药品供应链可靠性及其对药品短缺的影响
Pharmaceutical Supply Chain Reliability and Effects on Drug Shortages
摘要：
药品短缺经常发生，往往是供应链中断造成的。为了实现改进，必须能够估计药品供应链的脆弱性。在这项工作中，我们提出了第一个模型的医药供应链的可靠性。我们考虑了公司可能用于提高可靠性的三种关键方法：配置，中断风险和恢复速度。关键指标包括预期药物短缺、平均短缺时间和平均恢复时间。我们参数化的模型使用的数据从主要的药物短缺数据库和一个通用的注射肿瘤药物的情况下的例子。在精益供应链配置下，我们观察到在现状条件下的预期短缺为10%。通过将恢复速度提高一倍或将中断率减半，预计短缺率可能降至5%。最有影响力的单一变化将是在精益配置中增加一个备用供应商，这将导致4%的预期短缺。我们还考虑了盈利能力，并提出了不同配置的盈亏平衡价格。我们的分析结果可能会产生直接的政策影响，为冗余和提高设施质量的好处提供证据。
英文摘要：
Drug shortages occur frequently and are often caused by supply chain disruptions. For improvements to occur, it is necessary to be able to estimate the vulnerability of pharmaceutical supply chains. In this work, we present the first model of pharmaceutical supply chain reliability. We consider three key approaches that companies may use to improve reliability: configuration, risk of disruptions, and speed of recovery. Key metrics include expected drug shortages, average time-to-shortage, and average time-to-recovery. We parametrize the model using data from major drug shortage databases and a case example of a generic injectable oncology drug. With a lean supply chain configuration, we observe that expected shortages at status quo conditions are 10%. By either doubling the speed of recovery or halving the disruption rate, expected shortages could drop to 5%. The most influential single change would be to add a back-up supplier to a lean configuration, leading to expected shortages of 4%. We also consider profitability and present the breakeven prices for different configurations. The results from our analyses could lead to immediate policy impact, providing evidence of the benefits of redundancy and improving facility quality.
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