Abstract
BACKGROUND: The pharmaceutical supply chain (PSC) faced numerous challenges, particularly during the COVID-19 crisis. Due to the supply chain (SC) 's vulnerabilities, it requires enhanced capabilities to address these challenges. In Iran, specific economic and political issues have intensified the vulnerabilities of the PSC. OBJECTIVES: This study investigates the issues caused by the COVID-19 crisis in the PSC, identifies and characterizes these issues, and recommends appropriate courses of action to address future SC disruptions. METHODS: This study is a qualitative-quantitative analysis conducted in Iran during the COVID-19 crisis. Qualitative thematic analysis was performed from July 2022 until May 2023. Semi-structured, in-depth, face-to-face interviews with 23 Iranian PSC specialists were conducted until saturation was reached. The qualitative phase was analyzed using MAXQDA 2021. The quantitative phase included a survey of 547 individuals working in pharmaceutical manufacturing in Iran, with the questionnaires analyzed using SPSS 26. RESULTS: In the qualitative phase, the research identified two main themes: (1) vulnerabilities and (2) capabilities, along with 15 subthemes providing solutions to enhance the resilience of the PSC. In the quantitative phase, findings from 64 questionnaires highlighted major vulnerabilities and capabilities necessary to create a resilient SC. The median score for vulnerabilities was 5.12, while the median score for capabilities was 5.39. CONCLUSIONS: According to the questionnaire results, the quantitative findings indicate that capabilities received a higher score, suggesting that this sector of the PSC demonstrated better resilience against the pandemic. This study, with its contextual focus, mixed-method approach, comprehensive analysis of vulnerabilities and capabilities, and sector-specific insights, offers a novel contribution to the understanding of SC resilience within Iranian pharmaceutical manufacturing. It also has the potential to promote further research in other sectors of the PSC.