Medicine Shortages Index hits high of 239 as new supply-chain factors emerge

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Emerging signs of shortages of nasal sprays due to supply chain weakness, with demand increasing before hay fever season

Medicine shortages are likely to worsen without some intervention in the market, according to European pharmaceutical and supply chain experts, as new emerging disruptions and pricing issues affect patients.  

The number of medicines in short supply has hit a new high for the second consecutive week, up by 11 since 27 January, an increase of 34% since October. 13 currently unavailable medicines are listed on the World Medical Organisation’s (WHO) ‘critical medicines’ list. 

The latest shortages analysis indicates an emerging scarcity of commonly used nasal spray products and skin treatments. Among other additional medicines to go into short supply across multiple suppliers in the past week include Ezetimibe, which treats high blood cholesterol, and Lercanidipine used for the treatment of high blood pressure. While many antibiotics and over-the-counter cough and cold medicines are still under pressure. 

The Medicine Shortage Index, prepared by industry experts, Azure Pharmaceuticals, analyses data made publicly available by the Health Products Regulatory Authority (HPRA).    

European experts will speak in Dublin this week at an online event on Thursday, Feb 9, at 11am.

They said emerging supply chain disturbances coupled with pricing factors have seen medicines disappearing from markets across Ireland and Europe.  

Across the majority of the 27 EU member state as well as the UK, governments have taken specific measures in response to the escalating medicine shortage issue. Portugal recently took the measure to increase medicine prices up to 5% in order to secure its medicine supply.   

The issue is caused by many factors in the chain, such as shortages in raw materials, transport costs going up, geopolitical factors such as the war in Ukraine, and a surge in demand for certain medicines due to intensive seasonal epidemics. These more acute factors are further spotlighting systemic weaknesses in the supply chain that have been there for years.
What has changed is that the present crisis has really brought home to people that if you depend on highly globalised, complex supply chains and if something goes wrong, it’s going to have an impact and cause shortages.

Thyra de Jongh,
Lead author of a recent European Commission report on medicine shortages

“Pricing is part of the issue. The link is there in terms of its effect on supply security. Low margins on medicines have changed the structures of supply chains making the whole system more vulnerable.” 

Commenting on emerging medicine output trends that may be felt in the marketplace, Claudio Zurzica, an international medicine supply-chain expert, said:  

Anything that contains a primary packaging container like syringes, or other type of plastic devices used to house pharmaceutical products might see some disruption or delay due to the supply chain repercussions coming through from China during the past few months.
What we see in pharmaceutical supply chain is that disruptions happen because the manufacturing is complicated. There are undoubtedly supply chain reasons for the present medicine shortages, but that factor is mixed with a combination of other reasons like overheads and logistics going up due to geopolitical factors, and also commercial and pricing reasons.

Claudio Zurzica
An international medicine supply-chain expert

Weaknesses in the supply chain highlight the imperative of revisiting the pricing framework for medicines to protect the supply of stock and mitigate the potential for shortages, said Sandra Gannon, CEO of Azure Pharmaceuticals:

“We’re seeing shortages emerging for nasal sprays, in part because of increased demand, but also due to supply issues that are slowly emerging down the chain from manufacturing sites on the other side of the world. There are similar issues with prescription skin treatments, eye drops and creams, many of which come from a single supply source and are reimbursed at such low prices that other suppliers are unwilling to enter such a small market as Ireland.

“One of the means we have to protect our domestic supply of stock of these medicines is through pricing. Portugal has recently taken action to mitigate against situations in which its stocks run out by bringing forward a set of measures to raise its pricing by up to 5% for cheap medicines. 

“The goal of raising prices is to facilitate access to medicines and avoid situations of stocks running out. This would be a direct measure in response to the concerns of healthcare professionals as well as ensuring citizens confidence in the system.”