The MIA project 2020-2024
BI Norwegian Business School, INSEAD, Jimma University, Lancaster University, Norwegian Institute of Public Health, Rotterdam School of Management, St. Paul's Hospital Millennium Medical College
Objectives and background
Ensuring availability of essential medicines and vaccines is one of today’s critical societal challenges. While the COVID-19 pandemic exposed the vulnerability of medicine supply chains at full scale, medicine shortages were already an increasing global problem in normal times before the pandemic, particularly off-patent (i.e. generic) medicine shortages. When medicine supply chains break down, it can lead to serious injury and death. The primary objective of MIA was to help key stakeholders make evidence-based decisions that sustainably reduce medicine and vaccine shortages, addressing a key societal challenge to ensure future health and care services. Secondary objectives were:
- To contribute to improved supply security, i.e. access to medicine and vaccine services in Norway and the UK.
- To provide policy makers and other key stakeholders with a holistic and rigorous analysis of the direct and indirect costs and benefits of measures for enhanced supply security, thus contributing to more efficient and effective health services.
- To provide a basis for comparative studies in other countries by developing baseline data, research design protocols, and analytical and pedagogical models and tools.
Results achieved
Our research shows that although policymakers discussed strategies to address shortages, few had implemented them by the time the pandemic struck. There is increased governmental interest in the vulnerability of supply and the level of preparedness. However, the numerous stakeholders differ in goals and incentives in terms of focusing cost, quality, service, and/or sustainability. The supply chains are complex with many global actors involved. Furthermore, supply chains are vulnerable due to specialization, few buffers, and outsourcing to low-cost countries. Focus on low prices for generics, while reducing public spending for medicine and improving access for more people, has led to many medicines with very few suppliers. This, in addition to lack of transparency and information sharing, means that fixing the causes of shortage problems is easier said than done. Particularly we provide knowledge concerned with the type of interventions used to avoid shortages in normal and abnormal times and the role of policymakers in selecting and implementing these interventions. We have brought the government perspective into OSCM and vice versa and demonstrated the need for a cross-disciplinary approach to medicine shortage. We have provided insights on how to prepare medicine and medical equipment supply chains for future epidemics/pandemics in the long-term and presented practical conclusions and implications with recommendations for policymakers and direct supply chain members. A key finding is the need to combine preparedness with adaptability in response through process modularity; resource interaction in cross-sectorial/disciplinary collaboration; the interplay between temporary and permanent organizing; the use of a mixed set of risk mitigation strategies and differentiation depending on drug characteristics beyond medical criticality. Policymakers can use our frameworks, tools and findings to improve the availability of generic medicines in (ab)normal times. To answer the research questions, we conducted the following sub-projects:
