Abstract
Introduction: Utilizing blockchain technology helps to address issues that the supply chain faces, including the intricate connections between chain network members, regulation of the distribution network, and inventory management.
 Objective: To adopt blockchain technology in the drug supply chain, this study aims to offer a multi-stage optimization strategy based on Swara and QFD approaches and a zero-one nonlinear optimization problem employing a fuzzy approach.
 Methods: First, field and library research was conducted to identify the barriers to the adoption of blockchain technology in the drug supply chain and the ways to overcome these barriers. The relevance of the barriers is ascertained using the fuzzy Swara approach following their refinement employing the Friedman test. The output is entered as an input in the house of quality (HOQ) rows, while the barrier-reducing techniques are presented in the columns. These approaches to reducing barriers are arranged in rows in the second phase of the house of quality.
 Results: Among the criteria of the barrier-reduction approach, the Performance Expectancy criterion with a score of 0.0521 has the greatest score, and the criterion of Focusing on the Major Points has the minimum score, as determined by the findings of the fuzzy Swara model. The criterion of Enhancing Transparency with a score of 0.5374 and Reducing Risk with a score of 0.4045 have the maximum, and Sustainability Performance with a score of 0.07 has the minimum score, according to the findings concerning the objectives of blockchain technology adoption in the drug supply chain. The criterion of lack of customers' awareness and attitude about sustainability and blockchain technology has the greatest score among the barriers to adoption, scoring 0.521, and the criterion of difficulty in altering organizational culture, scoring 0.033, has the minimum value.
 Conclusion: Based on the results of the fuzzy house of quality, we concluded that, for the adoption of blockchain technology in the drug supply chain, the eighth (long-term perspective), first (performance expectation), and tenth (focused on the primary strengths) strategies are more beneficial. In addition, it was demonstrated that the second (Effort Expectation), ninth (information sharing), and sixth (Trust) strategies have poor rankings.
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