Back to search

HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester

MIA - Measures for Improved Availability of medicines and vaccines

Alternative title: MIA - Hvordan sikre god nok tilgjengelighet for vaksiner og medisiner?

Awarded: NOK 12.0 mill.

Project Manager:

Project Number:


Application Type:

Project Period:

2020 - 2024


Subject Fields:

Pharmaceutical supply chains are complex and global. Opaque and vulnerable networks connect a large number of manufacturers, buyers and end users (patients). When these supply chains break down, it can lead to serious injury and death. The networks are opaque because they are large and because the problems and priorities of the pharmaceutical industry are not necessarily the same as national governments'. MIA (Measures for Improved Availability of medicines and vaccines) addresses the fact that previous research has tended to look at pharmaceutical supply chains from the manufacturers' perspective. Together with partners from the Norwegian Institute of Public Health, INSEAD, Lancaster University and Erasmus, BI take a system-wide approach to understanding the medicine and vaccine distribution. Aiming to design supply chains that function both under normal conditions and in crises, MIA will include patients' and governments' perspectives, a better understanding of competition and the impact of digitalization. By building a comprehensive model of the networks, different methods of supply chain preparedness will be compared to see what works best under different circumstances. Shortages lead to costs for patients, health systems and society at large. To prevent this supply chains must be able to withstand both smaller and bigger disruptions. COVID-19 is one such big disruption. Hence, we are including what we learn from the response to and effect of COVID-19 on causes to and interventions for solving shortage problems. National governments must also be able to make decisions in the context of difficult trade-offs between availability, quality, delivery time and cost. MIA will contribute by providing decision makers and others with better knowledge about how these supply chains work. The focus countries are Norway and the UK, but we are also doing comparative studies of an additional 4 European countries: Belgium, France, Netherlands, and Sweden to get a broader European perspective. In a later phase, they will share knowledge with other countries facing similar challenges, including developing countries. The first peer-reviewed paper was published this summer as an Impact Pathways paper suggesting a research agenda for use of operations and supply chain management (OSCM) in the study of drug shortages. This was based on documents from governments, wholesalers, and other stakeholders in 6 European countries and a review of scientific OSCM research. Ongoing sub-projects include availability of paracetamol in Norway and modelling of interventions to reduce shortage, antibiotics (focus on transparency to reduce shortage), impact on price policies and tendering on drug shortages, strategies for buffer-stocks, price spikes on pharmaceuticals related to shortages and/or market power, collaboration by sharing test-kits to flatten the pandemic curve, and equity in vaccine distribution. All sub-projects are set up in collaboration between two or more partners and make use of mixed research methods, and aim to provide decision support for key stakeholders and pedagogical tools in addition to peer-reviewed papers. As of now outputs include numerous seminars, workshops, presentations and reports, popularised publications, master theses and pedagogical material.

Due to increasing shortages, ensuring availability of medicines and vaccines is a key societal challenge. Complex and vulnerable global supply chains, manufacturing problems, product recalls, short product shelve life, new digital technology, a few suppliers dominating markets, funding limitations, and high demand volatility are among the causes of this worldwide problem. In response, countries are developing strategies to safeguard against smaller (e.g. price increase) and larger disruptions of supply (e.g. health system breakdowns) and/or demand (e.g. pandemics). Extant literature on medicine and vaccine supply chains has failed to conceptualise and model them as systems that must adapt from stable situations to crises and back to stability again. Existing models tend to exclude patients, treating demand as exogenous, and not accounting for market behaviour. There is limited understanding of private-public-partnerships, procurement and contracting, and regulation for improving supply security. The purpose is to help key stakeholders make evidence-based decisions that sustainably reduce shortages ensuring future health and care services.. We will provide rigorous analyses of costs and benefits of measures, and a basis for comparative studies in other countries by developing baseline data, research design, analytical and pedagogical models and tools. Findings will inform ongoing strategy work and collaboration initiatives within Norway, the UK and Europe more broadly. We will draw policy implications and put forth recommendations for supply chain design, procurement strategies and alignment of economic incentives. We will develop training resources and tool kits and embed these into higher education curricula in pharmaceutical education, risk management and operations/supply chain management, thus increasing cooperation in educational programmes across sectors, stakeholders, and disciplines including health, social science and economics.


HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester

Thematic Areas and Topics

UtviklingsarbeidBransjer og næringerTransport og samferdselFNs BærekraftsmålLTP2 Samfunnssikkerhet og samhørighetInternasjonaliseringOrganisasjon og ledelseResponsible Research & InnovationRRI MedvirkningPolitikk- og forvaltningsområderOffentlig administrasjon og forvaltningLTP2 Helse, forebygging og behandlingLTP2 Samfunnsikkerhet, sårbarhet og konfliktPortefølje HelseFornyelse og innovasjon i offentlig sektorPolitikk- og forvaltningsområderLTP2 Et kunnskapsintensivt næringsliv i hele landetPortefølje Demokrati, styring og fornyelsePortefølje Humaniora og samfunnsvitenskapResponsible Research & InnovationTjenesterettet FoULTP2 IKT og digital transformasjonLTP2 Muliggjørende og industrielle teknologierBransjer og næringerLTP2 Styrket konkurransekraft og innovasjonsevneLTP2 Fornyelse i offentlig sektorAnvendt forskningFNs BærekraftsmålMål 3 God helsePortefølje Muliggjørende teknologierPolitikk- og forvaltningsområderForsvar og sikkerhetSamfunnssikkerhetPortefølje Industri og tjenestenæringerDigitalisering og bruk av IKTOffentlig sektorPolitikk- og forvaltningsområderHelse og omsorgPolitikk- og forvaltningsområderVelferdPortefølje Energi, transport og lavutslippInternasjonaliseringInternasjonalt prosjektsamarbeidPolitikk- og forvaltningsområderSamferdsel og kommunikasjonFornyelse og innovasjon i offentlig sektorForskning for fornyelse av offentlig sektorPortefølje LivsvitenskapHelseDigitalisering og bruk av IKTBransjer og næringerVarehandelLTP2 Innovasjon i stat og kommune