Abstract
Traditional centralised manufacturing offers efficient economies and broad market reach but faces increasing limitations with the rise of complex products requiring rapid localised delivery and greater supply chain resilience. The logistics demands of hospital-compounded therapies expose vulnerabilities in existing infrastructure, accentuating the need for rigorous evaluation of alternative paradigms. This study investigates the comparative performance of centralised and decentralised pharmaceutical manufacturing models, applying an agent-based simulation framework designed for specialised or time-sensitive drug product orders. The work implements an agent-based simulation to model both centralised and decentralised scenarios using key structural, resource, and demand parameters identified within the supply chain ecosystem. Comparison criteria include labour requirements, sustainability (as measured by environmental emissions and operational efficiency), and end-to-end supply chain lead times, informed by the geospatial distribution of manufacturers, hospitals, and clinics. The centralised case considers a single facility supplying major hospitals and several clinics from a designated hub, while the decentralised case models multiple smaller production sites supplying care centres more directly. Demand frequency, emergency inventory buffers, personnel allocations, and practical constraints are explicitly built into the simulation inputs. Preliminary simulation results reveal trade-offs between manufacturing paradigms across multiple performance dimensions. The decentralised model shows potential advantages in reducing supply chain lead times and improving responsiveness to localised demand surges, while the centralised model demonstrates efficiency gains in resource utilisation under steady-state conditions. The framework enables quantitative comparison of throughput, cost implications, delivery timeliness, and system resilience under varied operational scenarios. These findings will inform strategic design decisions for patient-centric and resilient pharmaceutical supply chains, facilitating adoption of flexible models capable of meeting modern healthcare delivery needs within the medicines manufacturing and supply ecosystem.