A review of the article of “Sustainable pharmaceutical procurement" with the argument model and the Socratic Method for MBA students

A review of the article of “Sustainable pharmaceutical procurement" with the argument model and the Socratic Method for MBA students

 

How to describe the article in Harvard reference format?

Jahre, M., van Oorschot, K., Årdal, C., Sverrisson, E., Pettersen, M.S. and Wangen, A., 2026. Sustainable pharmaceutical procurement: Environmental tendering criteria for better or worse?. Journal of Purchasing and Supply Management, 32, p.101081. https://doi.org/10.1016/j.pursup.2025.101081 [Accessed 4 October 2025].

 

Highlight the main research issues and research objectives, 2 main academic theories used and the main research methods used in this article.

Based on the article "Sustainable pharmaceutical procurement: Environmental tendering criteria for better or worse?" by Jahre et al. (2026), here is a summary of the requested information:

Main Research Issues:

• The environmental challenges in pharmaceutical supply chains, especially related to manufacturing and disposal of antibiotics causing antimicrobial resistance (AMR).
• The potential unintended consequences of including environmental criteria in pharmaceutical procurement, specifically concerns about higher costs leading to market exit by suppliers and subsequent medicine shortages.
• The complexity and dynamics involved in pharmaceutical tendering processes balancing price, environmental criteria, supply security, and transparency.

Research Objective:

• To advance knowledge of the effects of using environmental criteria in the tendering and procurement of pharmaceuticals, particularly generic antibiotics.
• To understand how introducing environmental criteria in pharmaceutical procurement influences the market in terms of price and availability.
• To explore both intended and unintended short- and long-term effects of including environmental criteria in procurement decisions.

Two Main Academic Theories Used:

1.    Supply Chain Risk Management (SCRM) Theory: Used to understand causes of shortages and potential solutions by examining demand, manufacturing, and upstream supply risks.

2.    Sustainability and Procurement Theory: Specifically, green public procurement and sustainable purchasing integrating environmental criteria into supplier selection and contract management.

Main Research Methods Used:

• A longitudinal, qualitative case study of the Norwegian Hospital Procurement Trust from 2016 to 2023 focusing on the development and implementation of environmental criteria in antibiotic procurement.
• Data collection involved 44 semi-structured interviews with 38 interviewees from various stakeholders (manufacturers, distributors, governmental agencies, procurement organizations), document analysis (77 documents including policy and tender documents), workshops, meetings, and secondary quantitative data on prices and supply.
• Analytical approaches included systematic combining of theory and data, axial coding to develop hierarchical themes, and causal loop diagramming (CLD) to visualize dynamic feedback loops and interrelationships between concepts such as prices, supply base, transparency, shortages, and environmental criteria.

This approach allowed for an in-depth understanding of both the structural and behavioral aspects of including environmental criteria in pharmaceutical procurement.

 

Describe 2 main empirical findings of the article.

The two main empirical findings from the study on sustainable pharmaceutical procurement with environmental tendering criteria are:

1.    Balancing Environmental Criteria with Price Does Not Reduce Supplier Attractiveness or Increase Shortages:

• Contrary to initial fears, rewarding environmental criteria fulfillment while placing less emphasis on the lowest price did not lead to a less attractive market for suppliers.
• Higher prices paid due to environmental criteria caused increased public spending in the short term but helped maintain or stabilize the supply base of generic antibiotics.
• Maintaining a healthy supplier base helped prevent medicine shortages, which is critical for patient treatment and reducing antimicrobial resistance risks by avoiding substitutive use of broad-spectrum antibiotics.
• This finding shows that environmental criteria can be incorporated without exacerbating the existing shortage problems in antibiotics procurement.

2.    Increased Transparency into Supplier Risks as an Unexpected Positive Outcome:

• The introduction of environmental criteria fostered more extensive discussions and data exchange about suppliers’ environmental sustainability practices.
• This process enhanced upstream transparency regarding supplier risks, such as geographic vulnerabilities and production practices, which was previously difficult to capture.
• This increased transparency improves risk management and supports better-informed procurement decisions beyond just environmental concerns.
• Importantly, this effect reverses much of the prior focus in the literature that transparency primarily drives sustainability; here, sustainability criteria themselves drive increased transparency, with beneficial effects on supply chain robustness and sustainability.

These two findings highlight that including environmental criteria can lead to positive systemic effects on pharmaceutical supply chain sustainability, risk management, and public health outcomes over both the short and long term

 

Describe 3 main claims of the article in terms of Toulmin's model of argument and then provide a critical review of the article using the Socratic Method.

Below are three main claims from the article framed using Toulmin's model of argument (Claim, Data, Warrant), followed by a critical review through the Socratic Method.

---

1. Claim 1:

Including environmental criteria in the procurement of generic antibiotics does not reduce the attractiveness of the market for suppliers and helps prevent shortages.

• Data: The case study found that despite higher prices resulting from rewarding environmental practices, the supply base was maintained rather than shrinking. Interviewees initially feared supplier exit but reported that suppliers remained engaged, helping to avoid shortages.
• Warrant: If prices paid are higher due to environmental criteria, suppliers gain necessary compensation for investments in green practices, which maintains their market participation and the robustness of supply chains.

---

2. Claim 2:

Introducing environmental criteria in pharmaceutical procurement increases transparency about supplier risks, enabling better supply chain resilience management.

• Data: Tendering processes requiring firms to disclose production sites and environmental practices improved the procurer's knowledge of geographic concentration, sole providers, and supply vulnerabilities. Procurement teams obtained better visibility into supply chains and associated risks.
• Warrant: Environmental criteria force suppliers to reveal previously confidential information, thus improving transparency, which is critical to managing risks and reducing vulnerability in supply chains.

---

3. Claim 3:

Long-term focus on environmental criteria in antibiotic procurement is expected to reduce antimicrobial resistance (AMR), thereby improving public health and lowering healthcare costs.

• Data: Interviewees expressed expectations that environmental improvements at production sites reduce pollution of antibiotics into the environment, which is a key factor driving AMR development. Certification schemes like those from BSI Group corroborate this approach.
• Warrant: Reducing antibiotic pollution lowers the environmental stimulation of resistant bacteria, which decreases AMR transmission rates, leading to better health outcomes and ultimately reducing healthcare expenditures.

---

Critical Review Using the Socratic Method

1.    What assumptions underlie the claim that environmental criteria do not reduce supplier attractiveness?

• The article assumes suppliers are willing to engage if compensated with higher prices and that the procurement context in Norway is representative. How might these findings differ in markets with different regulatory or economic conditions?

2.    Could higher prices in the short term eventually lead to market exit if public budgets become strained?

• The short-term increase in public spending is acknowledged, but is the sustainability of budgetary support for higher prices addressed fully? What if political will changes?

3.    Does increased transparency necessarily lead to better supply chain resilience?

• Transparency uncovers risks, but does the procuring organization have sufficient capacity, knowledge, and tools to act effectively on this information to manage risk?

4.    How generalizable are findings from Norway, a small country with specific procurement laws, to other countries with larger or more fragmented pharmaceutical markets?

• The study notes limited transferability and calls for further research. How might different market structures influence the effectiveness of environmental criteria?

5.    What evidence supports expectation that reduced pollution leads to measurable reductions in AMR?

• The article relies on interviewees’ expectations and external certification schemes. Are there quantitative data linking procurement changes to AMR trends, or is this an assumption requiring more evidence?

6.    What potential unintended consequences might arise from increased environmental criteria that are not fully explored?

• For example, could focusing on environmental factors inadvertently favor larger manufacturers and reduce supplier diversity over time?

7.    How might conflicts between the goals of cost containment, environmental sustainability, and supply security be effectively reconciled in procurement policy?

• The article highlights tension between price and environment but does not fully address possible trade-offs or decision-making frameworks beyond the MEAT criteria.

---

Summary: The article provides valuable empirical insights into the effects of environmental criteria on pharmaceutical procurement, highlighting positive effects on supply security and transparency. However, the generalizability, the assumptions about supplier behaviors under higher prices, the long-term sustainability of increased costs, and the causal link to AMR reduction could be further interrogated and empirically substantiated. Further comparative studies and quantitative outcome measures are needed to strengthen confidence in these conclusions across different contexts and over longer periods.

 

Describe 2 main research limitations of the article.

Two main research limitations of the article are:

1.    Limited Generalizability Due to Single-Country, Single-Case Study Design: The study is a longitudinal single case study focused on the Norwegian Hospital Procurement Trust's procurement of generic antibiotics. As noted by the authors, findings from this context may not readily transfer to other countries or procurement systems with different regulatory environments, market structures, or healthcare contexts. The authors themselves acknowledge that more studies are needed to identify whether the findings hold in other contexts, limiting the external validity of the conclusions.

2.    Potential Bias from Procurer’s Involvement and Subjective Data Sources: One of the key individuals from the procuring organization (SI) became a co-author and was deeply involved in the study, granting access to data that might have been otherwise unavailable. While this provided rich, detailed insights, it may have introduced bias or limited critical distance. Additionally, much of the qualitative data rely on interviews and self-reports, which can be influenced by the interviewees' perspectives and interests, potentially affecting objectivity and the representation of supplier or public viewpoints.

These limitations suggest that while the study offers important exploratory insights, its findings should be corroborated by further multi-contextual research using varied methodologies.