Research Project

Measures for Improved Availability of medicines and vaccines (MIA)

Ensuring availability of essential medicines, vaccines and health commodities is one of today’s critical societal challenges

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  • MSc Theses


  • Seminar on medicine shortage in Europe and the US - causes and solutions

    On April 27th, stakeholders from the UK, Netherlands, and Norway along with researchers from France, UK, Netherlands, Norway, and Sweden gathered for a seminar on medicine shortage in Europe and the US to address their causes and solutions.

  • Jahre, M., Van Oorschot, K., Årdal, C. (2022) Developed two modules for MSC Master in Pharmacy with OsloMET on Pharmaceutical SCM to be piloted spring 2023.

  • Van Oorschot, K., Årdal, C. (2022) Developed two modules for MSc Major in Supply Chain and Operations Management on Pharmaceutical SCM to be piloted spring 2022.

  • de Vries, H. (2022) Session on Access to Medicine in RCN MSc course Health & Humanitarian Logistics 2022.

  • Stakeholder meetings RSM: February 2022: Meeting on strategic stocks with policy makers from the Dutch MoH

  • Oorschot, K.E. van, Van Wassenhove, L., Jahre, M.

    Riding the Waves of the pandemic in supply chain management

    Production and Operations Management Society [POMS] conference) April.

  • Viana, J., Jahre, M., Årdal, C. and van Oorschot, K

    Generic medicine shortage interventions – comparative cost effectiveness analysis

    NOFOMA Iceland, June.

  • de Vries, H., Dube, N., Selviaridis, K. and Aardal, C.

    Promoting resilience in medicine supply chains: An exploration of the role of contracting

    EUROMA Conference 2022

  • de Vries, H. Jahre, M., Selviaridis, K., van Oorschot, K. and Van Wassenhove, L.N.

    A Systems View of Medicines and Vaccines Supply Chain Management

    Suggestion for a Special Issue in Journal of Operations Management.

  • de Vries, H. and Lemmens, S.

    Policies for National Medicine Stockpiles

    POMS Conference, 2022.

  • Oorschot, K.E. van, Van Wassenhove, L., Jahre, M.

    Collaboration-competition dilemma in flattening the COVID-19 curve

    Production and Operations Management.

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    Testing for COVID-19 is a key intervention that supports tracking and isolation to prevent further infections. However, diagnostic tests are a scarce and finite resource, so abundance in one country can quickly lead to shortages in others, creating a competitive landscape. Countries experience peaks in infections at different times, meaning that the need for diagnostic tests also peaks at different moments. This phase lag implies opportunities for a more collaborative approach, although countries might also worry about the risks of future shortages if they help others by reallocating their excess inventory of diagnostic tests. This article features a simulation model that connects three subsystems: COVID-19 transmission, the diagnostic test supply chain, and public policy interventions aimed at flattening the infection curve.

  • Brekke, K.R., Dalen, D.M. and Straume, O.R.

    Paying for pharmaceuticals: uniform pricing versus two-part tariffs

    Journal of Health Economics, 83, 102613

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    Two-part pricing (the Netflix model) has recently been proposed instead of uniform pricing for pharmaceuticals. Under two-part pricing the health plan pays a fixed fee for access to a drug at unit prices equal to marginal costs. Despite two-part pricing being socially efficient, we show that the health plan is worse off when the drug producer is a monopolist, as all surplus is extracted. This result is reversed with competition, as two-part pricing yields higher patient utility and lower drug costs for the health plan. However, if we allow for exclusive contracts, uniform pricing is preferred by the health plan. The choice of payment scheme is also shown to influence on the incentives to spend resources on drastic innovations relative to incremental, me-too innovations.

  • Friday, 11 February 2022 - Dagens Medisin Dalen, D.M. (2022) Anbud – så lenge det varer

  • Wednesday, 12 January 2022 - Forsvarets Forum Fjeldavli, S. (2021) Beredskap vs. Just-in-time, citing Jahre


  • MIA physical meeting

    From the 10th-11th of November a long-awaited physical meeting took place at BI Norwegian Business School to discuss our progress and the strategy moving forward in the project.

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    We exchanged thoughts, had discussions, and workshops to gather input for each sub-project. We had great dinners and interacted socially, which further strengthened our connection. The two days generated exiting thoughts for collaborative efforts on both academic and pedagogical outputs.

    MIA kake

  • MIA workshop

    On October 13th 2021, eight MSc students who wrote a MSc thesis about medicine shortages gave a short summary of their findings in a “MIA thesis research seminar”. The students were supervised by researchers affiliated to the MIA project, and came from BI Oslo, Lancaster University (LU), and Rotterdam School of Management (RSM). The audience included academics, students, and representatives from various stakeholders such as Ministries of Health and the pharma industry.

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    The presentations covered a wide range of topics. Andreas Moe and Harald Wright (BI Oslo) discussed availability of antibiotics in Norway and provided recommendations for improving supply security. The second presentation, by Max Olivier (RSM), showed that shortages in European countries have limited overlap (i.e., it is not too common that a given medicine is in shortage in many countries at the same time), which provides a strong argument for pooling strategic stocks across countries. Hanne Bastholm and Shan Trau (BI Oslo) subsequently discussed PPE preparedness in Norwegian public hospitals and how to improve this. Kieran Arron (LU) discussed the findings from his qualitative research on secondary care tendering in the NHS, e.g., on the criteria being considered in the tendering process. Next, Mustafe Jama and Stian Taalesen (BI Oslo) presented a system dynamics model to explain how data science can advance knowledge about drug shortages, and illustrated that with results from a cluster analysis. Finally, Lineke Bruijnooge (RSM) summarized the results from her interviews on how tendering impacts the availability of generic medicines in the Netherlands. They do so among others by affecting the number of manufacturers active in a market, demand uncertainty, and inventories.

  • Jahre, M. (2021) Short of Drugs? Call Upon Operations and Supply Chain Management, Keynote Speech, NOFOMA, September 30.

  • MIA Master´s theses

    MIA Master´s theses at BI Norwegian Business School

  • Viana, J., Jahre, M., Årdal, C. and van Oorschot, K.

    Medicine supply chain resilience: A hybrid simulation cost effectiveness analysis study of disruption intervention strategies, (European Conference on Operational Research [EURO])

    July 12, 2021

  • Viana, J. Jahre, M., Årdal, C., and van Oorschot, K.

    Defining measures, identifying, and obtaining data to conduct (cost) effectiveness analysis of medicine supply chains, (Operational Research Applied to Health Services [ORAHS] conference)

    July, 7, 2021

  • Viana, J.

    Reflections on healthcare applications of hybrid simulation modelling in the UK and Norway (Invited seminar Simon Fraser University, Complex Systems Modelling Group)

    November. 26, 2021

  • Jahre, M., van Oorschot, K., Soldal, O.B., Viana, J. and Årdal, C.

    Summary Explorative Interviews Norwegian Stakeholders

    Unpublished Report, January 18 2021

  • de Vries, H. Jahre, M., Selviaridis, K., van Oorschot, K. and Van Wassenhove, L.N.

    A review of scientific and grey literature on medicine shortages and the need for a research agenda in Operations and Supply Chain Management

    No. 1 – 2021, Series of Research Reports, BI Norwegian Business School

  • Breugen, T., Van Wassenhove, L. and Jahre, M.

    MIA Report Work Package 2, Unpublished Report, MIA

    August 2021

  • Monday, 28 June 2021 - MIA was among the highlights in BIs report on Sustainability for 2020

    The report received the 2020 Award: Principles for Responsible Management Education (PRME) has awarded BI this year’s Excellence in Reporting Award for its latest report on the school’s sustainability efforts.

  • MIA pre-covid study and cross-country paracetamol project presented at seminar for Region Stockholm, Sweden, in connection with the CRITFLOW-project

    Presenters were Victoria Ahlqvist and Marianne Jahre. 100 participants from crisis preparedness and strategic public procurement functions.

  • De Vries, H., Jahre, M., Selviaridis, K., van Oorschot, K. and Van Wassenhove, L.

    Paper accepted for publication:

    Short of Drugs? Call Upon Operations and Supply Chain Management (2021), forthcoming in International Journal of Operations and Production Management, DOI (10.1108/IJOPM-03-2021-0175).

  • Medicines supply and shortages: A UK perspective. Kostas Selviaridis & Nonhlanhla Dube

    This research seminar focused on the UK medicine supply system and provided an overview of issues and practices with respect to the management of supply and observed shortages. In the first part of our presentation we summarised the key issues emerging from our ongoing, exploratory research in the UK, both in ‘business-as-usual’ situations and in crisis events such as COVID-19 and Brexit.

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    We highlighted a number of common themes across relevant UK stakeholders, including supply chain actors and other governmental and NHS England-affiliated organisations. We subsequently discussed a number of focused research projects to potentially undertake moving forward, all of which are informed by our engagement with UK stakeholders and our empirical research thus far. We concluded the seminar with a few thoughts on research methodology and design, notably the potential use of intervention-based research strategies to investigate specific aspects of the medicine shortages problem. Participants in the seminar contributed their comments, questions and reflections throughout, making it a highly interactive and fruitful event.

  • Master thesis Lund University on the COVID-19 vaccine supply chain in India

    The COVID-19 pandemic has subjected many countries to economic and political turmoil which has mandated the world countries to eradicate the disease immediately. This needs an effective immunization supply chain which helps in timely delivery and administration of vaccines to a country’s population.

  • MIA Master's theses at BI Norwegian Business School

    This spring, two master's theses have been written in connection with the MIA project at BI Norwegian Business School. Andreas Farstad Moe and Harald Wright have investigated how the Norwegian healthcare sector can improve its availability of antibiotics, while Hanne Bastholm and Shan Trau have examined how Norway can build a more resilient personal protective equipment (PPE) supply chain. 

  • Viana, J., Jahre, M, and Årdal, C.

    Risk, Resilience and Sustainability in Paracetamol Supply Chain Networks: A Norwegian Case Study

    Production and Operations Management Society [POMS] conference. May 3. Revise and submit to journal.

  • Ahlqvist, V., Dube, N., Jahre, M., Melaku, T., Moe, A., Olivier, M., Selviaridis, K., Viana, J. and Årdal, C. (2021), Proactive and Reactive Interventions to Mitigate Medicine Shortages in (Ab)Normal Times, NOFOMA Conference Proceedings, Iceland, 2021.

  • Jahre, M. (2021) How to lead (research) projects during the pandemic – experiences from MIA and COVID-19 research projects, To BI management.

  • Sunday, 02 May 2021 - Legeforeningen Hvis egenproduksjon er svaret, hva er spørsmålet? Dagens

    Jahre, M. and Årdal, C. Reprint in ‘Overlegen’, 21 (2), May 2021.

  • Jahre, M. (2021) Implications of resilience on humanitarian logistics research, Decision Science Institute conference, November 19. Panel chair.

  • de Vries, H. (2021) Session on Access to Medicine in RCN MBA course Health & Humanitarian Logistics 2021.

  • Jahre, M. (2021) Developed a course concept for pharmaceutical supply chain management based MIA and MIA+research.

  • Van Oorschot, K., Breugem, T., Jahre, M., Viana, J., Van Wassenhove, L., Årdal, C.

    How good is Europe’s access to medicines? Why Norway and other European countries struggle to ensure equitable and financially sustainable access to medicines. Teaching Case on the Norwegian Paracetamol Supply Chain

    Unpublished, BI Norwegian Business School.

  • Viana, J., Van Oorschot, K., Årdal, C.

    Assessing Resilience Of Medicine Supply Chain Networks To Disruptions: A Proposed Hybrid Simulation Modeling Framework

    2021 Winter Simulation Conference Proceedings

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    The objective of the proposed hybrid simulation modeling framework is to improve the understanding and operation of medicine supply chains, to strengthen their resilience to ensure the availability of medicines. The framework draws upon hybrid simulation, supply chain resilience and medicine supply chain literature. The utility of the proposed framework is presented through the development of a case model of a generic (off-patent) case medicine in the Norwegian system to perform scenario-based experiments on disruption events and interventions.

  • Tuesday, 27 April 2021 - Legemiddeldebatten kan ikke reduseres til en diskusjon av egenproduksjon.

    Innlegg i Dagens Næringsliv av professor Marianne Jahre og Christine Årdal (Folkehelseinstituttet).

  • Wednesday, 21 April 2021 - Hvis norsk egenproduksjon er svaret, hva er så spørsmålet?

    Kronikk i Dagens Næringsliv av Professor Marianne Jahre og Christine Årdal (Folkehelseinstituttet).

  • Hospital medicines pricing and procurement workshop

    Tendering systems are frequently being mentioned as a cause of drug shortages in high-income countries. The reasons include that tendering drives down prices and increases revenue uncertainty for market authorization holders (MAHs) of medicines. This, in turn, drives many MAHs out of the market and disincentivizes them to invest in inventories, slack production, and production quality. Each of these consequences enhances the risk of drug shortages.

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    The question that arises is: how might we redesign a tendering system in such a way that it strikes the right balance between affordability (i.e., the capability of the tendering system to keep prices low) and availability (i.e., the capability of the tendering system to attract a diverse and reliable supply base)?

    To address this question, MIA researchers Christine Årdal (Norwegian Institute of Public Health), Harwin de Vries (Rotterdam School of Management), Dag Morten Dalen (BI Oslo), and Kostas Selviaridis (Lancaster University) organized a seminar with experts on the hospital medicines tendering systems in Belgium (Thomas de Rijdt), Denmark (Flemming Sonne), France (Jonathan Rodrigues), Norway (Eirik Sverrisson), Sweden (Ulf Törnqvist) and The Netherlands (Peter Dohmen, Prof. Erik van Raaij), which took place on April 8th, 2021. The participants shared how the system in their country works and discussed how the characteristics of these systems affect drug shortages. The latter include the level of centralization, the number of winners, and the duration of the contracts. The findings will form the basis for research on the link between tendering and shortages and optimal tendering system design.

  • Tuesday, 23 February 2021 - BI Business Review Vaksinespillet

    Dalen, M.

  • de Vries, H. Jahre, M., Selviaridis, K., van Oorschot, K. and Van Wassenhove, L.N.

    Short of Drugs? Call Upon Operations and Supply Chain Management

    International Journal of Operations and Production Management

    Read more (+)

    This “impact pathways” paper argues that operations and supply chain management (OSCM) could help address the worsening drug shortage problem in high-income countries. This significant societal problem poses difficult challenges to stakeholders given the complex and dynamic nature of drug supply chains.


  • Sustainability and Responsibility Management Report 2020

    Sharing information on progress (SIP) 2018-2020

  • Mapping workshop: for the researchers involved in the COVID project

    25 November: The purpose of the workshop was to provide each other with knowledge on how to map supply chains, what data and tools are available, and the specifics of the Ethiopian context. Participating presenters included Marianne Jahre, Tsegaye Melaku and Emily Gooding.

  • Friday, 30 October 2020 - Seminar Kriseledelse og krisehåndtering

    Verden har opplevd en situasjon helt utenom det vanlige og helsevesenet har vært spydspissen i håndteringen av covid-19. Hva har vi lært og hva kan vi bruke det til?

  • Monday, 05 October 2020 - MIA host workshops on medicine shortages with health care professionals

    On a Thursday afternoon 17 September MIA-researchers and more than 20 health care professionals gathered for a digital workshop on measures to improve access to medicines in the wake of Covid-19.

  • Sunday, 04 October 2020 - MIA researchers participate at the 12th annual conference on heath and humanitarian logistics

    Between 29 September and 1 October, the annual Conference on Health & Humanitarian Logistics was hosted by Georgia Tech’s Interdisciplinary Research Centre on Health and Humanitarian Systems. The MIA project was represented by a large delegation and took active part in the three-day conference.

  • Thursday, 01 October 2020 - MIA research presented at the Ethiopia Seminar

    Three MIA researchers participated in a recent seminar hosted by the University of Oslo in a digital format.

  • Wednesday, 02 September 2020 - BI Business Review Hvordan sikre forsyninger mot neste krise

    I en global verden, blir forsyningskjedene i samfunnet mer ustabile, usikre, komplekse og vanskelige å forutsi. Hvordan kan organisasjoner sikre sine forsyninger bedre?

  • Monday, 31 August 2020 - dagensmedisin.no Bedre legemiddeltilgang med Netflix-metoden?

    Jeg er ikke lenger sikker på at Netflix-metoden vil trylle bort dilemmaet med at ikke alle får bruke nye effektive legemidler. Det er langt fra desentralisert og prisfølsom seeratferd for filmer og serier til sentraliserte forhandlinger om finansiering og bruk av nye legemidler.

  • Friday, 21 August 2020 - The Guardian Syringe shortage could hamper delivery of Covid-19 vaccine, experts warn

    US companies make roughly 663m syringes a year but the Trump administration has calculated that an extra 850m may be needed.

  • Wednesday, 19 August 2020 - CGDEV Modelling the Manufacturing Process for COVID-19 Vaccines: Our Approach

    Researchers across the world are working flat out to develop and manufacture a vaccine for COVID-19 that can end what has been the worst pandemic in at least a century.

  • Monday, 27 July 2020 - Vox The global risk of “vaccine nationalism”

    A Covid-19 outbreak in one country is a threat to all. What happens if the vaccine race is every nation for itself?

  • Thursday, 02 July 2020 - New Master of Science in Crisis Management

    Crisis management is an interdisciplinary research field that seeks to understand and guide how organizations can prepare for and respond to such events. This field draws from numerous disciplines including strategy, communication science, organizational behavior and leadership, business continuity and supply chain research, and is sometimes referred to as disaster and/or risk management. The field is more important than ever.

  • Thursday, 02 July 2020 - Crisis management Summer course hosted by MIA researchers

    BI recently kicked off the annual summer school programme. Under the special circumstances of the coronavirus affecting worldwide mobility, this year’s summer school was like no other. This year, 70 students from BI was enrolled to a special course on crisis management, with a special emphasis on covid-19.

  • Thursday, 02 July 2020 - BI Business Review Why countries should give away Covid-19 tests post-peak

    Being too careful helps no one. As soon as a country reaches peak infections, the demand for tests will sink and any excess capacity should therefore be given away.

  • Thursday, 25 June 2020 - Digital seminar on state-of-the-art research on the ongoing coronavirus pandemic

    MIA project leader, Professor Marianne Jahre, met with the Norwegian minister of development, Dag Inge Ulstein, in a digital seminar on state-of-the-art research on the ongoing coronavirus pandemic. During the meeting, hosted by the Norwegian Research Council, Prof. Jahre presented the MIA project and the ongoing work in the covid-19 Task Forces. She presented some of the initial findings on how to mitigate and cope with shortages in medical supplies as well as how one could prevent similar situations in the future. She also pinpointed a few important development aspects relevant to the MIA-partner institutions in Ethiopia, Jimma University and St. Paul’s Hospital Millenium Medical College.

  • Thursday, 18 June 2020 - Tungt Logistikk LOGMA: How to Succeed with Logistics in Crisis

    In a recent article, MIA-researcher Marianne Jahre argues they can and describes how to best go at it as we deal with the fallout from the ongoing pandemic (in Norwegian).

  • Saturday, 30 May 2020 - Successful inaugural meeting for the MIA Project

    In a novel approach, the digital project meeting gathered more than 25 researchers, practitioners and master students from six different countries in an online conference room through Zoom.

  • Friday, 03 April 2020 - Harvard Business Review A Covid-19 Vaccine Will Need Equitable, Global Distribution

    With the development of potential vaccines for Covid-19 progressing quickly, we need to invest now in infrastructure for distributing a vaccine globally on an equitable basis as soon as it is proven safe and effective. Article by MIA-research partner Prashant Yadav in INSEAD’s Humanitarian Research Group in the Harward Business Review.