The paper addresses the optimal design of the last branch of the pharmaceutical supply chain, i.e., the hospital drug distribution chain (HDDC), starting from suppliers till the patients of a department. Considering a distributed healthcare system composed of different stages connected by medicine and information links labeled with suitable performance indices, a procedure employing digraph modeling and mixed integer linear programming is presented to select the (sub)optimal HDDC configuration. The optimization model is applied under structural constraints to a case study describing an Italian healthcare regional distribution chain. The problem solution provides different HDDC structures allowing the improvement of the healthcare supply chain flexibility and performance
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