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This new case study shows how an operationally complex global pharmaceutical company based in Hyderabad, India, responds to the challenges of high demand variability and other uncertainties. It reviews operations spanning the entire pharmaceutical supply chain, including development, manufacturing, drug formulation, and packaging; its 20 manufacturing plants throughout India; and export operations to 40+ countries worldwide. Throughout, it focuses on realistic issues and challenges, offering exceptional value to both students and practitioners. Authors: Sourabh Bhattacharya, Surajit Ghosh Dastidar; both from The Institute of Management Technology.