Missing cold chain data in MediLedger’s blockchain pharmaceutical supply chain raises concerns about temperature-sensitive drug integrity. MediLedger, designed to enhance transparency and compliance with the Drug Supply Chain Security Act, tracks drugs using blockchain but lacks robust cold chain monitoring. Temperature deviations, costing $35 billion annually, can degrade vaccines and insulin. Smart contracts could enforce real-time quality checks, halting distribution if breaches occur, yet current implementations fall short. Integrating IoT sensors and zero-knowledge proofs could address data gaps while ensuring privacy. Collaborative efforts with industry leaders like Pfizer and Cardinal Health are crucial to develop interoperable solutions, ensuring patient safety and regulatory compliance without compromising sensitive data.