"Sustainability of production supply chains for essential consumer goods A case study of European generic, injectable on-cology medicines shortages"

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Some consumer products, termed essential consumer goods, are crucial to sustaining health or even life. A lapse in supply of essential consumer goods can result in shortages that have tangible negative influences on the social and economic sustainability of society. The study applies this topic to the case of inexpensive, generic, injectable oncology medicines shortages in Europe. Cancer patient outcomes including survival rates, as well as treatment costs are significantly influenced by oncology medicines shortages. Even though the problem is well documented and universally acknowledged, a lack of data has deterred any quantitative solution-oriented studies. This study proposes the first causal model showing the underlying structure of the European inexpensive, generic, injectable oncology medicines supply chain. A structural model can provide reliable insight in cases where data is unavailable or unreliable through relying on structural validation. The study identifies the most common causes of supply shortages and develops a quantitative supply chain model with the ability to simulate causes of identified shortages. Key performance indicators are proposed to evaluate the social and economic sustainability of the supply chains in question. Finally, the study contributes to the existing discussion regarding oncology medicine shortages in Europe. The study calls for a quantitative comparison and robust sensitivity analysis of all primary and secondary causes of medicines shortages using the proposed model. Furthermore, both existing and new policy recommendations regarding oncology medicines shortages in Europe should be studied quantitatively. Key words Oncology medicine, medicine shortages, supply shortages, supply chain management, causal modelling, system dynamics
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