It is more than just an increase in demand that is causing the shortage of essential medicines

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Shortages in medicines, such as those used for treating adverse menopause symptoms, are growing rapidly in Ireland. It is an epidemic that is contributing to the suffering of large segments of the population without any end in sight.

Narratives in both media and politics attribute this growing issue to increased patient demand but, in reality, there are multiple root causes.

Dwindling competition in the marketplace, unattainable reimbursement prices, and shortages of key ingredients are all putting pressure on medicine supplies.

Breaking down the issue

Examining these root causes further, we understand that each of them are intrinsically linked to the other.

  • Ireland’s reimbursement prices for older medicines are among the lowest Europe. This diminishes return on investment and can make it completely unfeasible for pharmaceutical companies to produce some of these older medicines at all.
  • Pharma companies abandoning production leave many medicines, such as HRTs like divigel and lenzetto, with just one supplier. This, in turn, leaves patients totally dependent on one supplier to produce a medicine essential to their daily health and wellbeing. Any snag or delay in production threatens their ability to access this medicine directly.
  • Unfortunately snags and delays are not uncommon as there is widespread unavailability of many active ingredients. Medicines that are made up of active ingredients in scarce supply run a constant risk of ending up on a medicine shortage list. This uncertainty does not encourage pharma companies to restart production, leaving the market without competition and patients without medicine.

Building out a solution

By positioning increase in demand not as the cause of the issue, but merely as an exasperating factor, we can begin to build out a solution. In order to prevent shortages, we must apply a step-by-step plan that addresses each core cause.

Review and approve generic licenses for essential medications like HRT.

Currently there is a sizeable amount of generic licenses waiting to be reviewed by the HSE.  An increase in generic medicines available will revitalize the marketplace and increase competition.

Reexamine the reimbursement prices for older medicines.

Higher reimbursement prices will increase the viability of medicine production, fostering interest in competing pharmaceutical companies.

Revise HPRA’s list of Interchangeable Medicines to include medicines at risk of shortages, to help ensure consistent supply for patients.

Without the presence of products that are dedicated to treating ailments like adverse menopause symptoms, shortages will continue to occur, and women’s health will continue to be compromised.

Moving forward

We are ready to support the government in making the changes to reduce shortages and improve patients’ health. We have contacted the Department of Health and are awaiting a response. To support the sustainable access to essential medicines across Ireland, follow Azure on all digital channels.




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