Emerging geopolitical risks have begun to threaten global supply chains, including those that produce life-saving drugs. Export bans may prevent a company from shipping products internationally, and it is unclear how these new dynamics may affect company plans and persistent, worldwide drug shortages. To address these questions, we present a global pharmaceutical supply chain design model that considers the risk of export bans that are induced by supplier capacity disruptions and corresponding price increases. The model takes the company’s perspective as a decision-maker looking to locate plants and distribute drugs globally. It is a two-stage stochastic program that includes uncertainty in capacity, ability-to-export, and demand. The model is solved by integrating the Sample Average Approximation and L-shaped methods. We present conditions related to when demand will be met and a case study of a generic oncology drug. We find that preparing for geopolitical strain may increase resilience and profits as well as reduce shortages in the short term. At baseline, expected global shortages are high (17.2%) with disparities across country income levels (0.3%, 0.8%, 87.2%, and 87.6% for high, upper-middle, lower-middle, and low income countries, respectively). Pricing policies may improve drug access overall, back-shoring may slightly improve access for the country where it is implemented, and bilateral alliances may not be effective at improving access.

中文翻译：

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地缘政治压力对全球医药供应链设计和药品短缺的影响

新出现的地缘政治风险已开始威胁全球供应链，包括生产救命药物的供应链。出口禁令可能会阻止公司将产品运往国际市场，目前尚不清楚这些新动态将如何影响公司计划和持续的全球药品短缺。为了解决这些问题，我们提出了一个全球药品供应链设计模型，该模型考虑了供应商产能中断和相应价格上涨引起的出口禁令风险。该模型从公司的角度出发，作为希望在全球范围内寻找工厂和分销药物的决策者。这是一个两阶段随机计划，包括产能、出口能力和需求的不确定性。该模型通过集成 Sample Average Approximation 和 L 形方法进行求解。我们提出了与何时满足需求相关的条件以及仿制药肿瘤药的案例研究。我们发现，为地缘政治压力做好准备可能会提高弹性和利润，并在短期内减少短缺。在基线水平上，预期的全球短缺率很高 （17.2%），各国收入水平之间存在差异（高收入、中高收入、中低收入和低收入国家分别为 0.3%、0.8%、87.2% 和 87.6%）。定价政策可能会从整体上改善药物可及性，回流可能会略微改善实施定价政策的国家的可及性，而双边联盟可能无法有效地改善药物可及性。