Business Research Proposal: Comparative Analysis of Healthcare System Resilience to Medicine Shortages

Part 1: Information Collection

Recommended Frameworks for Analysis

1. Comparative Policy Analysis Framework: This is a method used to understand and explain differences in policy choices and outcomes across different political or administrative systems (in this case, healthcare systems). It involves systematically comparing the context, policy goals, tools, and results.
2. The "4 A's" of Healthcare Access (Affordability, Availability, Accessibility, Acceptability): This patient-centric framework ensures our analysis of "health equity" is comprehensive. It forces us to evaluate not just whether a medicine exists in the country, but whether people can actually get it.
3. Adapted SCOR Model (Supply Chain Operations Reference): The full SCOR model is extensive, but we will adapt its core logic—Plan, Source, Make, Deliver—to systematically dissect and compare the pharmaceutical supply chain in each system.

A. Web Search Plan

• Search Topics:
  • Regulatory Frameworks and Price Controls: "pharmaceutical supply chain regulations FDA EMA," "impact of drug price controls on medicine availability," "comparative analysis of national medical stockpile strategies."
    • Purpose: To gather data on the rules governing the pharmaceutical market in different systems. This information is a core component of the Comparative Policy Analysis framework.
  • Supply Chain & Manufacturing: "active pharmaceutical ingredient (API) sourcing concentration China India," "domestic pharmaceutical manufacturing capacity by country," "pharmaceutical supply chain resilience lessons from COVID-19."
    • Purpose: To collect the specific data needed to analyze the "Source" and "Make" components of our Adapted SCOR Model, identifying geographic concentrations and dependencies.
  • Health Equity & Patient Impact: "health equity implications of medicine shortages," "impact of drug shortages on vulnerable populations," "ethical frameworks for scarce medical resource allocation."
    • Purpose: To find studies and reports that will directly inform the 4 A's Framework analysis, focusing on how shortages disproportionately affect certain populations.

B. Expert Interview Plan

• Interview Subjects:
  1. Government/Regulatory Officials: Individuals from national health ministries or regulatory bodies (e.g., FDA, EMA) in countries representative of each system type.
  2. Pharmaceutical Supply Chain Executives: Vice Presidents of Supply Chain or Operations at both major brand-name and generic drug manufacturers.
  3. Hospital Pharmacy Directors: Heads of pharmacy at large hospitals in each system type, as they are on the front lines of managing shortages.
  4. Leaders of Patient Advocacy Groups: Representatives for patients with chronic conditions (e.g., cancer, diabetes, rare diseases) who are highly vulnerable to shortages.
• Core Interview Questions & Purpose:
  • For Government/Regulatory Officials:
    • Question: "Walk me through the established protocol when your agency is first notified of a potential critical medicine shortage. What are the key decision points and who is involved?"
    • Analytical Purpose: To understand the "governance" and "process" elements within the Comparative Policy Analysis framework.
  • For Supply Chain Executives:
    • Question: "What are the primary trade-offs you evaluate when deciding between a lower-cost, single-source API supplier versus a higher-cost, multi-source, geographically diverse strategy?"
    • Analytical Purpose: To uncover the business logic and economic pressures that create vulnerabilities in the "Source" stage of the SCOR model.
  • For Hospital Pharmacy Directors:
    • Question: "When a shortage forces you to ration a life-saving drug, what framework or criteria does your ethics committee use to make allocation decisions? Can you describe the impact this has on your staff and patients?"
    • Analytical Purpose: To gather critical evidence of how Availability and Accessibility are compromised at the point of care, directly feeding the 4 A's analysis of health equity.
  • For Patient Advocacy Leaders:
    • Question: "Beyond the inability to get a medication, what are the secondary impacts of a shortage on your members? (e.g., financial toxicity from alternatives, travel time to other pharmacies, psychological distress)."
    • Analytical Purpose: To understand the full scope of patient harm, particularly for the Affordability and Acceptability dimensions of the 4 A's framework.

Part 2: Information Analysis

Final Research Outputs:

1. A Comparative Resilience Scorecard: A clear visual comparing the three system types (public, mixed, private) against key resilience metrics (e.g., supply diversity, domestic manufacturing percent, stockpile levels).
2. A Vulnerability Heatmap: A matrix identifying the most acute vulnerabilities for each system type within the supply chain (e.g., private systems highly vulnerable to price shocks; public systems highly vulnerable to single-source API disruption).
3. A Health Equity Impact Report: A specific analysis detailing how shortages in each system affect vulnerable populations, structured around the "4 A's."
4. A "Best Practices" Playbook: A synthesized list of the most effective and resilient policies and strategies observed across all systems, forming a model for improvement.
5. Actionable Policy Recommendations: A set of concrete, targeted recommendations for leaders in each system type to improve resilience and health equity.

Step-by-Step Analysis Plan:

1. Profile Each System Type:
   • Using the web search data, create a baseline profile for each of the three healthcare system types. Document their key characteristics regarding regulatory environment, domestic manufacturing policies, stockpiling strategies, and price control mechanisms. This will serve as the foundation for the Comparative Policy Analysis.
2. Map the Supply Chain and Pinpoint Vulnerabilities (SCOR Analysis):
   • For each system type, use the data from web searches and executive interviews to map out the supply chain from "Source" to "Deliver."
   • Analysis: Ask, "Where are the points of highest concentration and lowest redundancy?" For example, analyze the API sourcing data to quantify reliance on specific countries. Use interview insights to understand why these dependencies exist. This process will populate your Vulnerability Heatmap.
3. Assess the Health Equity Impact (4 A's Analysis):
   • Synthesize the qualitative data from hospital administrators and patient advocates with quantitative data on drug pricing and geographic access.
   • Analysis: For each system type, analyze the shortage impact through the lens of the 4 A's:
     • Availability: Which system better maintains a supply of alternatives?
     • Affordability: How do prices for shortage drugs or their alternatives fluctuate in each system?
     • Accessibility: Do shortages disproportionately impact rural vs. urban patients, or patients at specialized vs. general hospitals?
     • Acceptability: How do alternative therapies or rationing protocols impact patient trust and well-being?
   • The findings from this analysis will form the core of your Health Equity Impact Report.
4. Conduct the Comparative Analysis & Synthesize Findings:
   • With the profiles, vulnerability maps, and equity reports complete, you can now execute the final comparison. Use a matrix to score each system type on key resilience and equity indicators.
   • Analysis: Look for patterns and trade-offs. For example, does a system with strong price controls ensure Affordability but suffer from lower Availability due to reduced manufacturer incentive? Does a system with high domestic manufacturing have better resilience but at a higher cost?
   • Identify standout strategies from any system—such as innovative stockpiling partnerships or flexible regulatory responses. These will form your "Best Practices" Playbook.
5. Formulate Actionable Recommendations:
   • Based on the comparative findings, translate the insights into specific advice. Your recommendations should be targeted to the vulnerabilities of each system type. This is the final step to creating your list of Actionable Policy Recommendations.