it dropped to 49% during the pandemic. Furthermore, the mean number of days out of stock per month was 11.7 (95% CI: 9.9 to 13.5) before the outbreak of COVID-19, which significantly increased to 15.7 (95% CI: 13.2 to 18.2) during the pandemic, indicating a statistically significant difference (p<0.001). Although the prices for some drugs remained relatively stable, there were significant price hikes for some products. For example, the unit price of insulin increased by more than 130%. Conclusion The COVID-19 pandemic worsened the availability of essential chronic medicines, including higher rates of stockouts and unit price hikes for some products in the study setting. The study's findings imply that the COVID-19 pandemic has aggravated already-existing medicine availability issues. Efforts should be made to develop contingency plans and establish mechanisms to monitor medicine availability and pricing during such crises.
This case examines Nova Post's strategic response to the challenges posed by the Russian full-scale military invasion into Ukraine in 2022, focusing on its expansion into the European market. As Ukraine's leading postal and express delivery service, Nova Post faced a dramatic decline in business at the onset of the war, prompting a reassessment of its operational and strategic direction. The case explores the company's journey from its inception as a small startup to becoming a national logistics giant, and its pivot during the crisis to adapt and explore new markets. Students are challenged to analyze the organizational issues surrounding expanding to other countries and strategies for doing so.
Purpose
This paper links supply chain risk management to medicine supply chains to explore the role of policymakers in employing supply chain risk management strategies (SCRMS) to reduce generic medicine shortages.
Design/methodology/approach
Using secondary data supplemented with primary data, the authors map and compare seven countries' SCRMS for handling shortage risks in their paracetamol supply chains before and during the first two waves of the COVID-19 pandemic.
Findings
Consistent with recent research, the study finds that policymakers had implemented few SCRMS specifically for responding to disruptions caused by COVID-19. However, shortages were largely avoided since multiple strategies for coping with business-as-usual disruptions had been implemented prior to the pandemic. The authors did find that SCRMS implemented during COVID-19 were not always aligned with those implemented pre-pandemic. The authors also found that policymakers played both direct and indirect roles.
Research limitations/implications
Combining longitudinal secondary data with interviews sheds light on how, regardless of the level of preparedness during normal times, SCRMS can be leveraged to avert shortages in abnormal times. However, the problem is highly complex, which warrants further research.
Practical implications
Supply chain professionals and policymakers in the healthcare sector can use the findings when developing preparedness and response plans.
Social implications
The insights developed can help policymakers improve the availability of high-volume generic medicines in (ab)normal times.
Originality/value
The authors contribute to prior SCRM research in two ways. First, the authors operationalize SCRMS in the medicine supply chain context in (ab)normal times, thereby opening avenues for future research on SCRM in this context. Second, the authors develop insights on the role policymakers play and how they directly implement and indirectly influence the adoption of SCRMS. Based on the study findings, the authors develop a framework that captures the diverse roles of policymakers in SCRM.
The turbulent business environment highlights the need for strategies for mitigating, responding to, and recovering from (that is, managing) supply chain disruptions. Resources are central in these strategies but remain unspecified in the literature. This paper shows how the resource interaction approach (RIA) can help understanding resources in this setting by acknowledging their interactive and networked nature. Based on a conceptual discussion that compares key assumptions within the supply chain risk management (SCRM) and supply chain risk resilience (SCRes) literatures with the RIA, we propose an alternative approach to strategies for managing supply chain disruptions. We challenge the SCRM and SCRes literatures by emphasizing interdependence (as opposed to independence) and pointing to relationships as key resources in strategies for managing supply chain disruptions. Collaboration relying on an interplay between temporary and permanent organizing is suggested as a starting point instead of being just one of several alternative strategies.
Den nye (u)normalen krever endringer i forsyningskjedene. Dette kan ingen virksomhet få til alene. Samarbeid er viktigere enn noensinne, ikke minst med tanke på hvordan fremtidens forsyningskjeder skal bli bærekraftige i vid forstand. System, differensiering og fleksibilitet er tre stikkord.
BACKGROUND
COVID-19 pandemic posed a major impact on the availability and affordability of essential medicines. This study aimed to assess the knock-on effects of the COVID-19 pandemic on the supply availability of non-communicable chronic disease (NCD) medicines and paracetamol products in Ethiopia.
METHODS
A mixed methods study was conducted to assess the supply and availability of twenty-four NCD drugs and four paracetamol products listed on the national essential medicines list for hospitals. Data were collected from twenty-six hospitals located in seven zones of Oromia region in the southwestern part of Ethiopia. We extracted data on drug availability, cost and stock out for these drugs between May 2019 and December 2020. The quantitative data were entered into Microsoft Excel and exported to statistical package software for social science (SPSS) version 22 (IBM Corporation, Armonk, NY, USA) software for analysis.
RESULTS
The overall mean availability of selected basket medicines was 63.4% (range 16.7% to 80.3%) during the pre-COVID-19 time. It was 46.3% (range 2.8% to 88.7) during the pandemic. There was a relative increase in the availability of two paracetamol products [paracetamol 500 mg tablet (67.5% versus 88.7%) and suppository (74.5% versus 88%)] during the pandemic. The average monthly orders fill rates for the selected products range from 43 to 85%. Pre-COVID-19, the average order fill rate was greater or equal to 70%. However, immediately after the COVID-19 case notification, the percentage of order(s) filled correctly in items and quantities began decreasing. Political instability, shortage of trained human resources, currency inflation, and limited drug financing were considered as the major challenges to medicine supply.
CONCLUSION
The overall stock out situation in the study area has worsened during COVID-19 compared to pre-COVID-19 time. None of the surveyed chronic disease basket medicines met the ideal availability benchmark of 80% in health facilities. However, availability of paracetamol 500 mg tablet surprisingly improved during the pandemic. A range of policy frameworks and options targeting inevitable outbreaks should exist to enable governments to ensure that medicines for chronic diseases are consistently available and affordable.
This research explores supply resilience through an equifinality lens to establish how buying organizations impacted differently by the same extreme event can strategize and all successfully secure supply. We conduct case study research and use secondary data to investigate how three European governments sourced for ventilators during the first wave of COVID-19. The pandemic had an unprecedented impact on the ventilator market. It disrupted already limited supply and triggered a demand surge. We find multiple paths to supply resilience contingent on redundant capacity and local sourcing options at the pandemic's onset. Low redundancy combined with limited local sourcing options is associated with more diverse strategies and flexibility. The most notable strategy is spurring supplier innovation by fostering collaboration among actors in disparate industries. High redundancy combined with multiple local sourcing options is associated with more focused strategies and agility. One (counter-intuitive) strategy is the rationalization of the supply base.
The humanitarian sector has formulated a collective strategic intent to localize. This involves delegating responsibilities and transferring capacities and resources to national and local actors. However, progress is slower than expected. Strategy execution is hard, and translating a general strategic intent to the actual way humanitarian organizations operate is not obvious. To suggest remedies for the slow progress, this paper investigates drivers and barriers for international humanitarian organizations (IHOs) to localize their logistics preparedness capacities. It is essential to understand IHOs' perspectives as they are global and powerful actors in the humanitarian sector and by far represent the largest recipients of donor funds. We focus on logistics since it constitutes key activities of strong local contextual character, such as procurement, warehousing, and transport. By interviewing practitioners from a representative set of large IHOs, and connecting the empirical insights with relevant theory, we unravel reasons that hinder localization. These include IHOs' strategic choices due to context-sensitive benefits of localization, mandated expectations on IHOs, the lack of internal drivers for IHOs to localize, and resistance to localize due to IHOs’ desire and motives for continued engagement in humanitarian aid. Based on these insights, actionable propositions are developed to help accelerate progress toward localization.
