More than 600 drugs disappeared from the shelves, shortages alarm in Europe

The impact on patients is significant. All responding EU Member States reported discomfort for patients and almost 9 out of 10 interruptions of treatment.

"For the first time, reduced patient confidence emerges as the most frequent consequence of pharmacists' reported shortages," the report points out, "signalling an erosion of trust in medicines and in the healthcare system itself.

In addition, countries report sub-optimal treatments, increased co-payments, medication errors related to drug switching and, in some cases, adverse events.

The community pharmacies, the report goes on to emphasise, increasingly play the role of shock absorbers within fragile supply chains.

On average, they now devote about 12 hours per week to shortage management: more than twice as much as only five years ago. This includes searching for alternatives, contacting prescribing physicians, advising patients, preventing medication errors and managing administrative tasks. 81% of countries report an increase in administrative burdens and financial losses related to the time invested in shortage mitigation.

For the president of the Pgeu (Pharmaceutical Group of the European Union), Mikołaj Konstanty, "these are no longer isolated incidents, drug shortages are becoming a chronic problem for patients, pharmacists and health systems".

Europe is heavily dependent on non-EU countries, in particular China and India, for the supply of active ingredients and raw materials. Any disruptions in these global supply chains immediately affect the availability of medicines, from manufacturing problems to accidents in production facilities to the withdrawal of batches from the market due to non-compliance with safety requirements.

Increasing production costs (energy, transport), coupled with often locked-in or falling sales prices for generic (off-patent) drugs also make the production of some essential medicines unprofitable for companies, which gradually abandon them.

And, then, there is the phenomenon of parallel trade: drugs are sometimes bought in countries where they cost less (such as Italia) to be resold in markets where prices are higher, taking stocks away from the domestic market

"Community pharmacists ensure continuity of care every day," concludes the Pgeu President, "but resilience cannot be based on the ability of frontline professionals to absorb systemic failures. We must strengthen security of supply, improve predictive capacity and equip pharmacists with the legal and operational tools to act quickly and safely".

For Stefano Collatina, president of Egualia, the number of off-patent medicines has tripled in the last five years, and in many cases these are equivalent medicines or in any case medicines with expired patents, "which represent the backbone of daily therapy for millions of patients and an essential component also for the sustainability of the National Health Service". Their role is also central in hospitals: in fact, it is estimated that around 60% of the drugs used in hospitals are equivalent or off-patent medicines. "This means," Collatina emphasises, "that any difficulties in the availability of these products do not only concern the territorial pharmacy channel, but also risk having direct repercussions on hospital activity and continuity of care. And the situation could worsen with the crisis in the Middle East'.