Pulse crops: nutrient density, affordability, and environmental impact.

Introduction: Sustainable foods need to be nutrient-rich, affordable, environmentally friendly, and socially acceptable. Pulses, which include beans, lentils, chickpeas, and dried peas are a food group that can fit all those criteria. Methods: These concepts were tested serially using nutrient profiling methods that focused on protein and were extended to include food prices, greenhouse gas emissions, and energy demand. The present sustainability analyses were based on the US Department of Agriculture (USDA) nutrient composition and food prices data. Environmental impact data came from life cycle assessments (LCA). First, the USDA Protein Foods Group was disaggregated into animal and plant proteins. Plant proteins were separated into pulses, soy products, and nuts and seeds. Results: Pulses were among the lowest-cost protein sources (per 100 g and per 100 kcal) and had the lowest greenhouse gas emissions GHGE and energy demand. Pulses were among the most sustainable foods when monetary and energy costs were expressed per 50 g of protein (equivalent to 100% DV). Pulses scored well on the Nutrient Rich Food (NRF9.3) nutrient profiling system and on the related Affordable Nutrition Index that assessed nutrient density per penny. Discussion: Pulses are a source of low-cost plant-based protein and a variety of priority vitamins and minerals, have low carbon footprint and energy demand, and are a valued culinary ingredient across diverse regions and cultures. As dietary guidance turns to plant-based diets, pulses need to be integrated into the global sustainability framework.

Uncovering the drivers of CO2 emissions in the United States: The hidden spillover effects.

This study explores the applicability of the Environmental Kuznets Curve (EKC) hypothesis in the United States (US) from 2006 to 2020, employing the Spatial Durbin Model (SDM) to analyze the cross-border effects of pollution among states. The results indicate that although economic growth initially decreases environmental degradation, it subsequently contributes to more significant environmental degradation, challenging the EKC hypothesis's validity at the US state level. Factors such as higher energy prices and reliance on fossil fuels are also identified as significant drivers of environmental deterioration, with varying impacts observed across states. Conversely, adopting renewable energy sources is crucial in mitigating pollution levels. The study underscores the importance of coordinated state-level efforts to harmonize economic growth with sustainable environmental practices. It highlights the complexities of policymaking in balancing economic development with environmental conservation and emphasizes the need for targeted interventions to address environmental challenges effectively. This research enhances our understanding of sustainable development pathways amidst diverse regional dynamics within the US by providing empirical evidence and policy insights.

Over- and underreporting of prices: most hospitals are not compliant with the Hospital Price Transparency Rule.

Concern has been raised about the effectiveness of the Hospital Price Transparency Rule to facilitate a clear understanding of health care prices due to poor reporting by hospitals. However, the relationship between what services the hospital provides and what prices they report is not clear. We assessed reported prices in the Turquoise Health database and compared them at the hospital level with the CMS Provider of Services File to identify if a shoppable service was provided at a hospital. We found significant mismatch between the hospital prices being reported and the services being provided. For example, 56% of hospitals providing at least 1 shoppable service that requires public price reporting did not report any prices. Of hospitals reporting prices, most hospitals (66%) reported prices for only a portion of the services they provide. In addition, 12% of hospitals reported prices for services they do not provide. Only 6% of hospitals had complete concordance with price reporting and services they actually provide. Current compliance enforcement and penalties do not appear to be adequate to achieve the goals of the Hospital Price Transparency Rule.

Estimating the cost and affordability of healthy diets: How much do methods matter?

Recently developed cost and affordability of healthy diet (CoAHD) metrics have quickly become mainstream food security indicators. However, published research on the sensitivity of estimation methods is limited. This paper focuses on two important innovations in CoAHD measurement at the global level. First, we develop a demographic scaling factor to adjust healthy diet costs for cross-country differences in age structures, since younger populations generally require fewer calories than older populations. Second, we improve the way in which household expenditure available for purchasing food ("food budgets") are derived. In addition, we explore sensitivity of global CoAHD estimates to potential problems with the representativeness and food product coverage of global food price data and vary assumptions for activity levels that shape energy expenditure requirements. We apply these explorations to the EAT-Lancet reference diet in 137 countries using price data from 2017. Relative to the conventional methods, we find that demographic scaling and improved food budget derivation substantially reduces the estimated population who cannot afford a healthy diet, from 3.02 to 2.13 billion. Adjustments for low product coverage can lead to modest reductions for specific regions and food groups, while higher physical activity assumptions increase the share of people who cannot afford a healthy diet, though perhaps implausibly so. Methods clearly matter in CoAHD estimation, and more accurate and timelier CoAHD estimates have substantial scope to improve policy analysis, design and targeting.

[The metamorphoses of denationalization of 1993. Report-I. The market fight for medications import].

In the history of the Russian pharmaceutical market the year of 1993 became the year of formation of rules of market relations and changing under them of market landscape. The significant segment of state-centralized purchases moved under responsibility of regional authorities and their health care authorities. At that, powers of three former state organizations being occupied with purchases of imported medications were distributed between new state companies of Ministry of Health and commercial organizations and firms that entered pharmaceutical market. This diversity rather soon gave rise to competitive fight for budget funds and experiments of Government with market regulation. The traces of these clashes and attempts to make market regulated can be found in Ministry of Health archives and journal publications. The Report I reveals circumstances of entrance of Ministry of Health into market relationships and its acquisition of market player identity.

Prices for veterinary care of dogs, cats and horses in selected countries in Europe.

Introduction: In recent years, prices for veterinary care have received considerable attention in mainstream media, yet scientific literature has not delved into actual figures. This study aims to elucidate veterinary care costs for dogs, cats, and horses across five countries [Sweden (SE), Norway (NO), Denmark (DK), United Kingdom (UK), and Ireland (IR, with limited data)] through web searches. Methods: Utilising online business directories, we located URLs featuring veterinary care prices in autumn 2022, and repeated tri-monthly five times. Vetpris.se (VP), a price comparison site for SE, NO, and DK, emerged from the search. Additionally, we sought to compare price data from veterinary clinics (ranging from animal hospitals to small private clinics) using a similar approach to VP. We targeted elective procedures (e.g., gonadectomy, GDY) and common procedures (e.g., pyometra surgery in dogs). Results: Comparing data from the same clinics' websites and from VP within extraction from autumn 2022 to winter 2023/2024, median prices for dog and cat GDY were largely consistent. By October 2023, median prices for male cat GDY ranged from €72 (SE) to €230 (DK), and €130 (SE) to €361 (DK) for females; for dog GDY from €390 (SE) to €599 (DK) for males, and €461 (UK) to €1015 (DK) for females. Across sources, median prices for cat and dog GDY increased by 2-24% over a year for procedures with at least 10 clinics per extraction. Equine GDY (per sedation and local analgaesia) in SE saw a 64% increase by year-end, with a median price of €492. Emergency surgeries during regular-hours (e.g., pyometra and caesarean section) in SE were approximately €2,300 at the last extraction, marking a 27% increase for pyometra surgery during regular-hours and 15% after-hours compared to the previous year. Variability existed within and across countries and diagnoses/procedures. Discussion: Cross-validation suggested VP generally provided reliable information, though data points for emergencies were limited. Our web searching tool necessitated extensive manual verification, indicating room for further development. We recommend enhancing price transparency for animal owners to become better informed about the cost of veterinary care and be able to make informed choices.

Access to essential medicines used in the management of noncommunicable diseases in Southern Ethiopia: Analysis using WHO/HAI methodology.

Objectives: This study aims to assess access to essential medicines used in the management of noncommunicable diseases through analysis of the availability, prices, and affordability of these essential medicines in Arba Minch town, Gamo Zone, Southern Ethiopia. Methods: A cross-sectional design was carried out using the World Health Organization/health action international methodology between 2 March and 2 May 2023, within public and private healthcare facilities located in Arba Minch town, Southern Ethiopia. The median price ratio served as a metric. Statistical tests like the Shapiro-Wilk and Kolmogorov-Smirnov were utilized to assess the normal distribution of price data. The Wilcoxon-Mann-Whitney U test was also employed to compare median buyer's prices (patient prices) between public and private healthcare institutions. Treatment affordability was determined by estimating the number of days' wages required by the lowest-paid government employee in Ethiopia to afford the prescribed medication regimen. Results: Among 23 health facilities surveyed, the pooled availability of essential medicine used in the management of noncommunicable diseases was 18.7% (range: 0%-30.1%), with the public and private facilities contributing 16.3% and 38.3%, respectively. The overall percentage of availability originator brand versions was 1.1% for overall health sectors, 0.6% for public sectors, and 1.2% for private sectors. The overall percent availability of lowest price generics was 36.2% (range: 0%-26.2%; public: 32.0%; private: 37.1%). Only seven lowest price generics satisfied the World Health Organization target of 80% and above. The overall median price of lowest price generic medicines in private was two times higher than in public sectors. The top five median price scorers were amlodipine, furosemide, insulin, beclomethasone, and salbutamol. The Mann-Whitney U test showed that 11.6% of lowest price generics medicines had a statistically significant median price disparity between the public and private sectors (p < 0.05). The overall percent of unaffordability was found to be 100.0%, (public: 70.4; private: 100.0%). Conclusions: This study revealed the limited availability and potential financial burdens on patients seeking essential noncommunicable disease medications. Limited availability suggests the need for better supply chain management and consistent stock availability. The price disparities and affordability challenges identified underscore the necessity for policy interventions such as price regulation and subsidized programs to ensure equitable access to essential noncommunicable disease medications in Arba Minch town, Southern Ethiopia.

Asymmetric impacts of climate policy uncertainty, investor sentiment on energy prices and renewable energy consumption: Evidence from NARDL and wavelet coherence.

This paper seeks to look into the asymmetric impacts posed by climate policy uncertainty (CPU) and investor sentiment (IS) upon the price of non-renewable energy, specifically natural gas prices, and the consumption of renewable energy, embodied in geothermal energy, biofuels, and fuel ethanol. To this end, the analysis draws on a non-linear autoregressive distributed lag (NARDL) model and wavelet coherence (WTC) technique with monthly data from January 2000 to December 2021. The NARDL results establish an asymmetric association between the variables, where negative shocks to CPU exert a greater effect on each energy variable than positive shocks, while the reverse is true for IS. Furthermore, it has been noticed that CPU and IS exhibit primarily negative correlations with the target variables over the long term, with CPU having a more pronounced effect on natural gas prices than on other forms of renewable energy consumption. Wavelet analysis also reveals that CPU leads the energy variables over the medium to long run, while IS assumes a dominant role in the short to medium run. These momentous findings underscore the importance of this study in informing energy policy formulation and environmental management, as well as optimizing investor portfolios.

Energy security and its determinants in New Zealand.

New Zealand relies on imported fossil fuels for about 38% of its primary energy. The country's energy demand is expected to grow due to population and economic growth, which will put more pressure on the energy system. Besides, resource scarcity, energy price volatility, and environmental challenges have made energy security a major concern for New Zealand and other countries. Given the lack of significant research on the effects of energy security factors in New Zealand, this study aims to shed light on the primary determinants of energy security using the dynamic autoregressive distributed lag method based on time series data from 1978 to 2021. The study found that a long-run link exists between energy security and energy intensity (energy efficiency), renewable energy use, fossil fuel consumption, and global oil prices. Real GDP, renewable energy consumption, and energy security were found to improve energy security, while fossil fuel consumption and world oil prices had a negative impact. The study also revealed a one-way causality from real GDP, fossil fuel consumption, and renewable energy use to energy security. In contrast, the relationship between energy intensity and energy security is bidirectional. Simulation results showed that global crude oil prices have a lower impact on energy security compared to other variables and are most responsive to a 5% shock in fossil fuel consumption, followed by economic growth.

Exploring the interconnection between international crude oil and silver rates volatilities: Novel evidence from the COVID-19 pandemic.

Several research studies globally focus on the volatility of gold and oil prices, neglecting an examination of silver price volatility in relation to other market commodities. The current Covid-19 pandemic has led to various uncertainties and fluctuations in financial and stock exchange markets, yet existing literature primarily concentrates on individual product rates rather than combined rate changes. Our study aims to bridge this research gap by analyzing the relationship between oil rates, silver rates, oil rate transitions, and silver rate transitions on the security exchange in China from 1990 to 2022, using the ARDL approach and Nonlinear ARDL for a comprehensive assessment. The findings reveal a significant impact of silver and oil rates on China's security exchange in the future, with the negative effects of oil rate changes and a positive effect of silver rate transitions. In the short term, oil and silver rates play a crucial role in influencing China's security exchange, highlighting the importance of monitoring these trends for investors. It is recommended that investors respond prudently to market transitions, particularly by considering silver as a secure option during times of uncertainty, while policymakers should implement appropriate measures to manage the rapid fluctuations from oil to the security market.

Inequitable Distribution of Global Economic Benefits from Pneumococcal Conjugate Vaccination.

Many low- and middle-income countries have been slow to introduce the pneumococcal conjugate vaccine (PCV) into their routine childhood immunization schedules despite a high burden of disease. We estimated the global economic surplus of PCV, defined as the sum of the net value to 194 countries (i.e., monetized health benefits minus net costs) and to vaccine manufacturers (i.e., profits). We further explored the distribution of global economic surplus across country income groups and manufacturers and the effect of different pricing strategies based on cross-subsidization, pooled procurement, and various tiered pricing mechanisms. We found that current PCV pricing policies disproportionately benefit high-income countries and manufacturers. Based on the 2021 birth cohort, high-income countries and manufacturers combined received 76.5% of the net economic benefits generated by the vaccine. Over the two decades of PCV availability, low- and middle-income countries have not received the full economic benefits of PCV. Cross-subsidization of the vaccine price for low- and middle-income countries and pooled procurement policies that would relate the vaccine price to the value of economic benefits generated for each country could reduce these inequalities. This analysis offers important considerations that may improve the equitable introduction and use of new and under-utilized vaccines.

Exogenous variable driven deep learning models for improved price forecasting of TOP crops in India.

Accurately predicting agricultural commodity prices is crucial for India's economy. Traditional parametric models struggle with stringent assumptions, while machine learning (ML) approaches, though data-driven, lack automatic feature extraction. Deep learning (DL) models, with advanced feature extraction and predictive abilities, offer a promising solution. However, their application to agricultural price data ignored the exogenous factors. Hence, the study explored advanced versions of the well-known univariate models, NBEATSX and TransformerX. The research employed price data for essential crops like Tomato, Onion, and Potato (TOP) from major Indian markets and complemented it with corresponding weather data (precipitation and temperature). To provide a comprehensive analysis, the study also evaluated traditional statistical methods (ARIMAX and MLR) and a suite of ML algorithms (ANN, SVR, RFR, and XGBoost). The performance of these models was rigorously evaluated using error metrics like RMSE, MAE, sMAPE, MASE and QL. The findings were significant indicating DL models, particularly when augmented with exogenous variables, consistently outshone other methods with NBEATSX and TransformerX showing an average RMSE of 110.33 and 135.33, MAE of 60.08 and 74.92, sMAPE of 22.14 and 24.00, MASE of 1.02 and 1.32 and QL of 30.04 and 34.07, respectively. They exhibited lower error metrics, as compare to the statistical and ML models underscoring their effectiveness and potential in agricultural crop price forecasting. This study not only bridged a crucial research gap but also highlighted the robust potential of DL models in enhancing the accuracy of agricultural commodity price predictions in India.

Modeling impact of inflation reduction act price negotiations on new drug pipeline considering differential contributions of large and small biopharmaceutical companies.

BACKGROUND/AIMS: Provisions of the Inflation Reduction Act mandating drug price negotiation by the Centers for Medicare & Medicaid Services have been criticized as a threat to pharmaceutical innovation. This study models potential impacts of the Inflation Reduction Act on drug approvals based on the differential contributions of large pharmaceutical companies and smaller biotechnology firms to clinical trials and the availability of capital. METHODS: This study examined research and development expense, revenue, and new investment (sale of common and preferred stock) by public biopharmaceutical companies and sponsorship of phased clinical trials in ClinicalTrials.gov. Financial data were incorporated in a model that estimates the number of drugs in each phase and approvals from reported phase-specific costs and transition rates, proportional sponsorship of trials by companies of different size, projected reductions in research and development spending based on company size, and three scenarios by which large companies may allocate reductions in research and development spending among clinical phases: (1) research and development proportionally reduced across phases; (2) research and development disproportionally reduced in phases 2-3; and (3) research and development disproportionately reduced in phases 1-2. RESULTS: Financial data were examined for 1378 public biopharmaceutical companies (2000-2018). Research and development expense was associated with revenue for 79 large companies with market capitalization ≥$7 billion with a 10% reduction in revenue reducing research and development expense by 8.4%. For 1299 smaller companies with market capitalization <$7 billion, research and development was associated with new investment, but not revenue. Smaller companies sponsored 55.2% of phase 1, 55.6% of phase 2, and 49.8% of phase 3 trials in ClinicalTrials.gov 2013-2018. In a model of clinical development that apportions clinical trials between large and smaller companies and determines the number of trials based on research and development resources, 400 drugs entering development produced 47.3 approvals (11.83% rate). A 10% reduction in revenue, reflecting the upper boundary of observed changes 2000-2018, with (1) proportional reduction across phases 1-3 produced 45.1 approvals (4.61% reduction); (2) disproportional reduction of phases 2-3 produced 42.8 approvals (9.55% reduction); and (3) disproportional reduction of phases 1-2 produced 46.9 approvals (0.95% reduction). CONCLUSION: This work suggests that the drug price negotiation provisions of the Inflation Reduction Act could have little or no impact on the number of drug approvals. While large pharmaceutical companies may reduce research and development spending, continued research and development by smaller companies and strategic allocation of research and development resources by large companies may mitigate any negative effects of the Inflation Reduction Act.

Sales Revenues for New Therapeutic Agents Approved by the United States Food and Drug Administration From 1995 to 2014.

OBJECTIVES: This study aimed to analyze worldwide sales of new therapeutic agents and to estimate the time it takes for product sales to exceed industry-wide average drug development costs. METHODS: Data obtained from company reports were analyzed to track worldwide sales of new medicines approved by the US Food and Drug Administration from 1995 to 2014. All sales figures were reported in 2019 US dollars. Kaplan-Meier curves were used to evaluate the time it took for discounted product sales to exceed the average costs associated with developing 1 new drug (accounting for the costs of failed trials), using published estimates of these costs. RESULTS: Based on data for 361 of 558 new therapeutic agents approved over the study period (median follow-up 13.2 years), mean sales revenue per product was $15.2 billion through the end of 2019; the median was $6.7 billion. These products jointly generated global sales of $5.5 trillion since approval. Revenues were highly skewed, with the 25 best selling products (7%, 25 of 361) accounting for 38% of this amount ($2.1 trillion of $5.5 trillion). Approximately 47% of products had discounted sales that exceeded the estimated industry-wide average costs of development within 5 years of approval, and 75% within 10 years. After attributing potential production, marketing, and other costs, these numbers dropped to 21% of products within 5 years of approval, and 46% within 10 years. CONCLUSIONS: Sales of new medicines approved from 1995 to 2014 were highly skewed, but many products had net discounted sales that exceeded the industry-wide average costs of development within 10 years of approval. An understanding of how sales revenues accrue in the years after initial approval, alongside data on business costs, can inform discussions about how to incentivize private investment in innovation while ensuring affordable prices for patients and the healthcare system.

Electric vehicle usage, pollution damages, and the electricity price elasticity of driving.

I study battery electric vehicle (BEV) usage and ownership characteristics with fundamental implications for the electrification of passenger transportation. Using data covering the entire BEV population in New York, I quantify BEV mileage and electricity consumption and highlight the important role of vehicle utilization in contributing to real-world pollution damages and their spatial variation. I then study the factors influencing how much BEVs are driven with a focus on estimating the electricity price elasticity of BEV mileage. Understanding how drivers respond to these changes in operating costs may help align the social and private costs of BEV driving and illustrates how electric utilities may affect transportation outcomes in the future. I find a 10% increase in residential electricity prices reduces mileage by 1%, but responsiveness falls as public charging stations-where prices are often decoupled from electricity costs-become available.

How much does overnutrition weigh? The environmental and social impacts of Metabolic Food Waste in Italy.

Excess Food Energy Intake (EFEI), namely Metabolic Food Waste (MFW) corresponds to excess calorie intake related to overconsumption of food and is responsible for overweight (OW) and obesity (OB) conditions. Identifying its causes and impacts could be important, so that it can be prevented and reduced, generating health, environmental and societal benefits. Therefore, this research quantifies MFW among OW and OB adult populations (18-75 years) in Italy and its environmental and social implications. Life cycle assessment (LCA) through the Simapro 9.5 software was used and then, the results were monetized according to the Environmental Price Handbook to understand the real environmental cost. Finally, Social LCA (S-LCA) was considered following the Product Social Impact Assessment (PSILCA) guidelines to understand the potential social risks behind the food that ends up on our plates. The results highlight the amount of MFW in Italy is 2696 billion kcal/year corresponding to 1.59 Mtons over-consumed food/year, while the impacts are mainly related to global warming (8.78 Mtons CO2 eq/year, or 2.29 % of the total Italian CO2 emissions), terrestrial ecotoxicity (843,451 tons 1.4-DCB/year), freshwater ecotoxicity (222,483 tons 1.4 DCB eq/year), and land consumption (8 million m2a eq/year), mostly due to the meat, fats and oils and sweets overconsumption. Impacts monetization also shows that MFW could induce an environmental price of € 1340/per capita/year, and finally, the S-LCA reveals how overconsumption of food has the potential to affect gender discrimination, water depletion, trade union, and social discrimination due to the high proportion of labor migrants in the agricultural sector.

The 30-Billion-Dollar Distribution Markups and Taxes of Pharmaceuticals in Latin American Countries: Impact, Options, and Trade-Offs.

OBJECTIVES: The World Health Organization provides 10 specific guidelines for managing the prices of pharmaceutical products. Many of those are widely known and used such as reference pricing, value-based pricing, price transparency, and tendering. Less attention and knowledge is concentrated in markup regulation across the pharmaceutical supply chain and distribution and in tax exemptions or reductions. This article quantifies the impact of these price components in the Latin American (LatAm) region and places the findings in the context of economic theory and international policy experiences. METHODS: 2020 retail pharmaceutical sales data from 8 major LatAm markets covered in the IQVIA database were decomposed into ex-factory, distributor markups, and taxes using price build up information and the Price Decipher Methodology developed by the Novartis Global Pricing Governance and Negotiation team. The findings were reviewed by an international panel representing academia, health policy, health economics, patient, and industry. RESULTS: The ex-factory market value of the analyzed markets was $49 billion. Distribution markups added $20 billion and taxes a further $10.5 billion. This represented a 63% increase over ex-factory prices, considered high if compared with 24% for an international benchmark of 35 ex-LatAm countries. Reducing markups for these LatAm countries to 24% would represent up to $19 billion in savings for payers and patients. CONCLUSIONS: There is potential for significant cost reductions associated with tax and distribution markup refinements in the LatAm retail pharmaceutical market. National policies should be informed by additional context-specific research for effective implementation.

Domestic and international impacts of rice export restrictions: The recent case of indian non-basmati rice.

This study examines the impact of India's export restrictions on domestic retail rice prices using a dynamic panel GARCH model. The findings suggest that export restrictions are not a sufficient condition to lower domestic prices. Export restrictions are associated with lower retail price volatility in the East Zone. Moreover, the international price transmission to a sample of Asian and African economies shows that all countries are vulnerable, but the degree and kinds of vulnerability differ. Rice exporters appear to be the most susceptible as domestic prices increase in these countries. Rice importers are also vulnerable because of price increases, but the increases are less than in countries where the private sector decides on import quantities.

Commodity prices and economic growth: Empirical evidence from countries with different income groups.

The purpose of this paper is to examine the effect of global commodity prices such as beverage, energy, fertilizer, food, metal and mineral, precious metal and agricultural raw material on GDP per capita of countries with different income levels which are low, lower-middle, upper-middle, and high. The results of the study using panel system GMM method over the period 2007-2021 showed that for all income group countries, the impact of energy and fertilizer prices on GDP per capita is negative, while the impact of food and metal and mineral prices is positive on GDP per capita. The study also found that rising prices of agricultural raw materials reduces GDP per capita of all income group countries except lower-middle income countries. Moreover, according to the results of the study, rising beverage prices increased the GDP per capita only of high-income countries, while rising precious metal prices decreased the GDP per capita of lower-middle and high-income countries. The study revealed that price changes in all commodity groups have an impact on the GDP per capita of high-income countries. It is demonstrated that price changes in all commodity groups have an impact in both directions on the GDP per capita of all income groups, depending on whether they are net producers or net consumers. The results of the study showed that, contrary to the literature, the countries most affected by commodity prices are high-income countries. Based on the empirical findings, this study point to the need for international cooperation to minimize the adverse effects of commodity price changes.

Rethinking counterfeit medical supply chains: A critical review of the current literature.

The medical device and pharmaceutical industries include a range of drugs, machines, instruments, and apparatuses used to prevent, diagnose, treat disease and illness, or aid in rehabilitation for patients, and are expected to grow substantially in the coming years. However, they are often targets of criminal organizations who manufacture and profit from fraudulent products, infiltrating the market with counterfeit medical supply chains. In this paper, we discuss and analyze the extent and nature of this problem and make suggestions for mitigation and prevention of this worldwide challenge. Ultimately, we argue that a holistic approach is essential to addressing this problem, including the creation and dissemination of reliable and good quality data, developing healthcare systems to be more robust, establishing/enhancing intra- and international cooperation around this issue, and employing effective technological solutions, such as digital tracing.