Dissertation Topic: EFFECTIVENESS OF SUPPLY CHAIN MANAGEMENT IN THE POST COVID SITUATION FOR THE PHARMACEUTICAL INDUSTRY IN THE UK @EasyAssignmentHelp

Dissertation Topic: EFFECTIVENESS OF SUPPLY CHAIN MANAGEMENT IN THE POST-COVID SITUATION FOR THE PHARMACEUTICAL INDUSTRY IN THE UK

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A dissertation submitted to Wrexham Glyndŵr University in accordance with the requirements of the degree of ''

3rd August, 2022

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Abstract

The research is based on the topic of supply chain management in the pharmaceutical sector in the era of post covid. The rationale of this research is based on the various challenges encountered by the operations of supply chain in the pharmaceutical industry. One of the problems identified in this research is related to labour shortage, economic challenges and disruptions in the supply chain. The aim of the study is to investigate the role of effectively managing the supply chain in the UK pharmaceutical industry. A PICO framework is employed for setting the research objectives. The section of literature review provides broad descriptions on the topic. In this section, the effectiveness of managing the supply chain is discussed. This is based on the demand and the logistics aspect of the supply chain. The factor of network visibility, capacity planning, inventory management and goods distribution is discussed. The challenges such as lacking transparency and pharmaceutical fraud are discussed. The resource-based and the agency theory are also discussed.

Table of Contents

Chapter 1: Introduction. 8

1.1 Background. 8

1.2 Rationale. 8

1.3 Problem statement 10

1.4 Aim and Objectives. 11

1.5 Research Question. 11

1.6 PICO (Population, Intervention, Comparison, Outcome) framework. 11

Chapter 2: Literature Review.. 13

2.1 Introduction. 13

2.2 Effectiveness of Supply Chain Management during the stage of Post Covid situation among the UK pharmaceutical industry. 13

2.3 Supply Chain Management takes actions to reshape UK's pharmaceutical industry in post covid situation. 15

2.4 Importance of Supply Chain Management in the Pharmaceutical Industry in the UK.. 16

2.5 Post Covid-19 required supply chain management improvements in the UK.. 17

2.6 Challenges are faced by the UK pharmaceutical industry while implementing Supply Chain Management 19

2.7 Mitigation Strategies to overcome challenges faced by the UK pharmaceutical industry in the post-COVID-19 era. 20

2.8 Theoretical Framework. 23

2.9 Conceptual Framework. 25

Gap analysis. 25

2.10 Summary. 26

Chapter 3: Methodology. 27

3.1 Introduction. 27

3.2 Search engine. 27

3.3 Application of inclusion and Exclusion criteria. 28

3.4 Search strategy. 31

3.5 Search characteristics 32

3.6 Selection and Screening of articles. 35

3.7 Study quality assessment and checklists. 37

3.8 Data extraction. 38

3.9 Reliability and validity. 40

3.10 Data characterisation table. 40

3.11 Research gap. 41

Chapter 4: Findings/Results. 42

4.1 Characteristics of study table. 42

4.2 Findings from the articles. 50

4.3. Table on the statistical findings. 58

Chapter 5: Discussion. 61

5.1 Discussion. 61

5.2 Strengths and weaknesses of the study. 65

5.3 Limitations. 67

Chapter 6: Conclusion. 68

6.1 Conclusion. 68

6.2 Linking with Objectives. 68

6.3 Recommendation. 69

6.4Limitations. 70

6.5 Future scope. 70

Reference. 72

Appendices. 80

Appendix 1: 80

Appendix 2: 80

List of figures

Figure 1: The ongoing influence of the Covid-19 pandemic on the pharmaceutical supply chains. 7

Figure 2: Sides of the effectiveness of Supply Chain Management 11

Figure 3: Pharmaceutical logistics distribution. 14

Figure 4: Changes in Industry Supply Chain. 15

Figure 5: Challenges faced by UK pharmaceutical industries. 16

Figure 6: Mitigation Strategies to overcome challenges faced by the UK pharmaceutical industry. 18

Figure 10: Conceptual Framework. 22

Figure 10: PRISMA framework. 33

Figure 11: Graph on Meta-analysis of the searched articles. 59

Figure 12: Recommendations for Post-Covid SCM... 67

List of Tables

Table 1: PICO framework. 11

Table 2: Inclusion and exclusion criteria. 28

Table 3: Keywords searched from the databases. 30

Table 4: Search strategy and result obtained. 31

Table 5: Search characteristics. 34

Table 6: CASP Tool 37

Table7: Data extraction table. 39

Table 8: Reliability and validity. 39

Table9: Characteristics of study table. 49

Table10: Findings from articles. 57

Table 11: Findings from articles. 60

Chapter 1: Introduction

1.1 Background

The supply chains in the Pharmaceutical industries are mainly associated with the delivery of concerned drugs and medicines to the patients at their places. Ciravegna and Michailova (2022) mentioned that these supply chains are immensely complex, and hence the challenges faced are unavoidable. The complexity in this context refers to the numerous steps involved in one process. Each step is significantly necessary to ensure the accessibility of medicines to the patients. The supply chains involve a huge number of stakeholders, starting from the manufacturers and wholesale distributors up to the managers of the pharmacies (Alsuwailem et al., 2021).

The pharmaceutical industries involve the human lives; hence even a minor challenge has to be given huge importance. A supply chain, that is not appropriately effective, can delay the healing process of a particular patient and eventually have a negative impact on public health (Dai and Tang, 2022). The main challenges that might be faced by the supply chains of the pharmaceutical industries are visibility in the supply chains, counterfeiting of drugs, illegal rise in the prices of prescribed drugs etc. As said by Kano, Narula and Surdu (2022), this adds additional costs to the patient, which is both inconvenient and unethical. The challenges can be experienced as an uprising with the introduction of the pandemic because Covid-19 has evidently affected the global supply chains of all industries. The prices of pharmaceutical products recovered from a sheer amount of 0.5 billion Euros to directly 16.8 billion euros in the month of February 2021 as a result of the pandemic (Ons. 2021). The whole supply chain in the pharmaceutical industry was affected due to the pandemic starting from the manufacturers to the suppliers (Gereffi, 2020). The consumers being the most important stakeholder in this context were majorly affected too. There were shortages faced in the supplies of the multinational companies because of the huge spread of the virus, and similarly, demand shocks were faced. The impacts of the pandemic were so huge that it took a lot of time and strategies for the pharmaceutical companies to recover from them.

1.2 Rationale

The challenges faced by the pharmaceutical companies during the pandemic mainly involved the demand and supply of essential products. There were concerns regarding the postponement of the deliveries of drugs, and that was the most unanticipated in the pandemic when many people were at the edges of death. Narula et al. (2021) said, there were delays in securing merchandise, travelling disruptions, and a labor shortage. The labor shortage was the biggest problem because labors are the working force in the organization without whom the whole system can fall. The labors were either directly affected by Covid-19, or the loss of nearby ones made them absent from work. Some organizations also had to cut off employees due to budget issues, and this shortage of employees led to a gradual decrease in the efficiency of the organizations (Balakrishnan and Ramanathan, 2021). All of these events led to a disruption in the companies' supply chains, and the point that the global supply chains are not prepared to combat challenges gained attention.

The issue of mismanagement in the supply chains during covid-19 not only hampered individual lives but also made the UK suffer a great economic disruption. The graph below shows the decrease in the GDP growth and the trade growth in the industries of the UK during the pandemic.

Figure 1: The ongoing influence of the Covid-19 pandemic on the pharmaceutical supply chains

(Source:Weforum.org. 2020)

The extent to which the supply chains were affected due to the pandemic had mandated some strategies for risk mitigation. The designs of their supply chains and their dependencies require reconstruction to tackle the losses in efficiency (Balakrishnan and Ramanathan, 2021). Certain steps are important for combating future disasters, which might result in more losses for the organizations.

Some challenges have made the managers of the huge supply chains rethink the pre-formulated strategies for avoiding the faced disruptions in future. The effect of the pandemic was not only on the supply chains but also on the relationship between the firms (Dai and Tang, 2022). Some forms had decided on shifting strategies from global to local and as a result of that, they had experienced a huge loss in manpower and money. The brand names and reputation were also hugely affected due to the loss of customers and eventually, the positions in the competitive market were hampered (Donthu and Gustafsson, 2020). Meeting unexpected disruptions would require an immensely efficient supply chain, representing a company that can combat such unanticipated situations.

1.3 Problem statement

The primary loss being experienced by the supply chains is associated with the loss of the labor force. The issues underlying this context mainly arose due to restrictions imposed by the Government of the UK that minimized the travel and the presence of the employees within the companies to avoid contact. As opined by Alam et al. (2021) mentioned, the decline in international trade has also been another impact of Covid-19 as a result of loss in the supply chains. There were uncertainties regarding the production or manufacture of drugs because of the pandemic as their demands were under question. On the contrary, the demand for certain essential drugs increased to such an extent that even the biggest companies failed to meet that demand. Additionally, the amount of production was immediately out of stock while meeting the demands and maintaining the ongoing demands. There was a need for more production at a very fast pace. However, this was not possible due to the shortage of labor in both production and delivery and mismanagement in the supply chains (Emanuelsson, Charles and Shivaprasad, 2021). As a result, the synchronization between the demand and supply was enormously hampered.

The high demand for critical medications disrupted their production, including vaccines, drugs, and other medical accessories involved in the treatment of Covid-19. Delay in the regulatory oversight of the medicine production was another challenge faced by the supply chains. The travel restrictions imposed by the government for the prevention of the spreading of Ciovid-19 prevented the officials of the MRHA ("Medicines and Healthcare products Regulatory Agency") to respond to the scenes and conducting investigations (Putter, 2021). These led to the export of many illegal drugs, which posed a serious challenge for both reputable organizations and governments. As said by Dai and Tang (2022), these resulted in the interaction within the global trade of pharmaceutical products because the countries chose to treat their own people rather than distribute the drugs to other countries. There were inadequacies observed in the supply chains due to improper planning and mismanagement, resulting from the pandemic resulting in a labor shortage.

1.4 Aim and Objectives

Aim

This study's main aim is to investigate supply chain management in pharmaceutical industries in the UK during the post-Covid situation.

Objectives:

● To understand present supply chain management in Pharmaceutical industries from the UK during the ongoing post-Covid-19 situation

● To demonstrate pre and post covid-19 SCM differences associated with pharmaceutical industries in the UK

● To identify several factors affecting the SCM practice related to the pharmaceutical industries in the UK during the post-covid-19 phase

● To propose effective mitigation strategies to promote the best operational workforce by improving SCM practice in the area of pharmaceutical industries in the UK

1.5 Research Question

RQ1: What changes have been associated with supply chain management in the circumstance of the post-Covid-19 situation in the area of the UK-based pharmaceutical industry?

1.6 PICO (Population, Intervention, Comparison, Outcome) framework

Population	● The participants have been associated with SCM in the pharmaceutical industries of the UK.
Intervention	● The impact of Covid-19 on SCM of pharmaceutical industries has been identified as the most crucial influencer in reducing the chain's continuity through observing the supply chain's estimated managerial function.
Comparison	● SCM performance during this ongoing post-Covid-19 emergence among pharmaceutical industries has been compared with the management structure of the pre-Covid-19 situation.
Outcomes	● The key outcome is the future SCM strategies development and continuity with organizational development of pharmaceutical industries from the UK.

Table 1: PICO framework

Supply chain managers and staff associated with the logistics department of pharmaceutical industries situated in the UK have been identified as the study population. The interventions have been described before covid-19, and after covid-19, SCM of different industries have faced major destruction, and the pressure on the health care sectors has been very high. The observation has demonstrated that SCM has destroyed lower employee numbers mainly.

Chapter 2: Literature Review

2.1 Introduction

The competitive market in the pharmaceutical industry mandates effective management of the supply chain and also provides a competitive advantage. In addition, gaining competitive advantages helps an organisation in improving its organisational performance and rapidly increases the rate of profitability and productivity. The working performance of an organization is represent able by the management of its supply chain and the pandemic has mandated the industries to enhance the effectiveness of this management (Gereffi, 2020). The introduction chapter has focused on the effectiveness of the management of the supply chains of the pharmaceutical industries in the UK. The chapter on the literature review is essential in the entire dissertation and covers previous studies on provided research topics. Along with that, different types of theories have been included for developing properly.

2.2 Effectiveness of Supply Chain Management during the stage of Post Covid situation among the UK pharmaceutical industry

The resilience of the supply chain depends upon the capability set. It enables every pharmaceutical industry to maintain and enhance all the operational and competitive positions in the competitive market in the UK. In addition, the Coronavirus brought itself to a fast-changing environment, and the pharmaceutical industry may be required to respond, rebuild, and mitigate the disruptions. As per the statement of Tasnim (2020), every mitigation strategy is completed with synerging, rebuilding and integrating all of its resources, capabilities, and competencies in the UK's Pharmaceutical industry. A supply chain consists of three sides namely the supply, demands and logistics sides and all of these have been severely affected by the pandemic (Raj et al. 2022). Most of the pharmaceutical supply chains have faced severe disruptions as a result of Covid-19. The reputed brands including "Healthcare ltd.", "Pfizer" and "Abbott Laboratories Ltd." have experienced disruptions despite their effectively managed supply chains (Bown and Bollyky, 2022). All those emerging sides of the supply chain of the pharmaceutical industry in the UK are mentioned below:

Supply-side

Every pharmaceutical industry must supply all its products at the proper time and place. But, during the Covid 19 situation, suppliers could not deliver all the raw materials required for manufacturing pharmaceutical drugs of the Covid pandemic. For this reason, Pharmaceutical Industries faced supply shock because they could not manufactured and supply essential drugs in the required time. As a result, patients recovered very slowly. According to the statement of Kalaitzi et al.(2021), after the pandemic era, all the pharmaceutical industry's supply chain managers focus on the manufacturing drugs and deliverance of all the medicines at the proper location and time. For this reason, it is increasing the profit rate and reducing the operational costs in the pharmaceutical industry.

Demand-side

The demand side in the pharmaceutical industry involves healthcare professionals, the patient directly, insurers etc. The pandemic has affected the demand side mostly because of the rising demand for drugs and masks (Bown and Bollyky, 2022). According to Handfield, Graham and Burns (2020), increasing the requirements of essential pharmaceutical products improve the supply chain management system in the Pharmaceutical Industry. Moreover, during the post-Covid 19 situation, there was a high demand for facemasks, and because of manufacturing a small number of products, all the pharmaceutical industries are facing demand-side issues after covid effects.

Figure 2: Sides of the effectiveness of Supply Chain Management

(Source: Sarkis, 2020)

Logistical side

An increase in essential product demands is witnessed, whereas concerns are raised during the postponed deliverance of pharmaceutical products. There are several reasons present through which pharmaceutical industries are facing some logistical issues during the post-Covid situation in the UK. All those issues are unanticipated travel disruption, postponed deliveries and labour shortages. Before the Covid 19 pandemic, every supply chain manager focused on improving inventory, which helped decrease costs and increase the working efficiency in the pharmaceutical industry in the United Kingdom (Joshi and Sharma, 2022).

2.3 Supply Chain Management takes actions to reshape UK's pharmaceutical industry in post covid situation

The Covid-19 pandemic has been a serious impediment to the manufacture of pharmaceutical drugs as well as their shipment because most of the set targets were difficult to meet in the midst of the rising demands. Moreover, the brand manufacturer is producing products with effective product manufacturer procedures. According to Masudin and Safitri (2020), genetics and raw materials, which are required for manufacturing pharmaceutical drugs, are procured from vendors. Finally, those are transferred to the production areas for end processing. Different kinds of actions can be taken in terms of reshaping the entire pharmaceutical industrial structure, and those are highlighted below:

Managed demand surges through network visibility.

Managing the supply of pharmaceutical drugs by providing proper recommendations is very important and effective. Moreover, by providing alternative suppliers' details is helping the pharmaceutical industry in terms of tracking details. In addition, providing alternate supply resources may help increase the productivity rate of the pharmaceutical industry in the United Kingdom. As per the statement of Friday et al.(2021), using other types of materials bills may help keep proper financial records, which will help the pharmaceutical industry increase the profitability rate and get more variants about the pharmaceutical drug products. In terms of managing the surges through a network, visibility may help improve the entire pharmaceutical industry system by improving supply chain management in the UK.

Capacity planning

This kind of action highlights the delays in mitigating the high demand. In addition to that, this action is providing every pharmaceutical industry in terms of manufacturing medical drugs efficiently, and it is improving the entire supply-chain-management system in the pharmaceutical industry. As per the statement of Farooq et al. (2021), recognising an alternate manufacturing plant, procedure, delivery locations and raw materials suppliers are additional capacity. It is also essential to come up with alternative planning procedures to reduce the operational costs and those associated with the suppliers (Donthu and Gustafsson, 2020). Moreover, the costs involved in implementing new equipment and resources might also be planned effectively with these alternative plans. For this reason, the pharmaceutical industry can easily get proper raw materials in adequate amounts and manufacture proper drugs with adequate dosages. Henceforth, it can be said that capacity planning for the pharmaceutical industry is effective in maintaining high demand.

Inventory Management

Maintaining an efficient supply chain management helps the entire pharmaceutical industry manufacture high-quality pharmaceutical drugs and deliver them at the proper time. Moreover, the Good Distribution Practice is also helping to improve the manufacturing procedure and provide them to the patients to overcome their health issues rapidly. It is also essential to come up with alternative planning procedures to reduce the operational costs and those associated with the suppliers (Donthu and Gustafsson, 2020). Moreover, the costs involved in implementing new equipment and resources might also be planned effectively with these alternative plans. Proper network visibility is enhanced after along with management of the demand surges and this is important in times of high demand (Raj et al. 2022).

2.4 Importance of Supply Chain Management in the Pharmaceutical Industry in the UK

An effective Supply Chain Management may create some efficient drugs for end users. In addition to that, it may transform the pharmaceutical industry in making better usage of all resources as well as assets. According to the statement of Kumar et al. (2019), it helps generate the profit chain, enhance shareholders' value, and mitigate customers' requirements effectively and positively. On the other hand, as stated by Roscoe et al.(2020), in between 2018 to 2023, the value of the pharmaceutical industry is forecasted to increase by around 19.3 percent to 25 billion euros. In addition to that, it is equal to the annual growth of nearly 3.6 percent in the era of Post Covid. Moreover, effective Supply Chain Management ensures the improvement of an organisation's working performance and working culture in several sectors in the Global World. Supply chain management involves the integrated management networks present in the pharmaceutical industry in the United Kingdom, and it consists of purchasing level, product facilities, suppliers and logistics solutions.

Figure 3: Pharmaceutical logistics distribution

(Source: Statista.com, 2022)

The importance of effective supply chain management lies in the fact that it can reduce expenses and enhance the sales of the company. As mentioned by (Alzoubi et al. 2020), it also helps pharmaceutical companies realign their supply chains to distinct concept sets. This can be done by providing solutions for proper functioning solutions for the needs of the enterprise. The needs associated with planning and forecasting products as well as their procurement. Proper management (Bradscholars.brad.ac.uk. 2021) enhances the efficiency of the whole execution of the supply chain. The nodes involved in a supply chain have certain functions that contribute to the product quality and hence its value in the market.

The primary factor that serves as the evidence of reduction of operational costs with the introduction of SCM practices is the involved dynamics and simulation. The use of SCM is not limited to the production of drugs. Rather its efficiency extends to the distribution chain as well, including warehouse storage (Sabouhi, Pishvaee and Jabalameli, 2018). Several agents with various objectives are brought together with the use of SCM, and the clustering of these objectives can work against the performance of the organisation. As said by (Ul-Hameed et al. 2019), a miscommunication between the employees can harm the product result, and that would bring out the necessity of collaboration. All the agents allocated in the inventory, forecasting and planning are required to coordinate their activities, which are focused on with the help of an efficient SCM.

2.5 Post Covid-19 required supply chain management improvements in the UK

Supply Chain may be achieved as an emergent practice field and emerging academic domain. Moreover, the future progression of each domain can be enhanced as well as indeed, and it is dependent on each other. For this reason, this research study is taking stock of development theory and practice in recognising all the barriers and possibilities. According to Donthu and Gustafsson, (2020), having effective supply chain management provides an organisation with a competitive advantage and this is extremely crucial to sustain in the midst of competitiveness. In addition, gaining all the competitive advantages helps an organisation improve the organisational working performance and rapidly increase the rate of profitability and productivity. Henceforth, it can be said that maintaining proper supply chain management in any industry may help improve customer relations and gather customer loyalty. For this reason, any kind of pharmaceutical industry can easily increase its productivity rate in the future.

Figure 4: Changes in Industry Supply Chain

(Source: Lee and Lee, 2021)

The UK's pharmaceutical industries have undergone noticeable changes in their structural organisations over time. One of the major changes in this context was the implementation of supply chain organisations. There has been evidence that an effective supply chain has resulted in a significant reduction in the amount of perceived waste. The associated costs have been reduced in most companies, and the service quality has been enhanced (Bradscholars.brad.ac.uk. 2021). This is because pharmaceutical waste is reduced by introducing tools and practices for effective SCM. Inventory control has been efficient, and that is the case for pharmaceutical companies all over the world and not just in the UK.

However, there is one negative aspect in this case, and that is the lack of experience in the employees. As an SCM involves a lot of steps and detailed programming, equipt professional employees might be preferable in this case. Most of the current employees in the reputed pharmaceutical companies in the UK are older men who have been relying on traditional methods since the start of their work. It becomes difficult for these people to adopt these new forms of technology in less amount of time. As mentioned by (Sabouhi, Pishvaee and Jabalameli, 2018), initial interventions like "Just-In-Time (JIM) approaches" and "Vendor managed Inventory (VMI)" has been introduced in the UK pharmaceutical organisations as a means of increasing the efficiency of the SCM. These have helped explore the quality of expired products like drugs and other surgical instruments. Simulation modelling and outsourcing of medical supplies that are not that critical have been essential steps in this context.

2.6 Challenges are faced by the UK pharmaceutical industry while implementing Supply Chain Management

Pharmaceutical distributors and wholesalers form a crucial link between drug manufacturers and hospitals. In addition, while implementing supply chain management, the pharmaceutical industry faces several challenges. Those are mentioned below:

Lack of transparency

The major issue is faced by every pharmaceutical industry while implementing supply chain management in the post-Covid situation in the United Kingdom. In addition to that, the pharmaceutical industry cannot trace its issues related to resources. According to Clauson et al.(2018), the pharmaceutical industry is arriving in an unsuitable condition for individual consumption or any kind of drug imitation, or prices are rising without any strong reason.

Pharmaceutical fraud

Pharmaceutical fraud is the remaining major issue for any kind of organisation or business. Moreover, it is possible during the post-covid situation in the United Kingdom. In addition, all the industry observers have predicted that misconduct during the pandemic may lead to higher than average healthcare fraud recoveries every year. According to Ten et al.(2018), pharmaceutical fraud involves different activities, resulting in various kinds of false claims for the insurers. All of them are associated with Medicare in the United States programs for financial gain for pharmaceutical industries.

Figure 5: Challenges faced by UK pharmaceutical industries

(Source: Cole, Stevenson and Aitken, 2019)

Patient-centric transparency

With the help of the Meta Pharma digital supply network, pharmaceutical producers, different types of health systems and other types of stakeholders present in the pharmaceutical industry's supply chain is getting end-to-end supply chain visibility and various kinds of collaborative tools. As per Wang and Jie (2020), all the health care providers increasingly shift far away from the size fits approach for personalised medicines.

Blockchain technology is one of the pharmaceutical industry's real challenges in supply chain management. Clauson et al. (2018) state that modification of the supply chain system in a pharmaceutical company with technology, multiple actors influence, such as the monitoring system and availability of the technology. However, self-proliferation of supply chain systems has occurred with technology application in pharmaceutical supply-chain-management systems. Implementation of blockchain technology can help in saving the cost of operations as well as accuracy can be maintained in the supply chain. Blockchain technology's critical challenge is maintaining integrity in the supply chain. Other challenges found are EU parallel trade and poor pharmaceutical governance in the supply chain (Clauson et al., 2018). Identification of the supply chain can influence finding ways to improve the supply chain system in the drug delivery system that can, in turn, influence the sustainable goal-oriented to health improvement. Supply chain management problems in the UK include emergency mitigation and disaster management involving the safe supply of healthcare products to health workers in different public health emergencies.

Other emerging challenges entail the pharmaceutical industry. As per the views of Sarkis et al. (2021), the product portfolio is an emerging challenge in UK pharmaceutical companies. Another major challenge is the long pharmaceutical product approval time. Therefore, maintaining a stalk is a problem. Long approval time also can decrease product quality. In the process designing of operation maintenance also, a different range of issues are faced by pharmaceutical companies (Sarkis et al., 2021). For instance, one common problem recognised in the pharmaceutical operational chain is the modes of an optimal operational unit.

2.7 Mitigation Strategies to overcome challenges faced by the UK pharmaceutical industry in the post-COVID-19 era

In terms of mitigating all the challenges mentioned above, every pharmaceutical industry requires several kinds of mitigation strategies. By which they can easily resolve their issues and overcome them. All those mitigation strategies are mentioned below:

Encourage sharing, not surveillance.

In terms of building trust or creating a strong bond, every team member in the pharmaceutical industry requires transparency. Every individual in healthcare feels free to discuss with the team leaders without any kind of hesitation and can access various kinds of information. As per the statement of Moktadir et al.(2018), every superior employee requires to set meetings or install technologies that allow team members to exchange knowledge voluntarily.

Maintain proper digitisation

Material digitisation is one kind of digital collection procedure that can follow various kinds of digitisation standards. In addition, digitisation provides effective links to resources containing additional information. Moreover, it describes the digitisation parameters which are recommended for digitising materials. According to Guha et al.(2022), maintaining proper digitisation procedures helps every pharmaceutical industry improve the supply chain during the post-Covid situation in the United Kingdom. The digital collection also contains different types of digital media such as audio, text, video, and still images.

Figure 6: Mitigation Strategies to overcome challenges faced by the UK pharmaceutical industry

(Source: Kumar et al. 2020)

Meta Pharma Digital Supply Network

With the help of the Meta Pharma digital supply network, the supply chain can be improved easily. In addition, it creates several opportunities to connect with disparate systems, enabling the communication procedure crossing the pharmaceutical industry in the United Kingdom. According to Liza et al.(2022), maintaining a proper digital supply network help to create a single source and gather proper resources to improve the working culture and styles in the pharmaceutical industry during a post-Covid situation in the United Kingdom.

Blockchain adaptation-related problems can be resolved to maintain a well-balanced pharmaceutical supply chain. As stated by Chang, Iakovouand and Shi (2020), blockchain management can be implemented by involving trusting stakeholders, which can enhance the supply-chain-management process. Description of blockchain technology and blockchain platform is essential to decide to escape from challenges in supply chain problems. To mitigate one of the identified challenges, which is identifying a product portfolio in a pharmaceutical chain, QTTP is required to understand (Sarkis et al., 2021). On top of that, outsourcing manufacturing management and the development of various contractors can alleviate the problem of the product portfolio. Another identified issue that is the long approval time of manufactured drugs can be reduced by finding different opportunities, such as using single-use technology (Sarkis et al., 2021). Multiple product facility is also can contribute to mitigating a long time of drug approval. Another challenge in the pharmaceutical operational channel is the patient-specific product development process. It has been found that adaptation of scale-out and parallel suits can help in the decision-making process that can help in resolving this particular problem. As per the views of Ding (2018), in the pharma industry presence of challenges causes hindrance to sustainable practice following. Therefore, it is important to mitigate the challenges remaining in the supply chain. Different process optimisation tools can be considered to help mitigate pharmaceutical supply chain gaps, such as difficulty in finding modes of operational units. Online process analytical technology can be used to measure the process and can facilitate the monitoring system.

2.8 Theoretical Framework

In this context, two different types of theories have been discussed. Additionally, those theories are very helpful in improving an organisation's working styles and culture. Those two theories are highlighted below:

Agency Theory

This theory is one kind of economic theory that suggests that the organisation is a contract set between self-interest individuals. In addition to that, an agency relationship is created while an individual is authorising another individual to act on behalf. According to the statement of Poletti and Briano (2019), agency theory has an application to labour economics, accounting, and industrial organisation. Moreover, it is becoming the base of the economic compensation model. This theory believes in a strong relationship between principles and agents in the pharmaceutical industry. Along with that, an organisation is making various kinds of policies by which the pharmaceutical industry can reduce its operational costs and expand its revenue during the post-Covid situation in the United Kingdom.

Figure 7: Agency Theory

(Source: Poletti and Briano, 2019)

Resources-based View Theory

This theory explains that all the resources are valuable, non-substitutable, and difficult to imitate. In addition to that, all the resources provide a leading position in the competitive market in achieving success positively. According to the statement of Freeman, Dmytriyev and Phillips (2021), all the strategic resources may provide the foundation for developing the firm's capabilities which may lead to superior performance over time. In addition to that, as per this theory, the supply chain of the pharmaceutical industry requires design in a way that will be used to an extent for utilising properly and developing the organisation in the future. This theory is also suggesting that maintaining a balance between the available resources by which the pharmaceutical industry can manage the supply chain systematically. As per this theory, it can be said that if the pharmaceutical industry may manage the supply chain in an effective way, then the industry may develop all its dynamic abilities smoothly.

Figure 8: Resources-based View Theory

(Source: Freeman, Dmytriyev and Phillips, 2021)

System Theory

This theory on the effectiveness of the supply chain management in the UK pharmaceutical industry is based on different types of variables, and it develops to improve the working culture and industrial profitability rate for the future. System Theory is a dominant theory present in the study of supply chain management in the pharmaceutical industry in the UK. As per this theory, a homeostatic system is provided in terms of describing the procedure of feedback-controlled regulation. The selected theory is looking to explain and develop the hypothesis, which surrounds every characteristic. Moreover, it is reshaping the complex structure of the UK's Pharmaceutical Industry. Additionally, it is creating efficient drug supply for end-users, maintains a high-quality drug, and delivers them within a target time.

Figure 9: System Theory

(Source: Craighead et al. 2020)

In addition to that, this theory is helping all the managers of the pharmaceutical industry to account for interdependence among various kinds of organisational verticals. Moreover, it assigns ownership in terms of achieving collective goals. As per the statement of Gligor et al.(2018), as system theory is helping to achieve all the targeted goals hence, it will help the pharmaceutical industries in terms of reshaping their supply chain management during the post-Covid situation. Controlling the manufacturing procedure may improve the product quality and decrease lawsuits during build a strong customer base in the competitive market. In addition to that, this theory is helping every pharmaceutical industry in terms of providing medicines with adequate amounts and high quality to the right place as well as customers.

2.9 Conceptual Framework

Figure 10: Conceptual Framework

Gap analysis

While completing the research study on the provided research study, the research developer faced different types of limitations while gathering information. For this reason, the research developer has not developed the research study properly and cannot draw a profound conclusion. In addition to that, concerned with the research topic, the research developer has collected ample information from secondary resources. For this reason, an issue has been recognised related to authentication, and there is not a wide range of data resources present by which the researcher cannot crosscheck all the collected data. Additionally, a sufficient number of theories and models are not available on the provided research topic. Henceforth, the researcher cannot discuss the research study properly by a major issue. Moreover, while developing the research study, the researcher has not adequate as well as proper information about the research topic. Henceforth, it has been very difficult to complete the entire dissertation in a good manner.

2.10 Summary

The entire research study it is providing a clear overview of the effectiveness of Supply Chain Management in the Pharmaceutical Industry in the United Kingdom in the post-Covid era. In addition to that, in terms of improving working performance and working culture, every pharmaceutical industry requires to follow several kinds of mitigation strategies and know about the necessity of Supply Chain Management for increasing productivity and profitability rate in the future. Along with that, effective Supply Chain Management ensures to improvement of an organisation's working performance and working culture in several sectors in the Global World. In this chapter, different types of challenges, as well as mitigation strategies, have been discussed properly. By which the research developer can easily complete the entire dissertation in a good manner. Besides that, the literature review plays an essential role in covering various kinds of perspectives effectively. Moreover, in this chapter, various kinds of secondary resources have been collected by which the researcher can compare and contrast the statements of different authors on the provided research topic. Supply Chain Management is present in the integrated networks of the pharmaceutical industry in the UK. Moreover, effective supply chain management may help to increase an organisation's productivity and profitability rate and improve its working style and culture.

Chapter 3: Methodology

3.1 Introduction

The benefit of the meta-analysis and the systematic review can be demonstrated by the fact that meta-analysis provides an excellent opportunity for critical evaluation as well as a statistical combination of the data gathered. The major aim of the meta-analysis is that it helps in increasing the number of observations as well as the statistical power of the research. It also helps in enhancing and improving the possible estimates of the actual effect size of an association or an intervention (Chen and Zhang, 2021). However, it is also to be kept in mind that the interpretation of the quantitative results of the research is made by following rigorous rules.According to Kraus et al. (2020), the benefit imparted by the systematic literature review is based on the fact that a systematic review helps in determining the technological improvements and the possible outcomes of the research. It is suggested that with the help of a systematic review of the literature, the creation of a total article is allowed without the need to consider the empirical data. Another major benefit of a systematic review can be explained by the fact that it helps in the production of a transparent and reproducible methodology.

3.2 Search engine

A systematic review of secondary resources is required to collect from significant libraries or sources. Hence, the present study has been oriented toward Supply chain management interferences and evaluation. This is a broadly asserted topic for this study, which has further subsection with specific industrial movements of "Supply chain management". As the study by Xu et al. (2020, p.160) has mentioned the Covid-19 impact on supply chain continuity destruction. Google is one of the most commonly used search engines for medical research activities, and it is being utilised for regular professional purposes in the study (Rethlefsen et al., 2021). Other popular search engines that are often used include Yahoo, "AltaVista", "Excite", "Science.gov", "BioMedNet" and "Search Medica". The search engines often save valuable time during the research activities by searching for the most appropriate key terms within a very short time period. It is very much relevant for all individuals who can freely access to operate their actions based on the comprehensive type of informative data (Johhson and Sylvia, 2018). The above-mentioned search engines initiate the study by using advanced search options to refine the results.

The external environment affects pharmaceutical product distribution (Hastig and Sodhi, 2020, p.952). Therefore, this is a stated interpretation and evidence-based depiction of existing and proceeding studies' interrelation. The searching plated forms such as Google Scholar and PubMed are highly recommended sites to search keywords. The main keywords of this study are "Post Covid", "SCM", "pharmaceutical", "Supply chain challenges", "Covid-19 impact", "Supply chain trends", "Supply Chain Performance Measurement", and "Pharmaceutical industries from the UK".

3.3 Application of inclusion and Exclusion criteria

The inclusion criteria for the research are based on the following points of consideration: the year of publication of the research articles, the type of the journals, and article types. It is made sure that only those articles are considered peer-reviewed journal articles and are available in the English language. It is also ensured that topics relevant to supply chain management are included. Another important criterion for the inclusion of data is based on the supply chain of the pharmaceutical industry's functioning in the UK.

The exclusion criteria for this specific research are based on excluding articles that are not peer-reviewed and are structured poorly. Also, the articles that are not relevant to the topic of the supply chain are excluded. Articles that were published before 2018 and not available in the English language are excluded. By effectively considering the inclusion and exclusion criteria, the risk of unfavourable outcomes in the research can be avoided.

Components	Inclusion criteria	Exclusion criteria
Year	Published from the last five years articles and journals (2018-2022)	Published before the last five years or before 2018
Types of journals	Online peer-reviewed journals with authentic information and data	Non-peer reviewed journals containing fake responses and results
Types of articles	Peer-reviewed online articles with accurate data based on the pharmaceutical industry	Non-peer reviewed articles with irrelevant data and false results
Language	All types of English language journals and articles	Articles and journals which are not published in the English language
Types of studies	Well-structured academic studies with relevant information related to the recent and updated UK data	Poorly structured articles and journals with irrelevant and unauthentic information
Type of data	After the pandemic, data on supply chain management has been included	Old journals before 10 years of supply chain management process have been excluded
UK country supply chain management data on the pharmaceutical industry has been considered.	Other country-published journals and articles have been excluded except for UK country data.

Table 2: Inclusion and exclusion criteria

(Source: Alamoodi et al. 2021)

The covid-19 extracted complications in the case of business management and performances have been significant (Rai, Tiwari, and Gupta, 2022, p.238). The details of participants included in this study with collected data sets, selection of articles with specific interventions, and different studies that have been included in this study are stated in the below section-

Type of participant

In the study of Koenig et al. (2019, p.16937), the participants were obtained from UK's different pharmaceutical industries. The industry experts from the Pharmaceutical industry have been included.

Justification

The participants are mainly selected from the supply chain management of the pharmaceutical industry who are involved and can easily provide the correct and authentic information for evaluating the entire study (Maglietta et al., 2022). The pharmaceutical industry experts, operational managers, production managers and suppliers are involved in the study to collect data during the post-Covid situation. They have been selected for the study as they have faced a critical situation during the post-Covid along with the impact of this condition on the pharmaceutical business of the UK population.

Types of intervention

The objective of this study is associated with evaluating the importance of the pharmaceutical industries' SCM, new SCM strategies to cope with the post-covid-19 situation, required changes identification for UK's pharmaceutical industries, and future mitigation strategies.

Justification

Supply chain management (SCM) strategies are being utilised for coping with the entire critical situation during the post-Covid to enhance the performance efficiencies of the pharmaceutical industry in the UK (Farooq et al., 2021). The main challenging issues, intervention related to the storage establishment and the diversification of the main suppliers, are very involved in enhancing the industry with positive outputs. The interventional strategies based on the supply chain improve the visibility along with the "data analytics" to decrease the inventory and the overhead cost level of the pharmaceutical business.

Type of studies

In this study, major inclusion criteria for selecting articles fall within the randomised, cohort, primary, quantitative and qualitative types of studies. The presented study mainly evaluates the impact of covid-19 in the case of SCM in the UK's pharmaceutical industries.

Justification

The SCM-related studies are selected for the study, and it has been identified that the selected articles include several methods and procedures during the conduction of the study. The studies provide a detailed idea about the barriers and strategies for improving SCM based on the UK pharmaceutical industry with potential results and outcomes (Cooper et al. 2018). Hence, the study of Bag et al. (2021, p.29) has been followed by a multi-methodological study application. In a clear and specific word, the exclusion criterion has included systematic review papers, meta-analysis papers, and multi-methodological research papers.

Search process

Step 1: A specific research question is being formulated to determine a clear and focused aim and objectives.

Step 2: The key concepts are identified with the help of the search engine to acquire the correct data quickly (Munn et al., 2019).

Step 3: After that, the search terms are developed containing "free text terms" by utilising the different types of medical databases.

Step 4: Controlled types of vocabulary terms are established based on the main key terms or search terms (Grames et al., 2019).

Step 5: Boolean operators are used to searching for the correct results from different databases, which help to focus more on a particular subject with productive results.

Step 6: After that, the articles are selected and screened properly from the databases with the help of the PRISMA framework for authentic data (Eriksen and Frandsen, 2018).

Step 7: At last, the selected and screened articles are chosen for reviewing systematically based on the different procedures that have been utilised for the study with potential outcomes.

3.4 Search strategy

The search strategy can be explained by the fact that many search engines are used to access relevant band important articles. These are google, google scholar, excite, yahoo, and search medica. Another effective strategy for searching for relevant articles is based on the usage of keywords. The main keywords used in this research article's search are SCM, supply chain, pharmaceutical industries, and post covid. Considering the inclusion and exclusion criteria has helped significantly in gathering authentic and relevant articles from Google Scholar.

Keywords

DATABASE

Google Scholar

Cinahl

Pubmed

SELECTED KEYWORDS

· Supply chain management

· Post-Covid

· Pharmaceutical industry

· Supply chain

· Covid-19

· Medical products

· Pharmacy

· Covid situation

· Effectiveness

Table 3: Keywords searched from the databases

The databases that are utilised for the study for searching for the most relevant and authentic information include "Google Scholar", "Medline", "Cinahl", "PubMed", and "MedLine". The authentic information and data are also collected from the government websites related to the UK, journals papers and articles, government books and publications based on the Post Covid situation for determining the most relevant and knowledgeable informative data (Grames et al. 2019). "Boolean Operators" include "OR", "NOT", and "AND" and are used in the study to search for the correct results from different databases, which help to become more focused on a particular subject with productive results (Usuzaki et al. 2020).

Keywords identified based on the research topic are supply chain management in the pharmaceutical industry, pharmaceutical industry in the UK, and pharmaceutical industry after pandemic and supply chain management after the pandemic. As stated by Bramer et al. (2018), deciding elements of keywords is essential in choosing a topic for obtaining the best results. As per the views of Rethlefsen et al. (2021), search strategies also include filter applications for finding relevant journals and articles in order to restrict the display of irrelevant search results.

Database	Keywords	Filters	Boolean operators	Resulted number of articles
Google Scholar	supply chain management impact on the pharmaceutical industry	2019	-	16800
Google Scholar	supply chain management and pharmaceutical industry	2019	AND	16800
Pubmed	supply chain management and pharmaceutical industry	Custom date, free full text	AND	41
PubMed	supply chain management and pharmaceutical industry in the UK	Custom date, free full text	AND	4
PubMed	The pharmaceutical industry and post-pandemic in the UK	Custom date, free full text	AND	3

Table 4: Search strategy and result obtained

The above table reflects the use of boolean operators in the search strategy. As mentioned by Tawfik et al. (2019), the proper databases for searching are PubMed, Google Scholar, Embase, Cochrane and others using boolean operators and gathered articles can be refined using PRISMA.

3.5 Search characteristics

Search characteristic also begins with considering the defined research question. The research question determines the search direction (Patino and Ferreira, 2018). The objective of this systematic review has been developed, which is indicative of the effect of supply chain management in the pharmaceutical industry after the pandemic.

Population	Author name	Intervention	Aim or purpose of the systematic review	Study design	The geographic location of the articles	Summary of the results
Supply chain Manager	Spieske et al. 2022	Use of two decision-making tools in supply chain management	To mitigate the challenging issues of the supply chain management faced by the manufacturers of the industry	Observational study	UK	Barriers to sustainability development in the pharmaceutical industry
UK supply chain managers	Hasan, Islam and Ishrat, 2022	Resilience maintenance in supply chain management of the pharmaceutical company	The purpose is to find the impact of a pandemic on the supply chain management of a multinational pharmaceutical company.	Primary quantitative and qualitative data research design	United Kingdom	Results show that microenvironment factors are altering the procurement strategies of multinational companies.
Supply chain Management expert	Frederico et al. 2021	Technology implemented in supply chain management	This study aims to investigate the impact of technology 14.0 on supply chain performance.	Survey research method	UK	Findings show that disruptive technologies significantly modify the supply chain's collaboration, integration, and transparency.
Social media user	Wilk, Roni, and Jie, 2022	Supply chain insights	This study aims to find the social media user response to operational management of the supply chain.	Qualitative research design	UK	Results reflect that negative sentiment on supply chain management
Supply chain managers	Sarkis, 2020	Implementation of environmental sustainability	This study aims to provide a pathway to maintaining sustainability in pharmaceutical supply chain management.	Interview method and secondary data collection method	UK	Findings depict that modern operations are implemented in supply chain management.
Managers	Frederico, Kumar and Garza-Reyes, 2021	Strategic sourcing for raw materials	This research aims to find the effect of strategic sourcing in supply chain management.	Survey-based research design	UK	Results show that strategic sourcing significantly contributes to developing a new direction in the production and management chain.
Managers	Belhadi et al. 2021	Technology adaptation	The purpose of this study is to find the supply chain resilience	Empirical Survey research design	UK	Findings reveal that technology 14.0 is the best strategy to implement in response to a pandemic situation

Table 5: Search characteristics

3.6 Selection and Screening of articles

The screening process in a systematic review can be summarised with the help of a PRISMA framework. The first step in the PRISMA flow chart is identifying where the protocols have been checked regarding the study. The number of databases that have been taken is 4, namely "Google Scholar", "PUBMED", "MEDLINE", and "PROQUEST". The next step was removing the records before performing the screening process; in this case, the number of records removed was 25. After this step, the number of articles that were eliminated and 12 articles were selected. The selected articles were then checked for retrieval, and the ones that passed this stage were 10, while two articles were eliminated at this stage.

Figure 10: PRISMA framework

The selected articles are being demonstrated by linking with the objectives of this study. This study aims to evaluate SCM in the UK's pharmaceutical performances and challenges related to Covid-19 impacts. Moreover, the critical reflection of different articles and their results for the screening process is important. The PRISMA framework has mentioned articles' clear and systematic inclusion and exclusion. A total of 8 articles have been included in the ultimate analysis section. The secondary research articles and papers are included with CASP implementation. The main intention of using these tools and frameworks is value effectiveness. Therefore, the systematic intervention process of study development effectively includes selection and screening criteria.

3.7 Study quality assessment and checklists

CASP Questions	Article 1	Article 2	Article 3	Article 4	Article 5	Article 6	Article 7
1	Yes	No	Cannot tell	No	Yes	No	Cannot tell
2	No	Cannot tell	Yes	Cannot tell	Yes	Cannot tell	No
3	Cannot tell	Yes	Cannot tell	No	Cannot tell	No	Yes
4	No	Cannot tell	No	Yes	Cannot tell	Cannot tell	Yes
5	Yes	Yes	Yes	Cannot tell	No	Yes	Cannot tell
6	Shows appropriate interventional strategy	Shows effective methodology portion	Shows appropriate interventional strategy	Shows effective methodology portion	Shows primary methods elaborately	Shows primary methods elaborately	Shows appropriate interventional strategy
7	Precisely evaluated	Correctly calculated	Cannot elaborate on the result	Correctly calculated	Cannot elaborate on the result	Correctly calculated	Precisely evaluated
8	Cannot tell	No	Cannot tell	Yes	Cannot tell	Yes	Cannot tell
9	Yes	Cannot tell	Yes	Yes	Cannot tell	No	No
10	Cannot tell	Yes	Cannot tell	No	Yes	Cannot tell	Cannot tell

Table 6: CASP Tool

Study quality can be assessed by using the CASP tool (Critical Appraisal Skills Programme). This CASP tool is suitable for the quality appraisal for qualitative evidence synthesis. As Long et al. (2020) stated, the strengths and limitations of any quantitative research can be measured using the CASP tool. Min et al. (2021) opined that methodological evaluation could also be conducted using the CASP tool. Quality assessment with the CASP tool indicates that data precision is high with selected articles and journals. Journals and articles selected produce UK intervention strategy; hence it can be stated that, locally it can be applied.

3.8 Data extraction

The process of the extraction of data is done by accessing various scholarly articles based on the topic of supply chain management.

Articles	Author	Data collection tool utilised in the articles	Chosen data portion from the articles
1	Spieske et al. 2022	Semi-structured interview process followed in the article based on the "resource dependence theory."	Nearly 39 procurement, along with the experts in supply chain management, for participating in the semi-structured interview procedure
2	Hasan, Islam and Ishrat, 2022	Semi-structured interview questionnaire tool has been considered	Challenges that are faced by the supply chain management process after the pandemic situation.
3	Frederico et al. 2021	Interview questions have been considered as a primary data collection tool	The considered portion of this article is the technology implementation impact after a pandemic situation in the supply chain
4	Wilk, Roni, and Jie, 2022	Machine learning-based software tool has been used to collect primary data	Social media network information regarding supply chain management operations
5	Sarkis, 2020	Personal search experience and semi-structured interview	Environmental sustainability maintenance in the supply chain after a pandemic outbreak has been taken into account
6	Frederico, Kumar and Garza-Reyes, 2021	The survey-based approach has been considered for primary data collection purpose s.	Strategic sourcing of material in response to the pandemic situation has been considered.
7	Belhadi et al. 2021	The methods are applied to analyse the barriers critically to proceed with further research activities with accurate results.	The distribution of the raw material is surely being improved with the implementation of the procedure.

Table7: Data extraction table

"Automation" and "digitalisation" can be applied in the article to reduce the negative influence or the major barriers. A meta-analysis of the secondary findings of the research is also conducted and this is based on the comparison of the various data in the articles taken into consideration for this research. Meta-analysis refers to the formal and quantitative analysis of findings of previous research that helps in deriving important and significant conclusions on the research topic. The advantage of conducting a meta-analysis in research is the review and consolidation of the complex and large literature on a selected research topic.

3.9 Reliability and validity

Reliability	Validity
Data articles have been selected based on this systematic review's aims and objectives.	The selected articles and journals mostly contain primary data collected from the managers; hence validity has been maintained in this systematic review.
Articles are all from peer-reviewed journal sources. Therefore, the results are reliable to use further for other research work.	Participants are mostly supplying chain managers in selected articles from whom primary data has been collected.
Articles provide data on challenges faced by the managers during supply chain operation in pharmaceutical companies. Hence, the data analysis will offer a precise information and corresponding solutions to handle these challenges.	All articles are based on UK data; therefore, using systematic review data, local changes can be initiated in supply chain management in a pharmaceutical company.

Table 8: Reliability and validity

3.10 Data characterisation table

The data characterisation table has been formed considering columns named as author, target population, intervention, the main outcome, control group and time for research. Every article has been thoroughly incorporated to be analysed in terms of finding data-oriented to identified objective and research questions or this systematic research.

3.11 Research gap

The gap in the research can be explained by the fact that the factor of innovation in the supply chain is unaddressed in this research study. The factor of innovation is crucial in the effective management of the supply chain of pharmaceutical products. With the advancement of the technology and its implementation in the supply chain, devices for effectively managing the supply chain can be done by the blockchain-based technology of IoT.

Chapter 4: Findings/Results

4.1 Characteristics of study table

Author	Target population	Intervention	Control group	Time durations	Main outcomes
Spieske et al. 2022	Manufacturers of medical supplies and hospital groups in Europe	The service providers in logistics increased the freight rates, and the procurement of medical supplies was extended beyond the need. The Governments engaged in funding for medical supplies. The production capacities were increased. Dependencies were buffered with additional options of sourcing. The hospitals formed collaborations with the public authorities to secure scarce materials. Leveraging new and existing BSRs.	NA	6 months	Procurement Challenges were encountered by medical suppliers and hospitals due to the pandemic. The availability of critical supplies was hampered. The hospitals had to exchange screen supplies and receive supplies from various upstream suppliers. Government bodies also donated medical supplies to the hospitals, and these hospitals procured supplies also from outside sources.
Hasan, Islam and Ishrat ( 2022)	The supply chains in the pharmaceutical industries in the emerging economy	Identification of the risks faced by the supply chains of the multinational manufacturers in the UK and evaluate whether the other businesses can learn from these challenges and provide recommendations to tackle the challenges	NA	7 months	The barriers have mainly occurred in the four-level hierarchy system of the supply chains. The most crucial barrier is the insufficiency in planning made by the supply chains, followed by the improper structure of decisions and inadequacy in risk-management policies.
Frederico et al. 2021	Supply chains of medical equipment	Stability for addressing the localised interruptions	NA	6 months	The threats of the pandemic were unknown to the medical supply chains. The stories of consumers affected by the ongoing panic were shared on social media platforms, which led to irrational behaviour within the supermarkets, which eventually led to a shortage of necessary products, which the suppliers failed to provide. Many risks were identified as being associated with the global networks of supply chains. Changes in the location characteristics of the global firms due to the pandemic affected the performances.
Wilk, Roni and Jie (2022)	Social media users have been influenced by panic buying of medical equipment because of the pandemic in the UK, Australia and the US.	Including social media strategies in the risk management processes by the managers of the supply chains, which is associated with managerial actions based on the sentiments of the customers?	Population in the UK, US and Australia who are not on social media or have not been a victim of panic buying	3 months	The herd mentality of the people influenced the herd mentality of the people. It pushed them towards panic buying due to anxiety, and eventually, the availability of medical products was affected.
Sarkis, 2020	The supply chains of the pharmaceutical companies	To some extent, strategic planning in the supply chains, which relies on agile production and rapid logistics delivery, has resolved the ongoing problem of increased demand. Local manufacturing of ventilator parts has built resilience in the supply chains and ensured the production of only the required amount.	NA	6 months	The operations in the supply chains were hugely moderated due to the introduction of the covid-19 pandemic. There were implications caused by sustainability that failed to be resolved and that urged some modernisation in the strategies. There were gains occurring due to short-term sustainability while long-term ones failed to produce any. Redundancy in the capacity of the supply chains due to agility resulted in the wastage of energy and resources.
Frederico, Kumar and Garza-Reyes, 2021	The supply chains of the pharmaceutical companies and other industries	Strategic sourcing includes people with distinguishable skills, knowledge and competence	NA	6 months	The performance of the supply chains was significantly altered with the introduction of strategic sourcing because the downstream processes of the supply chains were positively impacted. The disruptive situations were not a result of strategic sourcing. There were no significant alterations observed. The performance attributes, as well as the agility of the supply chains, were affected. The activities involved in purchasing and sourcing were improvised to sustain the strategies in the supply chains.
Belhadi et al. 2021	The supply chains of manufacturing and service of the organisation's	Perceiving Big-data Analytics to provide real-time information about the activities of the supply chains after the Covid-19 pandemic and cooperation between the stakeholders of the supply chains to address the difficulties that have been faced and overcome them and accelerate the usage of digital technologies. Automation of the supply chains, localisation and regionalisation, was adopted in the sourcing. Also, maintenance of lifeline and regulation of digital connectivity was ensured. Continuity plans for the business and creating virtual market places that would be safe for the suppliers. Adopting a real-time information system ann one that BDA drives. Collaboration of various supply chains and development of social focus. Conserving spaces in the inventories and receiving tec capacities were also thought of.	NA	1 year

Table9: Characteristics of study table

4.2 Findings from the articles

S. No.	Author	Aim	Methodology	Sample and Data source	Key Findings	CASP score
1.	Spieske et al. 2022	To find out medical supplies and hospitals, and the manufacturers and hospitals are managing it for managing the resource dependencies.	Semi-structured interview and approaches based on buffering and bridging with the help of both within-tier and cross-tier analysis	Primary data from 39 experts from supply chain management and procurement in the pharmaceutical companies of Europe	Significant growth was observed in the number of patients requiring intensive care and hence the rise in the demand for medical supplies. The delivery capabilities of the suppliers were impaired due to the constraints in global supplies. Central warehouses were established for covid-related products by the procurements organisations The difficulty of finding new suppliers increased, and the main industries' buying power increased by convincing new suppliers of a purchasing volume of supplies.	9
2.	Hasan, Islam and Ishrat, 2022	To investigate the barriers in the pharmaceuticals' supply chains that hamper sustainability and help decision-makers recognise these barriers.	Mixed methods	Both qualitative and quantitative data	Insufficiency in the strategic planning of the supply chains due to agility as that occurred in SCM. Poor information structure in the chains' contributors and inadequacy in risk management policies were also identified.	12
3.	Frederico et al. 2021	To investigate the effects of the 14.0 technologies on supply chain performances.	Survey-based approach, descriptive methodology based on the survey	Strategic responses from the survey	Concerns associated with the global supply networks in the pharmaceutical industries were huge. Changes that occurred due to the pandemic's short-term and long-term effects affected the firms' performances. The supply chains are positively impacted by strategic sourcing, and all the five stages included in the sourcing are highly valid.	14
4.	Wilk, Roni and Jie, 2022	To identify the positive and negative effects of the herd mentality of panic buying o the supply and manufacturing of medical products in three countries.	The primary collection of data is based on a survey of social media users globally, especially in the UK, Australia and the US.	Primary data from 208,806 uses of social media	Panic buying had led to a shortage of supplies in the markets. This resulted in a critical situation for the manufacturers, who also failed to restock the markets. The situation became more intense when the trend of panic buying emerged because of influence through social media. All of this occurred because social media users had decided to act according to their sentiments and not on practicality. However, these users hoarded others not to panic like them, and the managers of the supply chains set this as evidence to re-modulate their strategies.	14
5.	Sarkis 2020	To examine environmental sustainability in the supply chains after the Covid-19 pandemic.	Qualitative research analysis based on both primary and secondary data	Data was collected from previous research works, personal experiences of research, open forums and interviews of practitioners.	The uncertainties of the pandemic regarding the recovery time created fragility in the supply chains. There were some transformations that the supply chains had to undergo. There were potential opportunities provided to the supply chains in terms of transition. There were implementations like automation and data exchange systems in the manufacturing processes. Implementation of applications like cloud computing, IoT etc., decentralised the decision-making of the contributors to the supply chains. A requirement for behavioural change was mandated because of the failing of government systems, including both regulatory and market organisations. Organisations adapted immediate decision-making to resolve the short-term crisis rather than focusing on future goals as an effect of Covid-19. The industries adopted collaborative technologies such as blockchain to ensure sharing of transparent information. However, the decision-making was hampered, and the localised systems were more likely to become robust. The local production of ventilator parts ensured less wastage and the requirement of less transportation and inventory storage. There was employee downsizing due to budget issues after the pandemic. However, the carbon footprints of the organisations were reduced due to a reduction in the employee's number. There were requirements for the suppliers' physical visits, which were impossible because of longer distances. The companies relied on virtual meetings, and that resulted in negative sustainability that was unintended.	12
6.	Frederico, Kumar and Garza-Reyes, 2021	To find out the effects of the processes involved in strategic sourcing on the supply chains after the pandemic.	Survey-based approach, descriptive methodology of the survey.	Strategic responses from the survey	Both the organisational and performance and that of the individual firms have experienced significant changes with strategic sourcing. The profitability of the supply chains was also affected by strategic sourcing, and the competitive performances were increased within the organisations. Five phases were developed in the strategic sourcing: planning, research, conduction, contract alignment, establishment and management of supplier relationships. There were difficulties in meeting the demands due to a shortage of product supplies, and strategic sourcing helped maintain the operations' continuity. However, there were debates regarding the processes involved in strategic sourcing in terms of the number of steps. This gave rise to various considerations regarding whether or not to adopt strategic sourcing.	10
7.	Belhadi et al. 2021	Questionnaire-based survey for gathering short-term responses	Survey of 145 firms and their supply chains in both service and manufacturing.	Firstly, the employees' performances were hampered due to the pandemic, either due to physical weakness or other factors eventually hampering the supply chains. There were manufacturing shutdowns experienced by the sully chains of all the sectors. A shortage was encountered in the sales and working capital. No significant changes were observed after the changes implemented in the strategic planning, like inventory reserved and collaboration between supply chains. There was a shortage in developing capabilities in planning the potential threats of the supply chains, which led to a loss in the business profitability. This implied a requirement to develop the capabilities of the supply chains of these organisations.	12

Table10: Findings from articles

4.3. Table on the statistical findings

Articles	Source	Aims	Methods	Findings and statistical interpretation
Article 1	Spieske et al. (2022)	The aim of the study is to study the ways of mitigating the problems based on the management of the supply chain by the manufacturers involved in the pharmaceutical industry.	Research based on observational study	The statistical findings are derived from the symbiotic relationship between the suppliers and the supply restriction related to materials.
Article 2	Hasan, Islam and Ishrat, (2022)	This study aims to investigate the impact of an effective supply chain management system in the case of big pharmaceutical companies.	Qualitative as well as quantitative primary data is used	The statistical findings suggest that the maximum number of respondents in the study is between 21 and 34 years of age and account for 540% of the total participants. In the case of gender, 67% of the respondents in the study represent males. In the case of employment in the pharma supply chain, it is found that 42% of the respondents have been employed in this industry for 3 to 5 years. It is also found that the reduction in the profits and the returns contribute to the highest of 33%.
Article 3	Frederico et al. (2021)	The major aim of this study is based on the evaluation of the effect of Industry 4.0 technologies in better management of activities of the pharmaceutical supply chain.	The research method used is survey.	The findings of this study are based on the fact that both short and long-term changes due to the pandemic have affected the pharmaceutical industry's performance. With the help of strategic sourcing, the supply chain responded positively by improving the business operations.
Article 4	Wilk, Roni, and Jie (2022)	The aim of this particular study is based on the analysis of the response of users of social media in the process of operational supply chain managing processes.	A qualitative study is carried out	The findings is suggestive of the fact that people have both positive and negative sentiment on the aspect of panic buying. A major finding suggests that the users of social media are more reliable on the topic-consonant and location-based social herd.
Article 5	Sarkis, (2020).	This study is aimed at establishing the various ways through which the activities of managing the supply chain of pharmaceutical products can be done.	Both primary and secondary data type of qualitative data is utilized in this study.	The findings are based on the explanation that the socio-political factors that determine the functioning of the supply chain in the pharmaceutical business are technological practices, regulations and policies, goods tariffs and adoption of new norms.
Article 6	Frederico, Kumar and Garza-Reyes, (2021)	The aim of this research study is to evaluate the impact of strategic sourcing in the management aspect of the supply chain in the pharmaceutical industry.	A descriptive methodology based on a survey is done for obtaining the strategic responses	Th research findings demonstrate that the process of strategic sourcing in the pharmaceutical supply chain happens in five stages that are research, planning, contract alignment, conduction and effective management.
Article 7	Belhadi et al. (2021)	The study aims at investigating the role of resilience in the management of the supply chain.	A questionnaire is prepared for taking the survey of 145 organizations.	The statistical interpretation of this study is based on the fact that 51% of the respondents are suppliers, 38% belong to some local firm and the remaining 11% are retailing and distribution partners. In the context of the response strategies, it is found that the high mean values are representative of the successful adoption of the strategy by the respondents. The mean values are in the range of 3.54 to the value of 4.92.

Table 11: Findings from articles

Chapter 5: Discussion

5.1 Discussion

Managing the organization's supply chain to sustain the overall production and distribution of products according to demand has been complex. According to Khan, Alroomi, and Nikolopoulos (2022), consumer behavior and supply chain disruption are linked to each other. Hence, UK customer behavior has changed with covid-19 impacts. Farooq et al. (2021) state that the supply chain management of manufacturing companies and goods-providing companies are allowed to meet maximum demand. Pharmaceutical industries SCM required significant changes in application possess and developmental approaches to cope with the post-covid-19 phase. The global pharma extracted UK's pharmaceutical activities have collected GDP's 2.5%. Therefore, the UK's pharmaceutical industry's position is in the top ten, and the major companies are GlaxoSmithKline and Astra Zeneca (Khan, Alroomi, and Nikolopoulos, 2022). The highlighted services and product distribution throughout the world is the key business advantage of this country. The technological development and intervention of new strategies for business have allowed this industry from the UK to extend its markets. However, the global business and regional distribution of pharma products and equipment are experiencing significant supply chain destruction due to the covid-19 impact. The cases of infection have been higher than in other countries of the world in 2020-2021 (Nandi et al. 2021). The unavailability of sufficient workers at the workplace has become the core issue in sustainable supply chain management (Forehand, Roman, and Schaefer, 2021). Therefore, the result section has prominently depicted that the SCM prospect in the UK has changed with customer behaviour changes. The behaviour changes of customers have been driven by the Covid-19 impact (Handfield, Apte, and Finkenstadt, 2022).

The lockdowns, restrictions over travel, and "shelter-in-place orders" have disrupted economic transmission and cash flow. Kim and Zhao (2021) opined that 93% of senior supply chain executives intend to provide more agile, resilient, and flexible supply chains. In the UK, SCM has been followed by major theories of supply chain continuity such as TCA (Transaction Cost Analysis), System theory, and Network perspective theory. As Lavassani, Iyengar, and Movahedi (2022) suggested, networking supplying chain management in the UK has been performed by several pronoun companies such as the Shire. Thus, the risk associated with the supply chain in case of performance and supplier problems is significant (Sharma et al. 2020).

Figure 11: Graph on Meta-analysis of the searched articles

(Source: Self-developed)

The representation of the articles searched in various databases is represented with the help of a bar graph. From the above graph, it can be stated that the maximum number of articles are accessed on google scholar when the topic of management of the pharmaceutical products supply chain is searched for. These articles are all in English language and published after 2018. However, it is noticed that only a small number of articles could be accessed by the PubMed platform on the research topic.

The theories are based on the management of the supply chain are based on the systems theory and the agency theory. The agency theory is based on identifying the behavioural change in the supply chain players. The system theory is based on the fact that businesses are comprised of multiple components that work harmoniously to enable the optimum functioning of the larger business body. According to Kostev and Lauterbach (2020), the state of panic buying of medicines during the time of pandemic has resulted in significantly shortage levels in the post-covid time. It is suggested that the lack of correct information and the spreading of wrong information among the public is the major cause of creating the situation of panic buying. In the context of the supply chain functioning in the global pharmaceutical market, this involves the suppliers of the raw materials for making drugs as well as the sellers of the pharmaceutical products. Also, the delays in the delivery of medicines initiate the process of raising the cost of the medicines.

This type of management looks after the life cycle of drugs sold in the UK market. The GDP of pharmaceutical companies in the UK is estimated to be approximately 2.5%. During the pandemic era, there was a huge demand for medicines among people. As opined by Hasan et al. (2022), supply chain management looked into the3 production in large quantities. In this way, pharmaceutical companies can meet the rapid needs and demands of the common people. The technological interventions incorporated in the pharmaceutical companies helped it earn a maximum profit rate in the UK market. As a result of the huge demand from the people at the time of the Covid 19 pandemic, the supply chain of medicines at times felt it difficult to meet the needs of the common people. As stated by Sawyerr (2022), the frequent lockdown in the regions of the UK led to a massive loss in the pharmaceutical industry. The supply chain faced a massive challenge while transporting medicines to the required centre. The factor of medicine shortages is one of the critical aspects faced in the p[ost covid era. As referred by Acosta et al. (2019), the shortage of medicines is based on the differences in the perspectives between the management of the supply chain and the global market situation. The situation of medicines going out of stock is based on mainly four issues that are market situation, managing the supply chain in an effective manner, the process of manufacturing the medicines and the political issues prevalent in a country.

The outputs of the organization in relation to supply chain management are oriented with agile implementation. As a result of the covid-19 impact on value reduction and suppliers, complications have arisen (Cuong and Tien, 2022). Therefore, the critical analysis of the result has demonstrated the new strategic planning associated with supply chain management in the UK related to pharmaceutical companies adopting nearshoring processes. According to Golgeci, Yildiz, and Andersson (2020), the coming phases of post-Covid will require much more resilience and flexibility with digital interventions.

Robotics and AI specialized implementation have started to be incorporated within the pharmaceutical industries (Fonseca and Azevedo, 2020). In managing the supply chain, two major divisions have been associated with this field, the planning system and the execution system of the supply chain. In analyzing the existing evidence from pharmaceutical industries from the UK has faced supply chain visibility and cold chain shipping of products. The private and public partnership for supply chain continuity and development has been approached (Ishida, 2020). The bottlenecks and lack of readiness in reacting according to an emergency in the supply chain have impacted over sourcing process.

The multiple souring processes of eliminating souring issues in a particular organization and regions seem to evolve with post-Covid SCM continuity development. According to Sudan and Taggar (2021), the supply chain disruption with Covid development in 2020 and 2021 has left the pharmaceutical industries to adopt new and sustainable strategies for SCM's resilience and flexibility enhancement. The diversification approach implementation in SCM has been promoted. According to Hassan and Abbasi (2021), the multiple factories, suppliers, and regions of markets are additional key strategies in modern sourcing and SCM. Fonseca and Azevedo (2020) opined that the dependency on one single factory or supplier is required to shift to multi-layer sourcing. Thus, the UK has started to adopt and apply the robotics in logistics aspect of the organization to eliminate maximum human workmanship (Ozdemir et al., 2022).

Stock managing and inventory maintenance are two major approaches to SCM. The health care equipment and medicines are required to maintain stock for emergency support. Therefore, with the experiences of covid-19 pandemic impact on inventory and stock management new approach to intermediate inventory development and stock safety (Singh et al. 2022). The future changes in power dynamics in the supply chain and radical change in inventory strategy According to Modgil, Singh, and Hannibal (2021), the AI application can be effective in achieving a balanced demand and application approach for pharmaceutical companies in the UK. As suggested by Schleper et al. (2021), in shifting from global to local, Schleper et al. (2021) have used the Grey Decision-making trial and Evaluations laboratory (Grey-DEMATEL). The depiction has allowed stating the factors affecting supply chain disruption and has significant shared relations between them as well.

The significant challenges that emerged during the covid-19 pandemic spread are uncertainty in demand, inconsistency in supply, material scarcity, delayed delivery, labour scarcity, contrasting capacity, vehicle unavailability, and "last-mile delivery" (Xu et al. 2020). In responding to these, all challenges affecting SCM in the UK are further mitigated with significant strategic and analytical construction of new approaches. Hence, the existing studies on the UK business environment have stated that the three major issues that have been merged with the covid-19 pandemic and will last for a longer period are inconsistency in the supply chain, material scarcity, and scarcity of labour (Moretto and Caniato, 2021). However, the financial damage has been imposed with SCM disruption as well. The mitigation of financial loss has been asserted with pricing and costing development and the cost leadership implementation process for MNCs (Schleper et al., 2021). According to Ishida (2020), two types of strategies can be imposed to mitigate exciting challenges associated with SCM: long-term and short-term strategies. Contractual and dedicated labour force balancing processes are being introduced in Pharmaceutical sectors associated with SCM actions. (Nandi et al. 2021). Therefore, extracted information and existing studies evaluation have asserted the above-mentioned changes; thus, the result collected from different existing accounts has stated labour balancing along with the alternative substitution of raw material as a key mitigation strategy.

Capabilities of developing supply chain resilience with dynamic approaches of technologic and planning have demonstrated the leading customer demand and satisfaction delivery. As stated by Khan, Alroomi, and Nikolopoulos (2022), the future goal of SCM is going to be underlined with the social and humanitarian supply chain for a long-term strategic shift. Thus, this strategy has been contrasted with technological interventions. Therefore, Golgeci, Yildiz and Andersson (2020) opined that resilience reimbursement and efficiency development could be addressed with a mixed products optimisation approach. The financial crisis with SCM performance reduction and complexity development can be mitigated with reverse capacity investment. The reestablishment of the previously achieved state of SCM performance and resilience is only achieved with new strategic management and planning. Hence, the supporting evidence from the result section has highlighted Tailored Sourcing strategies for pharmaceutical companies from the UK.

The overall discussion has a description of the effectiveness of SCM in Pharmaceutical industries in the UK in the post-Covid-19 phase. The major outcomes and extraction are linked with existing challenges and future mitigation. The pre-Covid phases have distinct strategies of SCM, factors are also different from the present, and post-Covid SCM requires specialised strategies and planning for sustaining SCM. The suggested business planning strategy for the effective development of SCM is a critical approach to perform. Analysing the during covid-19 challenges, the most affecting challenge is suppler issues due to global boundaries (Forehand, Roman, and Schaefer, 2021). Therefore, local suppliers are an easy source to contact during crucial times to continue to stock and deliver materials and products to customers. Thus, the concerning industry is a very significant sector to be ready to provide products and services to their customers. However, demand for health care equipment and medicine is the last high demand during pandemics and post-pandemic.

5.2 Strengths and weaknesses of the study

The presented study with the focus on the SCM concept, strategies, and outcomes development with effectiveness evaluation is bounded with significant strengths and weaknesses. Pharmaceutical industries have experienced major demands and pressure in the UK during the Covid surge in 2020-2021. This pandemic has been enlisted as one of the greatest health crises in this nation. The technological interventions and digitalised equipment have failed to promote continuity in SCM performance (Forehand, Roman and Schaefer, 2021). The significant crisis of a number of labour, supply of materials, and delays in delivery significantly occur issues.

. The collaboration is a strength for future prospects of SCM development. According to Sudan and Taggar (2021), understanding the Covid impact on SCM has been tested with System and Networking partnership theory's significant theory. The strength of this study has been underlined in factors identified in SCM disruptions. The long-term strategies and short-term strategies have high prospects of providing significant planning development for industries with SCM (Kim and Zhao, 2021). Thus, the diversification in the strategic management of the Supply chain with technology and digitalisation has required training for employees at an organisation. Therefore, 1% of employees related to the UK's pharmaceutical industries have been involved with SCM. The asserted strengths are recounted to be affecting long-term outcomes and outputs of supply chain continuity.

The pharmaceutical industry's supply chain looks after the production and distribution of medicines to patients in the UK. This type of management looks after the life cycle of drugs sold in the UK market. The GDP of pharmaceutical companies in the UK is estimated to be approximately 2.5%. During the pandemic era, there was a huge demand for medicines among people. As opined by Hasan et al. (2022), supply chain management looked into the3 production in large quantities. In this way, pharmaceutical companies can meet the rapid needs and demands of the common people. The technological interventions incorporated in the pharmaceutical companies helped it earn a maximum profit rate in the UK market. As a result of the huge demand from the people at the time of the Covid 19 pandemic, the supply chain of medicines at times felt it difficult to meet the demands of the common people. AS stated by Sawyerr (2022), the frequent lockdown in the regions of the UK led to a massive loss in the pharmaceutical industry. The supply chain faced a massive challenge while transporting medicines to the required centre.

The frequent purchase of important medicines led to a shortage of medicines in the market of UK. This affected at supply chain at large, as it was unable to meet the growing demands of the people. The absence of workers acts as a major factor that leads to the inefficiency in the management of the supply champion of medicines in the market in the UK. The change in the behaviour pattern of customers as a result of the fear of the covid 19 virus affected the supply chain of medicines at large.

The result section has suggested that the effectiveness of SCM has been reduced with the scarcity of labour and scarcity of raw material availability. Therefore, the vehicles' unavailability has also been affected by the delay in delivery. The study has extracted that nearshoring and suboptimal manufacturing with significant technologic intervention are reliable approaches to enhance performance with continuity (Khan, Alroomi and Nikolopoulos, 20222). The systematic review of this research interest area with SCM in the UK has demonstrated the dynamic functionality of logistics as well as resilience development SCM. Therefore, the vendors develop with local and multiple vendors selection for stock safety and inventory intermediation applications.

This study has provided implementation of full skilled employees with digital tool application development and motivating workers for better performance. The long-term strategies related to this study have been encountered with AI, ML, and Cloud-based intervention (Hassan and Abbasi, 2021). The end-to-end digital technologies are helpful in supporting the problem associated with supply chain continuity. Hence, the handling capabilities required to be exercised with staff. All contribution of this has been asserted, and the positive impact is being delivered to UK's pharmaceutical industries.

5.3 Limitations

Despite all these strengths contributed by this study, there are certain shortcomings that have been identified. Firstly, this presented study has been focused on UK's geopolitical environment only. Therefore, the global comparison has been performed, but the emphasis has been imposed on the core UK's pharmaceutical industries. The manufacturing, supplying, and outcomes of SCM are being highlighted in UK's prospects. However, future studies may extend by exposing others sectors and industries as well. Comparative studies can be much more effective for creating significant conclusive states about global scenarios (Cuong and Tien, 2022). The qualitative analysis is also another limitation of this study. The quantitative research design with analysis may have extracted significant quantitative data from this present situation (Modgil, Singh and Hannibal, 2021).

Chapter 6: Conclusion

6.1 Conclusion

It can be concluded that the coronavirus outbreak has a negative impact on the logistics, manufacturing and supply chain of pharmaceutical companies in the UK. Supply chain disruption has created the need to improve resilience in pharmaceutical supply chain management activities. It has been evaluated that in order to manage the challenges faced by medical institutions in a pandemic situation, medical supplies are shared to meet the treatment requirement as well a warehouse management process has been improvised (Spike et al. 2022). Moreover, it has been estimated that the flow of medical goods such as vaccines and equipment is disrupted in pandemic situations that require resilience in the manufacturing and distribution system. Economic downtown also hinders the manufacturing of medical equipment and medicines due to changes in trade tax (Belhadi et al., 2021). As stated by Naz et al. (2021), changing the pharmaceutical business environment forces various pharmaceutical firms to update their products constantly. The pandemic's negative consequence is diverse in pharmaceutical company performance. Therefore, immense changes are required to compensate for the financial loss of the pharmaceutical company (Saleheen and Habib, 2022). Henceforth, it has been identified that the coronavirus outbreak forces pharmaceutical companies to adopt various technologies such as artificial intelligence in the supply chain management process.

6.2 Linking with Objectives

Objective 1: The present supply chain management shows the use of advanced technology in the supply chain resilience process. As per the views of Naz et al. (2021), the AI system enables analytical capabilities by offering algorithmic solutions for improving pharmaceutical supply chain management processes. Additionally, in the UK, tracking the supply chain has been easier with the implementation of the AI system. Network visibility has been improved that reflects the tracking process and manufacturing details of medicines. The UK pharmaceutical companies that help in the production of high-quality drug development have adopted good inventory management practices. Therefore, a systematic review has been able to provide transparent insight into the current management and technologies used in a pharmaceutical company in the UK.

Objective 2: The systematic review has been able to depict the challenges that are faced by current pharmaceutical companies in the UK, such as supply chain problems, demand-side problems and logistic problems due to the traditional way of supply chain management and manufacturing process. As mentioned by Joshi and Sharma (2022), before the pandemic situation, managers of pharmaceutical companies concentrated on inventory management and decreased drug manufacturing. After the pandemic situation, managers are focusing on productivity increase and meeting the demand.

Objective 3: Systematic review has been able to find the challenges faced by different pharmaceutical companies in the UK. As stated by Schleper et al. (2021), pressure is created among managers of pharmaceutical companies in the UK due to uncertainty. Moreover, the risk management process becomes a challenge for pharmaceutical companies. Pharmaceutical fraud cases have increased (Ten et al., 2018). Findings also suggest that raw material import also becomes a challenge for the UK that requires proper policy improvement from a political point of view. Henceforth, the result of the literature review has been successfully able to identify the threats in the supply chain management system.

Objective 4: The findings show the proposed mitigation process is the utilisation of artificial intelligence in the supply chain management process. Findings of the systematic review suggest that sharing resources such as drugs and manufactured equipment can potentially help in mitigating scarcity. Additionally, the warehouse management process can potentially facilitate the supply chain management process. As suggested by Belhadi et al. (2021), the digitisation process of supply chain management has increased the efficiency of the pharmaceutical industry. However, it is a threat to employment.

6.3 Recommendation

● Implement AI and automation technologies

Pharmaceutical industries can implement AI and automation technologies for better SCM performance with high efficiency (Naz et al., 2021). According to Panwar, Pinkse, and De Marchi (2022), the Covid-19 pandemic has limited physical contact, and worker reduction in different industries has been the most effective issue. However, the UK's technological environment and position are very high, incorporating any technology in organisational management and performance development aspects.

● Incorporated sustainability action in Supply chain management practice

The post-Covid phase is a highly proactive phase for moving towards sustainable development. Thus, the further recommendation for pharmaceutical industries SCM required sustainability approaches in supply chain management in the UK. As stated by Ellram et al. (2022), the post-covid-19 phases required a much more technological and sustainable approach to reduce sudden risks associated with SCM.

Figure 12: Recommendations for Post-Covid SCM

6.4Limitations

The study has been limited with major data limitations. The comparison and descriptive analysis of existing studies and works seem to be lacking with wider issues. In a systematic review, the major issue is being recognised with existing work's time scale and limited information. Thus, the SCM present risk and future risk are not being addressed with wider issues emerging within international boundaries. This study has been lacking with data and information about the present issues in details analysis.

6.5 Future scope

The study is going to allow us to go beyond the boundaries of single issues in SCM in UK's pharmaceutical industries. The investigation of post-Covid SCM strategies is viable to structure new approaches and strategies for industries. Thus, future studies can be conducted on a comparative account of UK SCM and Global SCM prospects. The changes faced UK's Pharmaceutical companies due to provide-19 and other pharmaceutical companies from different countries. Different strategies used by different countries and their outcomes related to a particular business environment can be tested. The greater exposure to comparative studies is associated with this study.

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Appendices

Appendix 1:

Chosen articles

Article 1: Spieske, A., Gebhardt, M., Kopyto, M. and Birkel, H., 2022. Improving resilience of the healthcare supply chain in a pandemic: Evidence from Europe during the COVID-19 crisis. Journal of Purchasing and Supply Management, p.100748.

Article 2: Hasan, F., Islam, M.R. and Ishrat, F., 2022. COVID-19 Pandemic Impact on the Supply Chains of UK-Based Multinational Manufacturing Companies.

Article 3: Frederico, G.F., Kumar, V., Garza-Reyes, J.A., Kumar, A. and Agrawal, R., 2021. Impact of I4. 0 technologies and their interoperability on performance: future pathways for supply chain resilience post-COVID-19. The International Journal of Logistics Management.

Article 4: Wilk, V., Roni, S.M. and Jie, F., 2022. Supply chain insights from social media users' responses to panic buying during COVID-19: The herd mentality. Asia Pacific Journal of Marketing and Logistics.

Article 5: Sarkis, J., 2020. Supply chain sustainability: learning from the COVID-19 pandemic. International Journal of Operations & Production Management.

Article 6: Frederico, G.F., Kumar, V. and Garza-Reyes, J.A., 2021. Impact of the strategic sourcing process on the supply chain response to the COVID-19 effects. Business Process Management Journal.

Article 7: Belhadi, A., Kamble, S., Jabbour, C.J.C., Gunasekaran, A., Ndubisi, N.O. and Venkatesh, M., 2021. Manufacturing and service supply chain resilience to the COVID-19 outbreak: Lessons learned from the automobile and airline industries. Technological Forecasting and Social Change, 163, p.120447.

Chapter 1: Introduction

1.1 Background

1.2 Rationale

Figure 1: The ongoing influence of the Covid-19 pandemic on the pharmaceutical supply chains

1.3 Problem statement

1.4 Aim and Objectives

1.5 Research Question

1.6 PICO (Population, Intervention, Comparison, Outcome) framework

Table 1: PICO framework

Chapter 2: Literature Review

2.1 Introduction

2.2 Effectiveness of Supply Chain Management during the stage of Post Covid situation among the UK pharmaceutical industry

Figure 2: Sides of the effectiveness of Supply Chain Management

2.3 Supply Chain Management takes actions to reshape UK's pharmaceutical industry in post covid situation

2.4 Importance of Supply Chain Management in the Pharmaceutical Industry in the UK

Figure 3: Pharmaceutical logistics distribution

2.5 Post Covid-19 required supply chain management improvements in the UK

Figure 4: Changes in Industry Supply Chain

2.6 Challenges are faced by the UK pharmaceutical industry while implementing Supply Chain Management

Figure 5: Challenges faced by UK pharmaceutical industries

2.7 Mitigation Strategies to overcome challenges faced by the UK pharmaceutical industry in the post-COVID-19 era

Figure 6: Mitigation Strategies to overcome challenges faced by the UK pharmaceutical industry

2.8 Theoretical Framework

2.9 Conceptual Framework

Figure 10: Conceptual Framework

Gap analysis

2.10 Summary

Chapter 3: Methodology

3.1 Introduction

3.2 Search engine

3.3 Application of inclusion and Exclusion criteria

Table 2: Inclusion and exclusion criteria

3.4 Search strategy

Table 3: Keywords searched from the databases

Table 4: Search strategy and result obtained

3.5 Search characteristics

Table 5: Search characteristics

3.6 Selection and Screening of articles

Figure 10: PRISMA framework

3.7 Study quality assessment and checklists

Table 6: CASP Tool

3.8 Data extraction

Table7: Data extraction table

3.9 Reliability and validity

Table 8: Reliability and validity

3.10 Data characterisation table

3.11 Research gap

Chapter 4: Findings/Results

4.1 Characteristics of study table

Table9: Characteristics of study table

4.2 Findings from the articles

Table10: Findings from articles

4.3. Table on the statistical findings

Table 11: Findings from articles

Chapter 5: Discussion

5.1 Discussion

Figure 11: Graph on Meta-analysis of the searched articles

5.2 Strengths and weaknesses of the study

5.3 Limitations

Chapter 6: Conclusion

6.1 Conclusion

6.2 Linking with Objectives

6.3 Recommendation

Figure 12: Recommendations for Post-Covid SCM

6.4Limitations

6.5 Future scope

Reference

Appendices

Appendix 1:

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