Medicine shortages!

21 February 2023 - World Economic Forum

There are medicine shortages across the world –especially generics including antibiotics. Why is this happening now and how can we ensure supply?

When seasonal bugs have you running to the clinic or pharmacy for medicines to bring down your temperature or soothe your child's cough, it can be frightening to hear that they can't help you because they are out of stock. Europe, for instance, is experiencing shortages of common medicines. In a survey of medicine shortages carried out between 14 November and 31 December 2022 by the Pharmaceutical Group of the European Union (EU), 100% of the 29 member countries reported experiencing shortages of medicines among community pharmacists and 76% said that shortages were worse than the previous year, 2021. About 79% of respondents reported shortages of anti-infectives for systemic use; while 76% found it difficult to get hold of drugs for respiratory problems; and a range of other conditions, including cardiovascular and gastrointestinal were also highlighted.

But medicine shortages are not unique to the EU region. The UK is experiencing an HRT shortage. US hospitals are reporting supply problems with liquid ibuprofen; while a sudden increase in ADHD diagnoses in the US has led to an unexpected shortage in the drugs used to treat it there. In Mexico, chronic medicine shortages are so dire that many prescriptions couldn't be fulfilled in 2022, while across Asia, sudden supply drops were linked to disruptions in China and in Australia, the TGA has confirmed various shortages have been seen, and rural areas may be worst affected.

There are several reasons for the medicine shortages. COVID-19 lockdowns limited the normal circulation of seasonal bugs. This weakened our immune systems and led to higher-than-normal outbreaks of seasonal illnesses, which has increased the annual average demand for medicines that should alleviate them. Pharmaceutical companies could not quickly meet these unexpected demands, as excess capacity is limited to control costs.

Meanwhile, the war in Ukraine continues to impact supply chains and the knock-on effect of high inflation and energy prices have hit generic drug manufacturers, who are sometimes subjected to pricing regulations, particularly hard.

Furthermore, to protect their limited medicine supplies, some countries have temporarily blocked the parallel trade of medicines to other countries. And, once an over-the-counter drug shortage is announced on the news, consumers begin stockpiling.

There is also the problem of over-prescribing. It is estimated, for example, that the UK's National Health Service loses as much as £300 million a year due to unused or partially used medication that cannot be recycled or re-used.

Some medicine shortages are down to misallocation, with some areas of a country being over-supplied with a particular medicine and other areas experiencing shortfalls. The effective use of data and analytics is key to helping to improve access to medicines globally and better-managing supply and demand to pharmacies and individual patients. The National Academies, for example, recently raised the concept of a public database on medical supplies.

As documented in a 2020 USP report, 'Increasing transparency in the medicines supply chain', real-time data from pharmacies and hospital systems would provide a better understanding of the demand for medical products. It states: "These considerations could include strategies for leveraging electronic health records to enable hospital systems or clinics to report information about medical product demand, without disclosing protected patient information." Improved access to critical data could also unlock opportunities with artificial intelligence (AI) / machine learning (ML) to transform supply chain efficiency.