For the second consecutive year, concerns over product safety and protection were high on the list of challenges facing key health care supply chain executives, according to a survey conducted on behalf of UPS Inc.

The fifth annual survey, "Pain in the (Supply) Chain," took the pulse of 375 senior-level decision makers in the United States, Western Europe, Asia, and Latin America who oversaw supply chain and logistics at companies in four health care segments. Of those, 57 percent said their chief supply chain concern was securing their products and ensuring their integrity.

Concerns over product security and integrity were more prevalent in emerging markets than in developed ones. In many emerging markets, those were the leading concerns of supply chain managers, according to the survey, which was taken in April and May of this year.

In 2008, only 13 percent of health care decision makers cited "security" as a supply chain issue. That number rose to 40 percent in 2010 and spiked to 61 percent last year before leveling off in 2012.

Concerns about product safety and protection could be rising as health care firms extend their reach into far-flung markets where transportation, storage, and distribution present unprecedented difficulties for supply chains.

With the advent of globalization, health care executives have "reported growing concerns around the areas of product protection and intellectual property protection," UPS said in a statement accompanying the report. "Product protection concerns include both product security and the issue of product damage and spoilage. Concerns around intellectual property protection have grown every year for the past three years."

More than 83 percent of respondents said their top two strategic initiatives involve expanding into global markets and investing in new technologies.

The top overall supply chain concern—as cited by 65 percent of respondents—was regulatory compliance. That was followed at 60 percent by cost containment issues. Only 41 percent of the respondents said they've been able to successfully manage their supply chain costs, according to the survey.