The Logistics of Medicines in Mexico: Between Public Centralization and Private Efficiency

The pharmaceutical sector represents around 14.5 billion dollars annually, making it the second-largest market in Latin America. Yet the real challenge lies in ensuring that every treatment arrives on time, under the right conditions, and to the right place.

Over the past few years, the country has undergone profound changes in how medicines are distributed. The rise and fall of the INSABI (Institute of Health for Wellbeing), the withdrawal and eventual return of private distributors to public supply chains, and the inauguration of the “Megafarmacia del Bienestar” in late 2023 have all marked a turbulent period in Mexico’s health system. At the same time, the private sector has continued to provide key infrastructure, innovation, and efficiency in last-mile delivery.

The challenge is enormous: a nation of 130 million people, spread across vast urban centers and remote rural communities, requires both the universal coverage of the state and the operational efficiency of private companies.

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The Regulatory Framework: A Tight Net of Rules and Standards

The distribution of medicines in Mexico is highly regulated. Standards such as NOM-059-SSA1-2015 (good manufacturing and storage practices), NOM-072-SSA1-2012 (labeling and conservation requirements), and NOM-073-SSA1-2015 (stability studies) establish the basic rules to safeguard drug quality from production to delivery.

In 2023, COFEPRIS (the Federal Commission for Protection against Sanitary Risk) issued guidelines for Good Distribution Practices (GDP) aligned with the World Health Organization. These guidelines demand:

●     Full traceability of every batch.

●     Contingency plans for cold-chain failures.

●     Rigorous evaluation of logistics providers.

●     Preventive maintenance of equipment and facilities.

On the international stage, Mexico has adopted certifications such as IATA’s CEIV Pharma for air cargo and the European GDP standards. These certifications are more than technical checkmarks, they are trust markers that open doors to global supply chains. On the other hand, non-compliance can mean severe consequences: warehouse closures, suspended operations, or multimillion-peso losses in inventories.

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The Cold Chain: A Critical Link

More than 30% of medicines require strict refrigeration conditions. Vaccines, biologics, and insulin must be kept between 2–8 °C, while others need storage at -20 °C. Any deviation can render them useless.

To manage this, both public and private actors have invested in:

●     Validated cold rooms following DQ, IQ, OQ, and PQ protocols.

●     IoT sensors and dataloggers for real-time monitoring, with instant alerts for deviations.

●     Advanced packaging capable of preserving temperature for up to seven days.

●     Redundant systems such as backup generators and dual sensors.

The COVID-19 pandemic accelerated the adoption of these technologies. Today, the system is more robust, but vulnerabilities remain, especially in remote regions where maintaining the cold chain is still a challenge.

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Public vs. Private: Strengths and Weaknesses

The Public Sector

Institutions such as IMSS-Bienestar, ISSSTE, and Birmex supply hospitals and public clinics. In December 2023, the government inaugurated the Megafarmacia del Bienestar in Huehuetoca, a 95,000 m² warehouse with space for 286 million units, envisioned as a national hub to solve shortages.

Yet audits in 2024 revealed over 36 million expired medicines in public warehouses, with financial losses exceeding 2.3 billion pesos. These findings expose weaknesses in planning, inventory rotation, and logistics management.

The Private Sector

Distributors like Nadro, Marzam, and Grupo Fármacos Especializados control about 50% of the private market and supply more than 25,000 pharmacies and private hospitals. Their distribution centers feature WMS/TMS systems, refrigerated storage, batch traceability, and practices such as FEFO (First Expire, First Out) to reduce waste.

Global logistics companies such as DHL, UPS Healthcare, and FedEx also bring international certifications and expertise in handling high-value products. But their main challenge lies insecurity: cargo theft has become increasingly common on highways, forcing companies to invest in GPS tracking, secure routes, and escorts.

The Unresolved Question: How Can Mexico Guarantee That No Patient Is Left Without Treatment?

Mexico’s recent experience shows that neither total centralization nor full privatization is asustainable solution. The way forward lies in a hybrid model, where the state ensures universal coverage and oversight, while private actors provide efficiency, speed, and innovation.

Three key priorities stand out:

1. Transparency and traceability: implement unit-level serialization and national information systems.
2. Technology and training: invest in IoT, digital management platforms, and specialized workforce training.
3. Balanced infrastructure: combine the Megapharmacy with regional warehouses and public-private partnerships.
      
      

The goal is straightforward yet critical: no patient should have to go without treatment, no batch should expire forgotten in a warehouse, and Mexico must be ready to respond to future health crises with resilience and fairness.