Background: Effective supply chain management is a challenge in every sector, but in healthcare there is added complexity and risk as a compromised supply chain in healthcare can directly impact patient safety and health outcomes. One potential solution for improving security, integrity, data provenance, and functionality of the health supply chain is blockchain technology. Objectives: Provide an overview of the opportunities and challenges associated with blockchain adoption and deployment for the health supply chain, with a focus on the pharmaceutical supply, medical device and supplies, Internet of Healthy Things (IoHT), and public health sectors. Methods: A narrative review was conducted of the academic literature, grey literature, and industry publications, in addition to identifying and characterizing select stakeholders engaged in exploring blockchain solutions for the health supply chain. Results: Critical challenges in protecting the integrity of the health supply chain appear well suited for adoption of blockchain technology. Use cases are emerging, including using blockchain to combat counterfeit medicines, securing medical devices, optimizing functionality of IoHT, and improving the public health supply chain. Despite these clear opportunities, most blockchain initiatives remain in proof-of-concept or pilot phase. Conclusion: Blockchain technology has the unrealized promise to help improve the health supply chain, but further study, evaluation and alignment with policy mechanisms is needed. Keywords: Blockchain, Distributed Ledger, Pharmacy, Pharmaceutical, Supply chain
House W. National Strategy for Global Supply Chain Security. 2012;
2.
Burmester M, Munilla J, Ortiz A, Caballero-Gil P. An RFID-Based Smart Structure for the Supply Chain: Resilient Scanning Proofs and Ownership Transfer with Positive Secrecy Capacity Channels. Sensors. 2017;17(7):1562.
3.
Mackey TK, Nayyar G. A review of existing and emerging digital technologies to combat the global trade in fake medicines. Expert Opinion on Drug Safety. 2017;16(5):587–602.
4.
2016;
5.
Mackey TK, Liang BA, York P, Kubic T. Counterfeit Drug Penetration into Global Legitimate Medicine Supply Chains: A Global Assessment. The American Journal of Tropical Medicine and Hygiene. 2015;92(6_Suppl):59–67.
6.
Pullirsch D, Bellemare J, Hackl A, Trottier YL, Mayrhofer A, Schindl H, et al. Microbiological contamination in counterfeit and unapproved drugs. BMC Pharmacology and Toxicology. 2014;15(1).
7.
Stevens WG, Spring MA, Macias LH. Counterfeit Medical Devices: The Money You Save Up Front Will Cost You Big in the End. Aesthetic Surgery Journal. 2014;34(5):786–8.
8.
Growing threat from counterfeit medications. Bulletin of the World Health Organization. (4):241–320.
9.
Firmware Update to Address Cybersecurity Vulnerabilities Identified in Abbott’s (formerly St. Jude Medical’s) Implantable Cardiac Pacemakers: FDA Safety Communication.
10.
Kvedar J. The Internet of Healthy Things. Boston: Partners HealthCare Connected Health. 2015;
11.
Gordon W, Wright A, Landman A. Blockchain in Health Care: Decoding the Hype. NEJM Catalyst.
12.
Kuo TT, Kim HE, Ohno-Machado L. Blockchain distributed ledger technologies for biomedical and health care applications. Journal of the American Medical Informatics Association. 2017;24(6):1211–20.
13.
WHO’s role in the prevention and control of medical products of compromised quality, safety and efficacy such as substandard/spurious/falselylabelled/falsified/counterfeit medical products. 23AD;
14.
World Health Organization. 1 in 10 medical products in developing countries is substandard or falsified. WHO urges governments to take action.
15.
Brechtelsbauer ED, Pennell B, Durham M, Hertig JB, Weber RJ. Review of the 2015 Drug Supply Chain Security Act. Hospital Pharmacy. 2016;51(6):493–500.
16.
Angelino A, Khanh D, Ha A, Pham N, T. Int J Environ Res Public Health. 2017;(9):28364941.
17.
Mackey TK, Cuomo R, Guerra C, Liang BA. After counterfeit Avastin®—what have we learned and what can be done? Nature Reviews Clinical Oncology. 2015;12(5):302–8.
18.
Title II of the Drug Quality and Security Act. US Department of Health and Human Services. 2014;
Directive 2011/62/EU of the European Parliament and of the Council of 8 June 2011 amending Directive 2001/83/EC on the Community code relating to medicinal products for human use, as regards the prevention of the entry into the legal supply chain of falsified medicinal products. 2011;
21.
Council E.
22.
9AD;
23.
Ahmed S, Broek N ten. Blockchain could boost food security. Nature. 2017;550(7674):43–43.
24.
Symbiq Infusion System by Hospira: FDA Safety Communication -Cybersecurity Vulnerabilities.
25.
Krishnamurthy R. The Voyage of Discovery: Blockchain for Pharmaceuticals and Medical Devices. Beyond Standards: IEEE Standards Association.
26.
Napier University-Spiritus Pilot Project Seeks to Demonstrate Assurance Layer for Tracking Medical Devices. 2017;
27.
Ishii L, Demski R, Lee K, K. Improving healthcare value through clinical community and supply chain collaboration.
28.
Ishii L, Demski R, Ken Lee KH, Mustafa Z, Frank S, Wolisnky JP, et al. Improving healthcare value through clinical community and supply chain collaboration. Healthcare. 2017;5(1–2):1–5.
29.
Peterson, MBA, CSCP, SCOR-P MR, Young, PhD, FCILT RR, Gordon, MSCE, MBA, PE GA. The application of supply chain management principles to emergency management logistics: An empirical study. Journal of Emergency Management. 2016;14(4):245–58.
30.
Patel A, ’alessandro D, Ireland M, K. Personal protective equipment supply chain: Lessons learned from recent public health emergency responses. 2017;(3):244–52.
31.
Bam L, McLaren ZM, Coetzee E, von Leipzig KH. Reducing stock-outs of essential tuberculosis medicines: a system dynamics modelling approach to supply chain management. Health Policy and Planning. 2017;32(8):1127–34.
32.
Gilbert SS, Thakare N, Ramanujapuram A, Akkihal A. Assessing stability and performance of a digitally enabled supply chain: Retrospective of a pilot in Uttar Pradesh, India. Vaccine. 2017;35(17):2203–8.
33.
Molemodile S, Wotogbe M, Abimbola S. Evaluation of a pilot intervention to redesign the decentralised vaccine supply chain system in Nigeria. Global Public Health. 2017;12(5):601–16.
34.
Zehrung D, Jarrahian C, Giersing B, Kristensen D. Exploring new packaging and delivery options for the immunization supply chain. Vaccine. 2017;35(17):2265–71.
35.
Till BM, Peters AW, Afshar S, Meara JG. From blockchain technology to global health equity: can cryptocurrencies finance universal health coverage? BMJ Global Health. 2017;2(4):e000570.
36.
Ibm. Supply Chain. 2017;
Citation
Copyright
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
