The pharmaceutical supply chain faces critical challenges such as counterfeit drugs, cold chain failures, and poor traceability, posing risks to drug safety and public health. This study proposes an Internet of Things (IoT) enabled Blockchain (BC) framework to enhance transparency, security, and efficiency across the supply chain. The system integrates real-time IoT based monitoring with BC’s immutable, decentralized data storage, leveraging Hyperledger Fabric, InterPlanetary File System (IPFS), and smart contracts for automation and scalability. Tested on a dataset of 10,000 simulated drug units, the framework achieved 98% traceability accuracy, reduced validation time by 94%, and improved counterfeit detection by 92%. Compared to traditional systems, it significantly boosts stakeholder trust, ensures data integrity, and delivers near real-time responsiveness with 1.2-s transaction latency. Additional benefits include reduced logistics costs and improved compliance with regulations like General Data Protection Regulation (GDPR). This paper also discusses key research questions, including comparative performance metrics, architectural design, mathematical modeling, and stakeholder perception. Furthermore, it addresses existing deployment challenges—such as IoT device reliability, smart contract vulnerabilities, and regulatory compliance (RC). Overall, the framework shows strong potential to reshape pharmaceutical logistics with secure, scalable, and intelligent infrastructure.