Medicine shortages tripled between 2005 and 2010 in some countries, and continues to worsen, with growing concerns for the serious potential of future medicine shortages worldwide.
Shortages occur when:
- There is only a single, or very few, suppliers of a key ingredient;
- When countries don’t manufacture domestically;
- Quality standards become ever more stringent; or
- When a country has limited economic capacity (as seen in Greece’s economic crisis).
Shortages also arise from increased demand, when newer therapies are more effective, the ageing population needs more, from shortages of related products, or as prescribing guidelines change (such as the penicillin G spike in Australian hospitals, which the sole provider couldn’t satisfy).
An array of stakeholders from across the globe recently gathered at the International Summit on Medicines Shortage to examine the various causes and to propose solutions. These included national formularies, however improved demand predictability could create monopoly markets with diverse negative consequences. Market forces don’t always protect supply; seen when protamine sulphate production in China was ceased as manufacturers reacted to a large price reduction.
The Summit concluded with six major recommendations:
- Make information about medicine shortages publicly accessible in a timely manner;
- Identify and list critical/vulnerable products for each country;
- Develop procurement processes to facilitate continuity of supply;
- Align transparent regulatory practices within and between countries;
- Appoint one national body to provide guidance, and to gather and disseminate information globally; and
- Develop evidence-based risk management strategies for supply continuity.
They observed that “medicines should not be considered as ordinary commodities of trade” and that medicinal social goals can’t always be achieved in a free market.
- Besançon L, Chaar B. Report of the International Summit on Medicines Shortage; 2013 June 20-21; Toronto, Canada. The Hague: International Pharmaceutical Federation; 2013.