Medica Pharmacy: SME survival under ecosystem pressures

Learning outcomes The learning outcomes are as follows: Case overview/synopsis This teaching package comprises two linked cases. Case A was set in the retail pharmacy industry in Ghana from 2011 to 2020. Kofi, a Ghanaian entrepreneur with retail experience in the USA, returned to Accra to build Medica Pharmacy. He secured a superintendent pharmacist, opened the first outlet in Dansoman after a fourteen-month licensing process, and later expanded to a second outlet in Tema using costly bank financing. Over nine years, Medica faced a series of systemic barriers: illegal advance rent demands, overlapping regulatory bodies, slow reimbursements from the National Health Insurance, high interest rates and internal control failures. By August 2020, COVID-related demand shocks and debt servicing pushed the business toward insolvency. Kofi had until Monday morning to decide whether to sell the Tema branch for GHS 85,000 to stabilize cash flow or refuse the offer and take out a family loan to keep both outlets alive. Case B advances to December 2024. After selling Tema and stabilizing the Dansoman location, Kofi faced a second decision: whether to accept a 49% equity partnership offer from HealthBridge Ghana Limited, a larger pharmacy chain, or to remain independent and pursue digitalization through the Ghana Enterprises Agency’s SME Growth and Opportunity Program. By 2024, Medica had returned to modest profitability and reduced its bank debt from GHS 120,000 to GHS 28,000, although liquidity remained tight. The two cases illustrate the transformation arc from crisis survival to strategic renewal within an ecosystem defined by weak institutions. Complexity academic level Target audience: senior undergraduates, MBA students and Executive Education participants in entrepreneurship, strategy and emerging markets courses. Subject code CSS 3: Entrepreneurship.