Drug shortages in German hospitals

Pharmaceutical manufacturers cope with delivery bottlenecks

21/12/2012

After media reports have pointed to supply shortages of medicines in hospitals across Germany, now also the drug manufacturers admitted in a letter to the policy that there are difficulties in the supply of medicines. This confession linked the pharmaceutical companies with some indirect demands on the policy. For example, they are opposed to the currently discussed obligation to increase the stocks of important medicines to be kept.

In fact, according to information from drug manufacturers, there are difficulties in supplying hospitals with individual medicines, although not every supply shortage leads to gaps in supply. In a letter to federal and state health politicians, pharmaceutical companies presented their situation and explained the current problems with, among other things, the unexpectedly high demand for pharmaceuticals, quality problems in production and limited production capacities. Also insist „Increasing cost pressure in the pharmaceutical sector, the manufacturers to use all possibilities of increasing the efficiency of manufacturing“ force, quotes the „Frankfurter Rundschau“ from the letter of the drug manufacturers. The Federal Ministry of Health has meanwhile begun talks with pharmacists and doctors to clarify the causes of drug supply shortages.

Clinics need to resort to alternative medicines
In a recent study of the German Hospital Association, a delivery bottleneck was found on average for 25 medicines per month at 100 hospitals surveyed. This mainly concerned cancer drugs and antibiotics. Up to six percent of the drugs in the clinics had corresponding delivery bottlenecks. In most cases, the physicians could fall back on alternative drugs, but these do not always ensure the same quality of treatment, report the study authors. Thus, in twenty percent of the cases, the alternative drug did not correspond qualitatively to the drug originally intended. They contained different active ingredients, which may jeopardize the safety of the therapy. Also with the supply bottlenecks an increased organizational effort is connected. In addition, sudden supply bottlenecks could lead to significant cost increases, as replacement must be procured at short notice.

Massive criticism of the arguments of the pharmaceutical manufacturers
In view of the investigation by the German Hospital Association, pharmaceutical manufacturers were left with no other option but to limit the supply bottlenecks for the pharmaceuticals. However, with the justifications that have been made, companies have blamed themselves and blamed external causes such as unexpectedly high demand or increasing cost pressure. The companies were forced to use all possibilities of efficiency increase in the production, which led to the concentration on few manufacturers and the relocation of production to low-priced locations outside the European Union. The renowned health economist Professor Gerd Glaeske from the University of Bremen practiced against the „Bavarian Radio“ massive criticism of the argument of the pharmaceutical manufacturers. In particular, the expert critically assessed the relocation of production abroad. „The cost-effective manufacturers are far away, but the just-in-time principle often does not work if the manufacturers are based in China or India“, so Prof. Glaeske. In his view, one should „actually assume that a pharmaceutical company works only with manufacturing companies who can deliver reliably.“ Also, the now discovered supply bottlenecks are not a new problem. For years, clinics have regularly struggled with bottlenecks in individual medicines.

Delivery bottlenecks in the hospitals unacceptable
In the face of bottlenecks in the supply of medicines, there has also been a demand from politicians for a legal requirement for drug manufacturers to oblige the latter to "keep a larger supply of medicines". A demand that encounters massive resistance in the pharmaceutical lobby. If stockpiling becomes compulsory, this would entail increased costs for manufacturers. For example, manufacturers may completely refrain from licensing low-cost medicines, which would further degrade the quality of care, the pharmaceutical industry warns. However, the demand of the policy seems quite understandable, because unlike ordinary products, delivery bottlenecks for medicines in terms of patient health are unacceptable. For example, if the desired shoes can not be delivered at Christmas, this is not a major problem. If the required anticancer drug is missing in a hospital, this may have fatal consequences. Here a solution must be found as quickly as possible, in order to avoid corresponding supply bottlenecks in the future. (Fp)

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Drug shortages in hospitals

Picture: Rita Thielen