Table 3.

Economic contextual factors identified affecting PTTSs; no data were retrieved for Denmark and India

Country	Investments	Technical and digital capacities
Turkey	High costs imposed on stakeholders; however, not investing meant no sales, providing sufficient incentive to invest.43
Ethiopia		One of the lowest smartphone ownership rates globally hampered adoption.27
Germany	Minimal investments required.30	Existing healthcare IT was fragmented, but this was well managed thanks to the adjustability of the system.30
Hong Kong	Investments were required, but the effectiveness of the investment was unclear. Implementation was costly, time-consuming and difficult.31	Current technical settings hampered the adoption of technologies.45
Iran		Current ICT structures were insufficient for the application of PTTS technologies.33
Pakistan		The lack of digital inventory management was a key barrier.27
Poland	The proposed implementation required significant investments.34	Pharmacies were not supported by electronic necessities.34
Taiwan	High initial investments were the key barrier to implementation, especially since the eventual benefits were hard to envision.35
UK	Supply chain actors were expected to invest much time and workforce resources.36	Hospitals did not have all technical prerequisites, and hospitals in rural areas might experience problems with their internet connection.36
USA	Investments in terms of finances and staff necessary to implement PTTSs were extensive, and supply chain actors were hesitant of investing.40	Most PTTSs were not interoperable with existing computer systems used by supply chain actors.40

ICT, information and communications technology; IT, information technology; PTTS, pharmaceutical track-and-trace system.