Hospital pharmacies: massive supply shortages

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Health risk: delivery bottlenecks in the clinics

Apparently, numerous clinics in Germany are struggling with supply shortages of important medicines. Ulrike Ott, chairwoman of the regional association of German hospital pharmacists in Rhineland-Palatinate, therefore raises the alarm. According to their information, the hospitals in the country "have to resort to alternative preparations in order to be able to care for the patients." In the meantime, the Federal Ministry of Health has also intervened. It is currently being discussed whether a central registration register for drug shortages will be set up.

For a year and a half "we have been busy getting replacement medication," complains Ott, who also manages the in-house pharmacy at Koblenz-Montabaur Clinic. In 2012, 20 out of 900 medicines per month had delivery problems. The number of delivery bottlenecks has more than tripled in the past two years, the expert said.

Therapies are being changed due to delivery bottlenecks
The difficult situation requires a high degree of flexibility from the doctors. Often, the drug regulations within the scope of the therapies would have to be adapted to the medication inventory in a short time. But that doesn't work without risks. Ott sees "drug therapy safety no longer exists" because the drugs are constantly changing. Conversely, this obviously also means a risk for the patient.

The chairman of the regional association of German hospital pharmacists in Saarland, Manfred Haber, is similarly alarmed. The in-house pharmacies would still be able to alleviate the supply bottlenecks by procuring alternative preparations, but "if the situation worsens, the safety of therapy for patients can suffer in the long term because the standards of the hospitals are mixed up," warned Haber.

However, Lutz Vogel, president of the Baden-Württemberg hospital pharmacists, is less worried. In his opinion, the clinic pharmacies could compensate for the bottlenecks with a sufficient number of alternative preparations. For this reason, he also does not expect that "for the foreseeable future there will be impairments for the patient". However, in some cases, the provision of alternative therapy in individual patient cases is "significantly more difficult".

Above all, cancer drugs, antibiotics and heart medication are affected
The hospitals in Berlin or Brandenburg report little to no difficulties. The clinics in North Rhine-Westphalia, Mecklenburg-Western Pomerania and Saxony-Anhalt report major delivery bottlenecks. A spokesman for the Saxony-Anhalt Chamber of Pharmacies reports: "At the end of 2012, the situation was sometimes catastrophic and dramatic". In particular, drugs for the therapy of diseases of the cardiovascular system or cancer are affected by the bottlenecks. Antibiotic agents were also partially affected. Medicines for outpatient medicine were also increasingly affected. Here the spokesman 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 numerous countries. "Only a few production sites are still being concentrated," reports the spokesman for the University Hospital in Gießen and Marburg, Frank Steibli. In principle, that is not yet the problem. However, if there are problems with the quality of individual drugs, it is now hardly possible to switch to other manufacturers.

Legislators should act
Therefore, numerous hospital pharmacies require legal requirements so that the problem can be solved promptly. "Legislators should oblige pharmaceutical companies to improve long-term preservation," is one of these demands. Because in order to save costs, many manufacturers have reduced their bearings to a minimum. However, a drug reserve restricted to Germany is controversial. With such a central reserve "we take the manufacturers' responsibility even further off," emphasized Hartmut Eggers, Chairman of the State Association of German Hospital Pharmacists in Mecklenburg-Western Pomerania.

It is still unclear how the Federal Ministry of Health will decide. The first reports on this have already started with all parties involved, as the media report. Clinical pharmacists are running out of time to ensure that patient care remains secure. (sb)

Photo credit: Michael Bührke /

Author and source information

Video: How The. Is Dealing With A Medical Supply Shortage. NPR

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