Drug shortages are likely to become chronic
Published: Tuesday, Jun 25th 2024, 10:10
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Medicines are always in short supply in Switzerland. Politicians are alarmed. However, there is no real solution in sight.
Switzerland saw a peak in the shortage situation at the beginning of last year, when almost 1000 medicines were out of stock. The media went into overdrive at the time and politicians also took up the issue.
The problem has been known for years. However, it has never been as acute as it has been recently. As an analysis by the news agency AWP of data from the online portal "drugshortage.ch" shows, just over 600 medicines are currently out of stock.
Suddenly children affected
For Pierre Voirol, Deputy Chief Pharmacist at the Centre Hospitalier Universitaire Vaudois (CHUV), the increased attention to the topic is also due to the fact that the shortage now affects a larger group of patients.
"To put it somewhat cynically, when it came to shortages of medicines for the elderly, politicians didn't care too much," he says in an interview with the news agency AWP. "But when it started to affect their spouses and children, as with the shortage of ibuprofen for children a year and a half ago, it suddenly became a real problem."
Many reasons
The reasons for these shortages are complex. Many of them have to do with globalization and a society trimmed for efficiency and profit. For example, a large proportion of the active ingredients used in drug production come from China, India, the USA and the UK. Modern supply chain concepts such as "just-in-time" delivery are also among the causes, as the FOPH recently wrote.
"In this extremely strained system, the smallest grain of sand in the gears, the smallest rejected batch, can lead to an interruption in supply," says Voirol from CHUV. The system was further strained by the outbreak of the war in Ukraine. Ukraine is considered an important supplier of pharmaceutical packaging and parts thereof.
The biggest problem with this situation was that it was not clear to many of those involved where exactly a new bottleneck was looming or already existed. This not only affects patients, but also doctors and pharmacies, who are constantly faced with challenges.
List launched
This led Enea Martinelli, hospital pharmacist and member of the board of the Pharmacists' Association, to launch the website "drugshortage.ch". Until then, there was no comparable overview of which medicines were currently in short supply. Although the Federal Office for National Economic Supply (FONES) also has a list, it primarily covers essential medicines.
Martinelli operates the site on its own initiative, with numerous manufacturers reporting supply shortages on their own initiative. The Geneva University Hospital (HUG) and the online pharmacy Zur Rose also provide platforms for drug shortages.
Recognizing the bottlenecks is a first step. Then we need to look at which medicines are important for Switzerland and look for solutions, Martinelli demands. He refers to France, which has drawn up such a list. "We have not yet completed this task because no one feels responsible for it and that is a problem."
You can't produce it yourself
Voirol also uses neighboring France as an example. Paracetamol, for example, is once again being produced in France. Meanwhile, Christoph Metzler, Head of Market at the Galenica division Galexis, does not believe that this is a path that will be taken in this country.
This is because many of the medicines that are difficult or impossible to obtain tend to be in the low-price range. "It's simply not profitable for the companies based here to produce medicines for which they receive perhaps 70 centimes a pack," he says in an interview with AWP. Entire production lines should therefore not be brought back.
One option that is available to hospitals in particular and which they can use to relieve acute supply pressure is to go into production themselves. Hospitals are able to produce certain medicines themselves to a certain extent.
Better procurement
Another option is to source abroad, says Christian Henseler, Head of Strategic Purchasing at the online pharmacy Zur Rose. Or you can use an alternative product that contains the same active ingredient.
It is also possible to counteract the persistent bottleneck to some extent through warehousing. However, this will not solve the problem, because some medicines also have very complex storage requirements.
People will probably have to come to terms with the fact that certain medicines will simply not be available in the future. "A process of adaptation is taking place - but a certain resignation can also be observed," summarizes Henseler.
Nevertheless, politicians have also recognized the need for action. In just a few weeks, the Federal Council is to decide on certain sub-projects that should lead to better care in Switzerland. In addition to closer international networking, aspects include stockpiling and incentives for the production of vital medicines.
For pharmacist Martinelli, this is crucial: "It is important that even a small country like Switzerland does not simply give up, but continues to look for solutions."
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