Hospital pharmacies Massive delivery bottlenecks

Health hazard: supply bottlenecks in the clinics

19/02/2013

Apparently, numerous clinics in Germany are struggling with supply bottlenecks for important medicines. Ulrike Ott, chairwoman of the Association of German Hospital Pharmacists in Rhineland-Palatinate, therefore raises the alarm. According to their information, the hospitals of the country „partly relying on alternative preparations to be able to care for the patients.“ Meanwhile, the Federal Ministry of Health has got involved in the matter. It is currently being discussed whether a central register of drug bottlenecks will be established.

For a year and a half „we are busy getting replacement medicines“, complains Ott, who also runs the in-house pharmacy at Klinikum Koblenz-Montabaur. In 2012, 20 out of 900 medicines per month had delivery problems. The number of delivery bottlenecks has more than tripled in the last two years, according to the expert.

Therapies are being changed due to delivery bottlenecks
Of the doctors, the difficult situation requires a high degree of flexibility. Often the drug prescriptions under the therapies would have to be adjusted to the stock of drugs in a very short time. But that does not work without risks. Ott sees „drug safety no longer exists“, because the medicines change constantly. Conversely, this obviously implies a risk for the patient.

Similarly alarmed is also the chairman of the national association of German hospital pharmacists in the Saarland, Manfred Haber. Still, the in-house pharmacies could cushion the delivery bottlenecks by getting alternative preparations, but „if the situation becomes more severe, patients 'therapeutic safety may suffer in the long term because hospitals' standards are disrupted“, warned Haber.

Less worried is the state chairman of the hospital pharmacist in Baden-Württemberg, Lutz Vogel. In his opinion, the hospital pharmacies could compensate for the bottlenecks with a sufficient number of alternative preparations. For that reason he does not expect that „it will come to harm to the patient for the foreseeable future“. However, in some cases, the care of alternative therapies in individual patient cases „much more difficult“.

Above all, cancer medicines, antibiotics and cardiac drugs are affected
Little or no trouble is reported by the hospitals in Berlin or Brandenburg. The clinics in North Rhine-Westphalia, Mecklenburg-Vorpommern and Saxony-Anhalt reported major supply bottlenecks. A spokesman for the pharmacy chamber Saxony-Anhalt reports: „At the end of 2012, the situation was sometimes catastrophic and dramatic“. In particular, drugs for the treatment of diseases of the cardiovascular system or cancer are affected by the bottlenecks. Also affected was partly antibiotic agents. To an increasing extent, medicines for the outpatient medical sector were also affected. Here the speaker called drugs for the treatment of eye diseases.

The main reason for the situation is the restructuring of the pharmaceutical industry. Companies are reducing the number of locations in many countries. „Only a few production sites will be concentrated“, reports the spokesman of the University of Giessen and Marburg, Frank Steibli. That is not the problem in principle. But if it comes to problems of the quality of individual medicines, a dodge to other manufacturers is now hardly possible.

Legislators should act
Therefore, many hospital pharmacies require legal requirements, so that the problem is resolved promptly. „Legislators should oblige pharmaceutical companies to improve their length“, is one of these demands. Because to save costs, many manufacturers have reduced their storage to a minimum. Controversial, however, is limited to Germany drug reserve. With such a central reserve „Let's take manufacturers even more responsibility away“, emphasized the chairman of the National Association of German Hospital Pharmacists in Mecklenburg-Vorpommern, Hartmut Eggers.

It is still unclear how the Federal Ministry of Health will decide. Initial consultations have already started with all those involved, as reported by the media. On the part of the hospital pharmacists, time is pressing to ensure the care of the patients. (Sb)

Picture credits: Michael Bührke