Table 1 Dimensions and related questions

Regulatory

A1: Preparation and periodic review of nation drug list.

A2: Forming the formulary committee to modify unnecessary drugs from list.

A3: Improving drug shortage monitoring department in IFDA.

A4: Formulating drug and raw material registration processes based on health system priorities.

A5: Developing the protocols for each part of SC.

A6: Legislation for information sharing in SC.

A7: Prosecution of the companies causing drug shortage due to not notifying on time.

A8: Monitoring the punishments for illegal drug import and export.

A9: Clarifying and stabilizing rules and procedures.

A10: Technical and qualitative monitoring of production lines to prevent a sudden stop in production.

Financial

A11: Prioritize supporting the entry of raw materials and essential drugs, according to the list of essential drugs.

A12: Using different competitive pricing for imported drugs.

A13: Reinforcement of cooperation and coordination with other relevant organizations.

Supply chain

A14: Planning for producing the raw material and finished products imported based on SC information.

A15: Pharmaceutical companies’ timely notification to the IFDA about the recall or problems in production and import of products.

A16: Creating a competitive environment for imports.

A17: Restructuring emergency pharmaceutical companies to meet the real needs of pharmaceutical market.

A18: Establishment of an integrated and capillary distribution system based on supply chain information.

A19: Improving the delivery system to the remote areas.

A20: Using track and trace system.

A21: Encouraging patients to use alternative drugs available in the drug shortage by physicians.

A22: Commitment of physicians to prescribe drugs based on national formulary.

A23: Physicians should be up to date and alert about the availability of the drugs in market and the alternatives of medicines in shortage.

IS

A24: Creating an integrated supply chain information system to manage medicines inventory.

A25: Creating and using the databases to predict the shortage of medicines.

Policy-making

A26: Taking out the OTC drugs from insurance coverage and allocate their budget to essential drugs.

A27: Preparing alternative medicine list by the expert committee for crisis condition.

A28: Reducing medicine waste by promoting rational use.

A29: Saving the strategic supply of essential medicines and keeping them up to date in macro level.

A30: Managing the allocation of drugs based on diseases priority in times of crisis.

A31: Adopting policies to build partnerships between all components of the supply chain and health services for the establishment of an integrated management.

A32: Recording strategies taken for drug shortage management and the reasons for their success or failure for use in future events.

A33: Adopting policies to increase the competitiveness of domestic pharmaceutical industry.

A34: Adopting policies to prevent the black market and drugs smuggling.

A35: Creating pharmaceutical industry think-tank to predict the effects of various economic and political factors on the pharmaceutical market.

A36: Actual value-based pricing and improving insurance coverage.

A37: Decreasing the effect of governmental authority in the field of production and import of medicine