Pharmaceuticals and life sciences under pressure: the energy crisis reopens the issue of European dependency

We are therefore not talking about an immediate emergency: for the time being, the institutions exclude emergencies on the supply side, but the issue of shortages remains in the background as a possible consequence of a prolonged shock on the global supply chain and is part of a scenario that needs to be addressed as a whole.

According to the Report on Pharmacies presented by Cittadinanzattiva and Federfarma, more than one in three citizens experienced difficulties in obtaining medicines in the past year, while among chronic patients about one in ten experienced delays incompatible with continuity of care.

Pharmacists report a recurring situation of tension along the supply chain, despite the absence of widespread criticality. Resilience tools such as substitution with equivalents, checking availability with other distributors and recourse to galenic preparations are activated to contain the effects of unavailability.

Farmindustria, too, emphasises that, at present, there are no emergency situations, thanks to the coordination between companies, distributors and institutions through the technical table at the Ministry of Health. However, the sector fears that a continuation of geopolitical tensions could increase supply difficulties, especially for antibiotics, anti-inflammatories and other essential medicines.

The fragility of the European supply chain emerges above all on the active pharmaceutical ingredients front. Over the last twenty years, the production of APIs (Active Pharmaceutical Ingredients) and chemical intermediates has progressively shifted towards Asia, especially to China and India, due to lower production costs.

According to industry estimates, China concentrates a large share of the world's production of active ingredients, while India is a major global generic drug hub. This is why shortages along major shipping lanes could result in critical delays in raw material supplies, increased operating costs and increased pressure on the continuity of production by European companies.

Pierfrancesco Morosini, president of Aschimfarma, the Federchimica association representing the manufacturers of active ingredients and intermediates for the pharmaceutical industry, points precisely to the issue of European industrial and health safety: "In Italia companies producing active pharmaceutical ingredients possess the know-how, technologies and skills to produce many of the molecules that are indispensable for the manufacture of so-called critical drugs, i.e. those at risk of shortages in the event of a supply-chain crisis". With a turnover reaching €5.8 billion in 2025, marking a growth of over 40% compared to 2018 (Aschimfarma-Prometeia survey), the sector represents a fundamental pillar for the Italian and European pharmaceutical industry. However, competition from low-cost selling countries, such as China and India, has shifted purchases in recent years, creating a dependency for Europe and thus making it "more vulnerable". Morosini emphasises 'the need to accelerate the reshoring of the production of critical medicines in Europe, which is a strategic choice, to protect the health of European citizens and to relaunch the competitiveness of a sector of excellence'. A position, that of the association of manufacturers of active ingredients, that was already clear and defined well before the outbreak of the war between the USA and Iran: a shock that may push towards more structural and definitive decisions.

One sector particularly exposed to turbulence is that of equivalent and biosimilar drugs, characterised by very low margins and strong price competition.

Riccardo Zagaria, president of Egualia, warns that geopolitical tensions are generating 'new criticalities in the drug supply chains, affecting both logistics and rising costs along the entire supply chain'. According to the association's findings, the system remains operational but vulnerable. "41% of companies have stocks for only 8-10 weeks. If disruptions in the supply chain were to continue beyond the capacity of current stocks, often life-saving short-term medicines would start to run out," Zagaria explains.

However, even in this case, rather than the immediate risk of empty shelves, the real issue raised by the companies concerns the industrial sustainability of the sector. Egualia, too, has long been calling for structural measures to prevent rising energy, logistics and production costs from making the production of equivalent medicines economically unsustainable.

Demands range from greater European coordination on supply chains to support for industrial investment, tools to limit the impact of energy costs and a review of the mechanisms that currently squeeze the affordability of patent-expired drugs.

The crisis comes at a time when the life sciences sector represents one of the country's most important industrial assets and it is precisely from this crisis that an opportunity may arise. "In the pharmaceutical sector, the issue of industrial sustainability must be tackled realistically: excessive pressure on prices risks shifting production elsewhere. Instead, companies must be able to remain competitive, invest in innovation, and maintain solid production bases in the territory," said Lucia Aleotti, Confindustria vice-president for the Study Centre and member of the board of the Menarini group.

Aleotti pointed out that the Italian life sciences supply chain represents 12.9% of GDP, over 70 billion euro of exports in 2025 with a growth of over 70% compared to 2019, and about 3 billion in R&D investments (15% of the private total), with growth prospects of up to 18% by 2035: a crucial sector that must be valorised and safeguarded.

"The explosion of energy, transport, raw material and material costs is a real bombshell for the industrial system in Italia," he said, and "the pharmaceutical industry, unlike other sectors, does not have the possibility to pass cost increases downstream. If aluminium increases by 100 per cent, that means there is a real challenge in maintaining production'.

The Iranian crisis, in this sense, is functioning as a geopolitical stress test for the entire drug supply chain. And it poses a strategic question to Europe and Italia: if health and drug supply are truly national security assets, how long can the continent afford to depend on production chains located on the other side of the world?

The industry associations call for strengthening European production capacity, reducing dependence on Asia for active ingredients and chemical intermediates, and supporting industrial investments through a more competitiveness-friendly European policy.

Among the dossiers considered crucial are the European Critical Medicines Act, the strengthening of the EU Life Science Strategy and the pathway for Italy to revise the Single Pharmaceutical Law Text.

According to Farmindustria and Federchimica, it is also necessary to overcome a number of elements that undermine the industrial sustainability of the sector: from the payback mechanism to regulatory pressure, and the need to speed up authorisation, clinical research and access to innovation.