DÜSSELDORF Whether cancer drugs, blood pressure medicine or antibiotics, consumers are affected by an increasing number of supply shortages in Germany. The result can lead to higher costs for the patient.
Sometimes it's antibiotics, sometimes it's painkillers or high blood pressure medicine - in Germany, important medications are increasingly unavailable. "There are currently 226 reports of limited availability or a delivery problem," said the spokeswoman for the Federal Institute for Drugs and Medical Devices (Bfarm) in Bonn to our editorial team. This is a continuing trend: In 2013 manufacturers reported 40 supply shortages, last year there were already 264. "In the past there were isolated shortages, today pharmacies have on average considerably more than 100 items which are not available", says Thomas Preis, head of the Pharmacists' Association of North Rhine-Westphalia. "Sometimes a certain dosage is missing, sometimes a certain form of drug, sometimes the entire active ingredient.”
Classics such as the painkiller ibuprofen are also affected: "Delivery shortages for ibuprofen AL 400, 600 and 800 film-coated tablets have been reported," the authorities announced. "Also small packs are often not available”, says Preis. Although ibuprofen is offered by dozens of companies, the active ingredient is only produced by six manufacturers worldwide. This summer, a problem from 2018 threatens to reoccur. "Last year, there were shortfalls in allergy emergency syringes, which people need for wasp stings. They were not available for weeks. Now stocks in pharmacies are again becoming scarce," says pharmacist Preis.
In the case of five reported supply shortages, the Federal Institute is taking a closer look because there is only one product license holder or manufacturer. One of these shortages is for the cancer drug Erwinase. In the event of supply shortages, pharmacies and doctors seek alternative medications, but they may have more side effects, the changeover may take time and sometimes it costs a lot of money. A well-known example is the high blood pressure medication Valsartan. This is a case where nearly all generic drug manufacturers can no longer supply the medication, according to the pharmacist federation. It is only available from the manufacturer of the expensive original drug. The consequence: “Patients must pay nearly 100 euros more a month in order to continue to receive the medication,” says Preis.
The reason is that the Chinese supplier of the active ingredient has quality problems and the generic manufacturers no longer receive the active substance. According to Preis, many active ingredients are produced in India, China or Israel and are only pressed into tablets and packaged by German manufacturers. In addition, the demand for drugs is increasing worldwide. "Particularly in the case of a monopoly of an active ingredient manufacturer, there is an increased risk of shortage," warns the authority. According to the pharmacists, discount contracts with some health insurance companies also contribute to this, with insured persons only allowed to use blood pressure reducers from selected manufacturers.
The AOK federal association admits that some local health insurance providers have contracts with only one manufacturer: "This makes higher discounts possible than when many different manufacturers are involved. This also benefits our members," explained the AOK spokesperson. However, this is generally speaking not a problem, as the selected manufacturer has more planning security and has to commit to always guarantee the supply. "Supply shortages have nothing to do with discount contracts, the main reason for the problems is the manufacturers' relocation of production abroad.” Orig. text: Antje Hönnige Translation: Carol Kloeppel