Pharmacies and health insurance companies are currently complaining about delivery bottlenecks. Around 300 medicines are currently in short supply, including antihypertensives, fever syrups and cancer therapies. We explain what’s behind it – and how the problem could be solved.
“It’s not available right now” – patients hear this sentence again and again in the pharmacy when they stand there with their prescription. Around 300 medicines are currently scarce in Germany.
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When drugs are scarce, they are on the list of the Federal Institute for Drugs and Medical Devices (BfArM) in Germany. However, this is by no means complete. In addition, only prescription drugs that are considered particularly relevant to care are listed.
When asked by FOCUS online, Daniela Hänel, pharmacist and chairwoman of the independent pharmacist association, confirmed: “Medicines that make it onto the BfArM list, i.e. that are not available, are just the tip of the iceberg, or active ingredients for which the pharmacy, despite efforts, cannot offer any goods or alternatives.” One example is the month-long non-deliverability of drugs containing the active ingredient tamoxifen. “Thousands of women have not been able to continue their breast cancer treatment as prescribed.”
Helmut Renz, chief pharmacist at the University Hospital Rechts der Isar, also reports in a press release that it affects drugs for all indication groups. The situation is explosive, especially in the hospital, because he and his team have to ensure that patients are supplied with vital medicines.
In the list of the BfArM, the column “Type of reason” contains either “Production problem” or mostly “Other”. Renz and Hänel give somewhat more precise reasons.
Contact us if you are also affected by the delivery bottlenecks. Write to us about the medication and how it is handled in the pharmacies and practices. How are you with that? Do you feel sufficiently informed? You can send your experiences to gesundheit@focus.de.
Reasons for the shortage include the corona pandemic and the Ukraine war. Because both crises show how dependent we are on other countries. Renz explains: “There were supply bottlenecks for medicines before that, but they became very clear during the corona pandemic. This has been a problem for pharmacies for a long time and is a major burden for us. You are faced with new surprises almost every day, which is currently not available or only available to a limited extent.”
According to colleague Hänel, this leads to the unavailability of medicines
The active ingredients are now mainly manufactured in the Far East, especially in China and India. If factories are closed there because of Corona or freighters are no longer allowed to call at the ports, even those finished medicines that are manufactured in Europe will ultimately be missing from the shelves of local pharmacies. Sometimes deliveries cannot be used because of contamination, explains Hans-Peter Hubmann, Vice President of the German Association of Pharmacists.
In addition: “Since the manufacturers also do not keep stocks, due to cost minimization and the motto ‘just in time’, supply bottlenecks can no longer be compensated for,” explains Hänel.
According to Hänel, the situation, which has been critical for years, has been exacerbated by another factor: during the pandemic, in the lockdown, drug sales and sales plummeted. Due to the lack of contact, people were less sick, but rather stayed healthy. The pharmaceutical industry then reduced its production.
Because they measure the production volume based on the sales of the previous year and order the raw materials accordingly. “That’s why many large pharmaceutical manufacturers can’t double or triple production all at once because the increased demand is suddenly there,” says the pharmacist. “In addition, there are the increased energy and transport costs.”
A National Reserve: With medicines in short supply, some are calling for a “national reserve” of these. Hänel thinks this makes sense, especially for antibiotics. “In addition, the manufacturers should keep a certain reserve and be obliged to report a bottleneck in good time,” the pharmacist suggests.
Strengthen national supply chains: According to experts, however, our dependence on other countries is particularly problematic. In May, a study by the German Economic Institute (IW) and the Healthcare Supply Chain Institute commissioned by the vfa showed that the USA and Europe are heavily dependent on Asian active ingredient manufacturers. 68 percent of the production sites for active ingredients destined for Europe are now in Asia.
The authors of the vfa study therefore recommend a combination of different measures to systematically strengthen the national supply chains in the field of drug production:
If certain medicines are not available, Christian Splett, deputy press spokesman for the Federal Union of German Pharmacists’ Associations (ABDA), explains that alternative medicines from other manufacturers are available in pharmacies. When filling the prescription, the pharmacies could check whether another preparation that is available could be considered for an exchange. The basis for this, however, is the “Sars-CoV-2 Drug Supply Ordinance”. It gives pharmacies more leeway to issue replacement drugs with the same active ingredient.
As an example of everyday hospital life, pharmacist Renz reports that they have always been able to ensure the supply of the hospital.
It is possible to one
In many cases, this is annoying for those affected and often involves additional work for the pharmacies. But it also means: There is currently no reason to panic.
Important to know: At the moment there are for the most frequently prescribed in Germany
This is fundamentally to be distinguished from delivery bottlenecks. Because in many cases drugs can be replaced by others with the same active ingredient.
A spokeswoman for Techniker Krankenkasse confirms that there is currently “a real shortage in the market” for none of the active ingredients in the top 10 drugs. “That means: For all medicines there are other products that are used as alternatives with the same active ingredient.” In general, she points out that stocking up on medicines also causes difficulties in supply.
This is also emphasized by Martin Scherer, Director of the Institute and Polyclinic for General Medicine at the University Hospital Hamburg-Eppendorf and President of the German Society for General Medicine and Family Medicine (DEGAM) in an interview with FOCUS online. “We don’t currently see any problems with the vital medicines,” says Scherer. “Patients are not undersupplied.” Hamsters, on the other hand, would be against any principle of solidarity.