Abstract
Sustainability in the pharmaceutical integrated supply chain ecosystem is understood as a balance between environmental, social, and economic pillars. Therefore, indicators for sustainability development in pharmaceutical industries therefore must cover all three dimensions of sustainability. The traditional supply chain was more about reducing costs and maximizing revenue and profit. Now the corporate goal is also about considering the environmental and social impact of their products and services journey through the entire value chain — from plan to source, to make, to deliver, to the service domain. Sustainability as part of corporate responsibilities is now mandatory to be mentioned as part of the broader commitment to safeguarding the planet. This multiple qualitative case study aimed to investigate the role of sustainability in the efficient pharmaceutical supply chain. Sustainability is also the key driver for the long-term growth of a pharmaceutical company. The study involved interviewing various pharmaceutical managers with proven strategies for implementing sustainability-related strategies. The theory of constraint was used as the conceptual framework for this qualitative multiple case study. Data from interviews and supporting documents were analyzed using data triangulation to discover themes. Three main themes emerged from data analysis: (a) known or unknown constraints, (b) business operational model change, and (c) training and building sustainability capability. Seven key strategies were developed pertain to these three themes. These themes were identified based on interview data inputs and documentation provided by participants. Identified themes and strategies are summarized in the system model. Researchers and industry leaders can utilize themes and strategies to identify constraints, risks, and issues in the current system and work towards a sustainable supply chain integrated ecosystem.

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