Development of Pharmaceutical Supply Chain Agility Model using an Interpretive Structural Modeling (ISM) Approach

Abstract
An agile supply chain can respond quickly and cost-effectively to unexpected changes in the market and increase the levels of environmental turmoil regarding both volume and variety. This study aims to present a model for the interactions of pharmaceutical supply chain agility (SCA) factors. In this study, the interactions of variables influencing pharmaceutical SCA were determined using the interpretive structural modeling (ISM) approach. The variables affecting SCA were extracted through library research and thematic literature, and the final variables were entered into the model using experts' views. These variables were classified according to their strength and dependence into 10 levels and 17 variables, and the relationships were determined at different levels. The results show that the indices of information technology, information sharing and organization integrity are the foundation of the supply chain agility and are the most influential indicators. MicMac analysis and the DEMATEL technique were used to test and confirm the model. ISM provides a way by which order can be imposed on the complexity of such variables. This insight from the model helps strategic planning managers to improve the SCA.
Introduction
The supply chain (SC) aims to deliver the right product, in the right quantity, under the right conditions, at the right time and place for the right cost. In recent years, the production field has moved to a new paradigm called agile manufacturing. The agile manufacturing paradigm was presented as a solution to management problems and environmental changes and strategies that keep organizations competitive (Landaran et a.l, 2014). Supply chain management (SCM) is also of strategic importance in healthcare. Inequality in health care delivery and complexities persist in healthcare systems worldwide. This highlights the need for efficient healthcare SCM. The pharmaceutical supply chain (PSC) represents the path through which good quality pharmaceutical products are delivered to the final consumer at the right place and time (Pitta & Laric, 2004). Managing such an SC is so sensitive that no activity less than 100 percent of the customer service level is acceptable, as it will directly influence the health and safety of the community (Zheng et al., 2006). This study, considering the importance of SC in the pharmaceutical industry, identified the factors affecting the agility of the PSC. Using the ISM technique, a map of relationships between different elements, concepts, or dimensions with different levels was drawn. Then, after reviewing the theoretical foundations and literature, we present the research methodology, findings, discussion, and conclusion.
Case study
This study was conducted to provide a model for agile SC in the pharmaceutical industry.
Theoretical foundations
In recent years, organizational agility has been derived from the organizations' needs to complement the earlier paradigms (Ghorani et al., 2016). The SCA is widely considered an essential element affecting corporate competition because companies with agile SC perform better in response to unforeseen events (Tse et al., 2016). Agility is a significant paradigm for progress and survival in today's business. In recent decades, marketing companies have focused only on money, but companies have also had to increase speed, quality, and resilience. Companies are looking to improve their agility in order to increase these factors. Agility is the ability of a system to establish an appropriate response mechanism in the event of uncertainty (Jain & Gupta, 2016). It can be claimed that SCA is a tool that helps the company achieve a competitive advantage at the firm level (wu et al., 2017). The pharmaceutical SC is the means through which critical medicines are distributed and delivered to the final consumer in the right quantity, at the right place, and at the right time (Mehralian et al., 2012). PSC is so sensitive that no activity less than 100 percent of the customer service level is acceptable, as it will be directly related to patients' health and safety. Therefore, most pharmaceutical companies try to store a large volume of inventory to ensure 100% accountability (Chandrasekaran & Kumar, 2003).
Methodology
This study aims to present a model for the interactions of pharmaceutical SCA factors. By exploring the thematic literature, the factors affecting SCA were extracted, and then, based on nine experts' views, the pharmaceutical SCA factors were determined. Since this study seeks to develop knowledge and help managers apply agile SCM in the pharmaceutical industry, it is methodologically applied and developmental research conducted through a survey study with a hybrid (qualitative and quantitative) approach. The purposive or judgmental sampling method was used according to experts' knowledge of the pharmaceutical industry. Then, using the ISM method and the relevant experts' views, the factors were extracted and classified, and their relationship was determined. The population consisted of academic and pharmaceutical experts with good experience. This study used library and field research methods for data collection. The library research method from internal and external sources in journal articles, books, and dissertations on SCA formulated theoretical foundations and literature reviews. The field research method was also used in interviews with experts.
Discussion and findings
The SCA prerequisite is to find the leading and influential factors and establish a relationship between them. Therefore, in this study, with an extensive review of the literature, the factors affecting the SCA were presented in Table 2, and according to experts, 17 dimensions affecting the SCA were determined. This study sought to present a model for the interactions of pharmaceutical SCA factors. The ISM approach was used to classify and level the SCA components. A model with 10 levels and 17 dimensions was presented following its steps. According to Fig.1, the study results showed that the dimensions of "IT utilization," "information integrity (knowledge sharing)," and "integrated processes (organizational integrity)" are at the bottom of the ISM model, respectively, which indicates a significant impact on other dimensions. In other words, the pharmaceutical SCA prerequisites are the dimensions that should be given more attention. "IT utilization," "skills development," and "competency building" are the most influential dimensions, and "increased customer trust and satisfaction" are the most dependent elements in the PSC. The MicMac analysis also confirms the results.
Conclusion
This study showed that pharmaceutical SCA depended on customer satisfaction, new product launch, continuous improvement, cost reduction, increased trust, and reduced uncertainty. These indicators are highly dependent on other indicators to provide the necessary capabilities for agility, of which IT utilization is one of these capabilities. Another requirement is to establish systems that can be used to be aware of changes in consumer tastes. Utilizing manufacturing technologies that provide the flexibility needed by the organization is another requirement for agility. On the other hand, holding continuous training courses needed by employees to develop their skills and competencies is an essential requirement for agility. Also, integrated planning must be done for the entire SC. In this way, all SC parts should move towards a common goal to create sufficient interaction, and differences between different parts do not slow down customer response. A combination of dimensions such as integrated processes, non-dependence on a supplier, and proper planning has a driving force and moderate dependence requiring careful management attention to increase SCA, as minor changes in the level of these indicators may severely affect SCA.