Abstract
Exploring the Challenges Facing Drug Wholesalers and International Pharmaceutical Companies in Iraq: A Qualitative Study
Abstract
Background: Iraq’s pharmaceutical supply chain faces regulatory, economic, and operational challenges affecting medicine availability and market stability. This is the first study in Iraq to examine the barriers confronting entities responsible for importing and distributing pharmaceutical products within the private sector.
Objective: To explore the challenges facing drug wholesalers and representatives of international pharmaceutical industries in Iraq.
Methods: A qualitative study included 10 semi structured interviews and two focus groups. In total, 13 pharmacists participated, comprising eight representatives of the scientific drug bureaus and five drug wholesalers. Data were collected between February and April 2025 and analyzed using inductive thematic analysis approach.
Results: Thematic analysis identified multiple interconnected challenges across the pharmaceutical supply chain. Key themes included regulatory and bureaucratic barriers, financial instability and widespread debt practices, market shortages, and the circulation of counterfeit and parallel-imported medicines. Participants highlighted prolonged drug registration timelines, inconsistent regulatory enforcement, and limited coordination between authorities. Economic challenges included declining profit margins and delayed payments from pharmacies. Drug shortages were reported to negatively impact patient access and pharmacy sustainability, while unregulated markets undermined trust in licensed supply channels. Digital solutions, such as e-ordering and payment applications, were perceived as improving operational transparency and efficiency. Participants also emphasized the need for policy reform, enhanced institutional coordination, and support for local pharmaceutical production. Major barriers included analytical laboratory limits causing quality control delays, inter-regional regulatory divergence, and gaps in monitoring direct-to-patient promotional compliance.
Conclusion: The pharmaceutical supply chain in Iraq is affected by interconnected regulatory, financial, and operational challenges, contributing to medicine shortages and market instability. These challenges are consistent with those observed in other developing countries, particularly regarding regulatory fragmentation, weak financial systems, and supply chain inefficiencies. Addressing these issues requires comprehensive and coordinated reforms, including regulatory harmonization, strengthening financial governance, improving forecasting and procurement systems, and enhancing enforcement against counterfeit medicines. While digital solutions offer important opportunities to improve transparency and efficiency, their effectiveness depends on integration within broader institutional reforms. Strengthening these areas is essential to ensure sustainable access to safe, effective, and quality medicines in Iraq.
| Intend to be published in the IJPS ? | Yes |
|---|---|
| Has the manuscript been published | not published |
