Drug shortages: A systems view of the current state

Kim E. van Oorschot*, Luk N. Van Wassenhove, Marianne Jahre, Kostas Selviaridis, Harwin de Vries

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)


The objective of this thought leadership article is to create a systems view of drug shortages based on the perceptions of practitioners and policymakers. We develop a comprehensive framework describing what stakeholders are currently doing when faced with drug shortages and show the outcomes of their actions. In a review of practitioner literature and public reports published from 2010 to 2020, we identify cause-and-effect relationships related to generic drug shortages in six high-income European countries (Belgium, France, the Netherlands, Norway, Sweden, and the UK) in normal times. By combining and connecting data from these different sources, we develop a systems view of the current state. Though several of the associations covered in the systems view are well known, putting them all together and considering their interrelationships is what is offered by this research. Based on this systems view, we derive three basic solution archetypes for drug shortages: (1) let the market handle it; (2) search for alternatives; and (3) bend the rules. The interactions between these archetypes generate causal ambiguity making it harder to understand and solve the problem as the side effects of solutions can be missed. We show how the interaction of archetypes can compromise intended behavior or escalate unintended behavior. However, our systems view allows us to suggest higher-level solution archetypes that overrule such side effects. The basic and higher-order solution archetypes can provide baselines for research and support the development of future interventions.

Original languageEnglish
Pages (from-to)969-984
Number of pages16
JournalDecision Sciences
Issue number6
Publication statusPublished - Dec 2022

Bibliographical note

Funding Information:
This research project is part of MIA (Measures for Improved Availability of medicines and vaccines). MIA is funded by the Research Council of Norway's HELSEVEL program for a period of 4 years from March 1, 2020, and is a collaboration with, among others, the Norwegian Institute of Public Health, Lancaster University, Erasmus University (Rotterdam School of Management), the INSEAD Humanitarian Research Group, and BI Norwegian Business School.

Publisher Copyright:
© 2022 The Authors. Decision Sciences published by Wiley Periodicals LLC on behalf of Decision Sciences Institute.


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