- Healthcare
Access to cancer medicines remains a significant challenge in many Low- and Middle-Income Countries (LMICs), limiting patients' ability to receive timely and affordable treatment. This study aims to analyze the impact of the pharmaceutical downstream supply chain on patient access to oncology medicines in LMICs. Utilizing a system dynamics approach, we developed a comprehensive causal loop diagram, CLD, to map the complex interactions between key variables and stakeholders in the downstream value chain. Qualitative data from interviews with PharmaCo experts and insights from a World Health Organization technical report were used to construct and validate the CLD. The analysis highlighted several key feedback loops influencing affordability and availability of cancer medicines, including market scale, competition, insurance support, and inventory management. Reinforcing and balancing effects among these loops were identified, highlighting the trade-offs and challenges in ensuring patient access. The study also examined the roles and interests of various stakeholders, such as manufacturers, distributors, healthcare providers, insurers, and governments. This research emphasizes the importance of a holistic, system-level understanding of the downstream supply chain dynamics to develop effective strategies for increasing patient access to life-saving cancer treatments in LMICs.