Supply chain transparency and the availability of essential medicines

Årdal, Christine; Baraldi, Enrico; Beyer, Peter; Lacotte, Yohann; Larsson, Dg Joakim; Ploy, Marie-Cécile; Røttingen, John-Arne; Smith, Ingrid

doi:10.2471/blt.20.267724

Cited by 18 publications

(9 citation statements)

References 4 publications

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“…Manufacturing processes are technically complex, and components come from geographically dispersed companies. Due to confidentiality of supplier information, policymakers have a limited understanding of supply chain geographical dependencies, manufacturing lead-times and supply chain resiliency, all of which differ per medicine (see for example Ardal et al, 2021). Furthermore, the industry is highly regulated to ensure medicine safety.…”

Section: Theoretical Background and Research Framework 21 Generic Med...mentioning

confidence: 99%

Supply chain risk management strategies in normal and abnormal times: policymakers' role in reducing generic medicine shortages

Ahlqvist

Dube²,

Jahre³

et al. 2022

IJPDLM

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PurposeThis 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/approachUsing 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.FindingsConsistent 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/implicationsCombining 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 implicationsSupply chain professionals and policymakers in the healthcare sector can use the findings when developing preparedness and response plans.Social implicationsThe insights developed can help policymakers improve the availability of high-volume generic medicines in (ab)normal times.Originality/valueThe 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.

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Section: Theoretical Background and Research Framework 21 Generic Med...mentioning

confidence: 99%

Supply chain risk management strategies in normal and abnormal times: policymakers' role in reducing generic medicine shortages

Ahlqvist

Dube²,

Jahre³

et al. 2022

IJPDLM

View full text Add to dashboard Cite

show abstract

“…This value chain crosses the entire financial medical industrial complex ( Basile and Feo, 2021 ). There is growing recognition of the important role of data transparency to better align this value chain to the access and rational use of medicines and in power relationships between stakeholders ( Årdal et al, 2021 ; Vargas et al, 2022 ). A major challenge of such transparency is the availability of detailed instruments to support the disclosure of data and information on the value chain to analyze whether transparency aids these goals in an accessible and structured way throughout the entire chain.…”

Section: Introductionmentioning

confidence: 99%

Transparency of data on the value chain of medicines in Argentina, Brazil, and Colombia

et al. 2023

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Introduction: The transparency of data on the value chain of medicines is crucial for the study and monitoring of the pharmaceutical system. These data may impact medicine pricing negotiations, contribute to patient access to pharmaceutical products, and strengthen health systems.Objective: This study analyzed the national strategies to ensure the transparency of data from medicine cost development to marketing in Argentina, Brazil, and Colombia.Method: A descriptive study was carried out by searching databases, reports, documents, and scientific articles published between January and August 2022 related to rules on transparency and databases, including 1) marketing authorization; 2) pricing; 3) intellectual property; 4) clinical trials; 5) research and development (R&D); and 6) health technology assessment (HTA) of selected biopharmaceuticals.Results: Transparency data, rules, and information are not uniform. The infostructures (organizational capacity for collecting and distributing information) regarding the pharmaceutical value chain in these three countries face limitations in appropriate measures to publicly share data and evidence, including pre-clinical data, clinical data, and costs. None of the countries require transparency about data on research and development costs. All three countries present similar publicization of data on marketing authorization and intellectual property, with some differences. The significant limitations in Argentina include the absence of formal price regulation and data on the volume of medicine purchased and respective amounts paid. Among the three countries, Brazil showed a higher degree of information transparency, perhaps due to the legal regulation that guarantees citizens access to information of public interest. Brazil also stands out in terms of the public availability of HTA reports and pricing, in addition to the highest volume of information. In contrast, Colombia has in place a decree that allows 5 years of trial data exclusivity for new medicines, an act contrary to data transparency. Despite the different stages of transparency, no country has evidenced a robust use of these data in public policy decision-making.Conclusion: The results reinforce the presence of information asymmetry between stakeholders, data fragmentation, data gaps and overlap, and difficulty in comparing available data across the three countries and the use of these data nationally to produce evidence.

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“…A wide range of other pandemic impacts, such as reduced surveillance capacity, disrupted antimicrobial supply chains, and modified composition of the human microbiota, may have, and continue to influence the epidemiological dynamics of AMR in ways that are as-yet poorly understood [8,[12][13][14]. Mathematical models are useful tools for the simulation and quantification of transmission dynamics, particularly when data are limited or lacking [15].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…On the other hand, non-pharmaceutical interventions (NPIs) implemented to control SARS-CoV-2 transmission -including lockdowns, physical distancing, travel restrictions, face mask use, and improved hygiene practices -may have had the opposite effect, concomitantly reducing the spread of antimicrobial-resistant pathogens [1,12]. A wide range of other pandemic impacts, such as reduced surveillance capacity, disrupted antimicrobial supply chains, and modified composition of the human microbiota, may have, and continue to influence the epidemiological dynamics of AMR in ways that are as-yet poorly understood [9,[13][14][15].Three years after the onset of the pandemic, data on global AMR trends remain relatively sparse. However, a joint 2022 report on antimicrobial resistance during 2020 from World Health Organization (WHO) and European Centre for Disease Prevention and Control (ECDC) has reported AMR trends across 29 European countries for eight antibiotic-resistant bacterial pathogens of concern, including Streptococcus pneumoniae [16].…”

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confidence: 99%

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Revealing the drivers of antibiotic resistance trends inStreptococcus pneumoniaeamidst the 2020 COVID-19 pandemic: Insights from mathematical modeling

Kovacevic

Smith

Rahbé

et al. 2022

Preprint

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COVID-19 pandemic responses have dramatically modified the global ecological and epidemiological landscape of many infectious diseases. However, the pandemic’s impacts on antimicrobial resistance (AMR) are currently poorly understood and lack data. While surges in COVID-19 cases during the first wave of the pandemic may have exacerbated AMR, decreases in antibiotic use may have had the opposite effect. To disentangle how pandemic impacts such as lockdowns and modified antibiotic prescribing may affect AMR, we developed a mathematical model formalizing simultaneous transmission of SARS-CoV-2 and colonization with a bacterial pathogen across six pandemic scenarios. We used simulation to assess the effect of each scenario on the bacterial carriage prevalence, antibiotic resistance rate, and the invasive bacterial disease (IBD) incidence, using parameters based on the commensal community bacterium Streptococcus pneumoniae. Pandemic scenarios without community-wide lockdowns all resulted in a decrease in carriage prevalence of antibiotic-sensitive bacteria and an increase in the prevalence of antibiotic-resistant bacteria, while the addition of a population-wide lockdown resulted in a large reduction in colonization prevalence and IBD incidence for both strains (>70%). This translated to an increase in the antibiotic resistance rate across all scenarios to varying degrees, with lingering effects after the cessation of COVID-19 response measures. In the absence of lockdown, a population-wide surge in antibiotic prescribing coincident with the peak in SARS-CoV-2 infection resulted in the greatest increases in resistance rate (23%) and resistant IBD incidence (6%). Within-host interactions, SARS-CoV-2 variants, and population immunity are found to further drive the magnitude of pandemic impacts on resistant IBD incidence. Sensitivity analyses suggest that the extent of such impacts likely varies across different bacterial species. Although real-life scenarios are significantly more complicated, our findings suggest that COVID-19 pandemic responses may significantly impact antibiotic resistance in the community and support the need for monitoring resistance during pandemic waves.

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Supply chain transparency and the availability of essential medicines

Cited by 18 publications

References 4 publications

Supply chain risk management strategies in normal and abnormal times: policymakers' role in reducing generic medicine shortages

Supply chain risk management strategies in normal and abnormal times: policymakers' role in reducing generic medicine shortages

Transparency of data on the value chain of medicines in Argentina, Brazil, and Colombia

Revealing the drivers of antibiotic resistance trends inStreptococcus pneumoniaeamidst the 2020 COVID-19 pandemic: Insights from mathematical modeling

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