PURPOSE Cancer treatment shortages are complex and a persistent problem worldwide. Patients with cancer are most vulnerable to drug shortages, which provides opportunities to examine the extent of the challenge(s) facing Saudi Arabia and to provide recommendations toward mitigating the impact of cancer treatment shortages on patient outcomes. MATERIALS AND METHODS A qualitative methodologic approach was conducted in April 2019 using a validated questionnaire and structured panel discussion for data generation. RESULTS Overall, 55 responses were received from practicing oncology health care professionals (26 pharmacists and 29 physicians). The annual average number of treated patients with cancer per institution was 640 (adults [n = 400] and pediatric [n = 240]). All respondents (100%) reported that cancer treatment shortages constitute a current problem in their center, with an average of 5 (range, 1-9) per month. The panelists recognized 2 fundamental points. First, the definition of cancer drug shortages should be standardized and recognized at the national level. Second, the current system must be improved to ensure proper and efficient use of the current resources. On that basis, the panelists developed 9 recommendations for action. CONCLUSION Cancer drug shortage is a significant problem in all health centers in Saudi Arabia. This study presents challenges that should be addressed at the national level and essential consensus recommendations for a coordinated action developed by a panel of experts to tackle the current national problem of cancer treatment shortages. Implementing these recommendations will provide a blueprint for management of national drug shortages in general and cancer treatment shortages in particular.

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The phenomenon of Global Software Development (GSD) has attracted the interest of businesses all over the world. It brings together partners from various national and corporate cultures to develop applications with numerous advantages, including access to a vast labor pool, cost savings, and round the clock growth. GSD, on the other hand, is technologically and organizationally diverse and poses a number of obstacles for the development team, such as geographical distance, cultural differences, communication and language barriers. Global services are provided by selecting one of the suitable global delivery options, i.e., the onshore model, nearshore model or offshore model. Experts typically choose one of the models based on the nature of the project and the needs of the customer. However, the vendors and clients lack an adequate decision support system that can assist them in making suitable sourcing decisions. Therefore, the current study presents a Multi-Criteria Decision Making (MCDM) model for offshore outsourcing decisions of application maintenance. To achieve our target, two systematic literature reviews were conducted that explored a list of 15 influencing factors. The identified factors were further evaluated in the outsourcing industry by performing an empirical study that resulted in a list of 10 critical success factors. We propose a sourcing framework based on the critical success factors that can assist decision makers in adopting a suitable sourcing strategy for the offshore outsourcing of application maintenance. In order to further enhance the decision-making process, the MCDM model is developed based on the Analytic Hierarchy Process (AHP). The MCDM model is evaluated with three case studies in highly reputable international companies, including IBM Stockholm, Sweden, Vattenfall AB, Stockholm, Sweden and a London based company in the United Kingdom. The outcomes of these case studies are further reviewed and validated by the outsourcing specialists in other firms. The proposed model is used as a decision support system that determines the ranking of sourcing alternatives and suggests the most suitable option for application maintenance offshoring.