Navigating Pharma 4.0

This paper investigates real-time monitoring and alert systems to enhance pharmaceutical traceability and patient safety, focusing on the impact of the Internet of Things, the blockchain, and machine learning. It also examines the lack of these systems in the Middle East. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method, literature was reviewed across 63 academic journals to analyze existing research systematically. Effective traceability in Pharma 4.0 is crucial for safety and product integrity, though gaps remain despite technological progress. Real-time monitoring systems are essential, with key challenges including integration, data standardization, compliance, and cost-effectiveness. The study's insights are valuable for industry managers, practitioners, and scholars in pharmaceutical traceability. This research builds on existing work by addressing persistent challenges and emphasizing comprehensive approaches to pharmaceutical traceability, highlighting the need for improved technology in healthcare systems.