ABSTRACT
This chapter deals with the parties in the supply chain and their different roles, between the original manufacturer of a product and its final delivery to patients. The attitudes, beliefs, management processes and rewards for those operating in the healthcare environment must reflect the importance of the potential consequences. Markets that have established a national healthcare framework and governance impose a level of service to which all regulated pharmacists, wholesalers and manufacturers must conform. In Europe there are two categories of wholesaler: the full-line wholesaler and the short-line wholesaler. In the basic three-tier model that we have identified manufacturer, wholesaler and pharmacist/patient there are many more wholesalers than manufacturers and many more pharmacies than wholesalers. The improper use of incentives to wholesalers to increase purchases of Bristol-Myers Squibb (BMS) products to sufficient amounts to meet the quarterly sales targets.
