Journal of Research in Environmental Health

Journal of Research in Environmental Health

Analyzing the Factors Affecting Waste Management in Pharmaceutical Cold Supply Chain (Case of Study: Insulin Supply Chain in Iran)

Authors
Matin Heydari Rostami 1
Shahab Bayatzadeh 2
HamidReza Talaie 3
1 MSc Student of Industrial Management, Department of Industrial Management, Faculty of Management and Accounting, Allameh Tabataba’I University, Tehran, Iran.
2 PhD Student of Industrial Management, Faculty of Industrial Management & Technology, College of Management, University of Tehran, Tehran, Iran.
3 Associate Professor, Department of Industrial Management, Faculty of Administrative Sciences and Economics, Arak University, Arak, Iran.
10.22038/jreh.2026.28093
Abstract
Background and Objective: The pharmaceutical cold supply chain is susceptible to temperature fluctuations and technical failures, and disruptions can lead to drug spoilage and hazardous pharmaceutical waste. This study aimed to identify and prioritize the factors influencing waste management in the cold supply chain of insulin in Iran.

Materials and Methods: This analytical-applied, survey-based research first identified initial factors through a systematic literature review. These factors were then refined using the Fuzzy Delphi method with input from 16 experts, resulting in the confirmation of 12 final factors. Finally, weighting and ranking were performed using the Interval Type-2 Fuzzy Best-Worst Method with the participation of 3 highly experienced experts.

Results: The most important factors, in order of priority, were environmental monitoring and control; technical issues and equipment failure; cold transportation infrastructure; warehousing and storage management; and tracking technologies and blockchain. The technical-technological dimension received the highest weight, followed by the logistical dimension, while the managerial dimension had the lowest weight. Weaknesses in temperature control and equipment performance are mainly responsible for insulin spoilage in Iran.

Conclusion: The primary focus for reducing insulin waste should be on strengthening real-time temperature monitoring, preventive maintenance of cold equipment, and upgrading refrigerated transportation fleets. Managerial and educational factors play a supporting role and will have a limited impact without first addressing technical and logistical infrastructure deficiencies.

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/
Keywords
Cold Supply Chain
Fuzzy Delphi
Interval Type-2 Fuzzy Best-Worst Method
Insulin
Pharmaceutical Waste Management
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