Medicine manufacturers, including companies producing medicines domestically, are getting paid up to four times as much for their products abroad than in Ireland, new analysis shows.
The authors of the Medicine Shortages Index, Azure Pharmaceuticals, also identified that medicine shortages have further worsened, with the number of medicines now out-of-stock standing at 224, an increase of 12 medicines in seven days (at 11 January). Among the additional medicines to go out-of-stock in the past week are Phenytoin which is used to treat epilepsy.
Azure has analysed the average prices paid for 10 essential mainstream medicines by Irish, UK and European governments (see table below).
Its analysis shows that, on average, the UK and EU member governments are paying twice as much to manufacturers than the comparative prices that the Irish government/industry agreement allows. Some countries are paying up to four times more than Ireland, giving rise to serious shortages for patients here as manufacturers choose to maximise returns through supplying higher price markets.
The Medicines Shortage Index
Azure is currently not supplying any of the above medicines to the Irish market.
The UK government and the majority of the 27 EU member state governments have taken specific measures in response to the escalating medicine shortage issue. This includes, changes to medicine pricing rules, stockpiling of key products, the introduction of an export ban of key drugs, and provision of additional powers to pharmacists. To date, the Department of Health is yet to meaningfully respond to this deepening challenge.
In less than a decade, we have gone full circle on what we pay for mainstream medicines with Ireland now paying substantially less than neighbouring countries for a range of medicines. As a result, manufacturers are choosing to supply their medicines to those countries who will pay better prices. This in turn gives rise to growing medicines shortages and discontinuations here with patients unable to source the medicines they need. We are paying the price for not paying the price.
The government appears to be at best misinformed and at worst, in denial about the root cause of this worsening problem. Changing legislation to give extra powers to pharmacists should form a key part of a package of solutions, but that alone will not resolve matters. The price we pay, and a medicines pricing agreement that is no longer fit-for-purpose, is at the heart of this issue.Sandra Gannon, Managing Director of Azure Pharmaceuticals
“The HPRA has a co-ordinating role to manage shortages but is can only respond with regulatory measures, as it acknowledged itself in a statement this week. This issue requires a mix of actions by the Department of Health. To date, that has been lacking.”
40% of the medicines out of stock this month in Ireland have just a single supplier, leaving pharmacists without licensed alternatives for patients. It also leaves Ireland out of sync with the rest of Europe, with a recently published European Commission report showing the EU wide singled-sourced average standing at 25%.
The Medicine Shortage Index, compiled by Azure Pharmaceuticals, is informed by publicly available information on current medicine shortages supplied by the Health Products Regulatory Authority (HPRA). Analysis based on latest data evaluated as of 11 January 2023. The average EU price is calculated on the basis of the reimbursement prices for seven EU countries that are publicly available—Denmark, Finland, Italy, Netherlands, Portugal, Spain and Sweden.