Drug shortages in German clinics

Pharmaceutical manufacturers concede delivery bottlenecks

After media reports drew attention to the supply bottlenecks of medicinal products in hospitals across Germany, the pharmaceutical manufacturers now also admitted in a letter to politicians that there are difficulties with the supply of medicines. The pharmaceutical companies linked this admission with some indirect demands on the politicians. For example, they are opposed to the currently discussed obligation to increase the inventory of important medicines.

Indeed, according to drug manufacturers, there are difficulties in supplying hospitals with individual medicines, although not every delivery bottleneck leads to gaps in supply. In a letter to the health politicians at federal and state level, the pharmaceutical companies explained their situation and justified the current problems, among other things with the unexpectedly high demand for pharmaceuticals, quality problems in production and limited production capacities. There is also "increasing cost pressure in the pharmaceutical sector, forcing manufacturers to use all possible ways of increasing efficiency in production", quotes the "Frankfurter Rundschau" from the letter from the pharmaceutical manufacturers. The Federal Ministry of Health has now started discussions with pharmacists and doctors to clarify the causes of the drug shortages.

Clinics have to switch to alternative medication In a recent study by the German Hospital Society, an average of 25 medicinal products per month was identified as a supply bottleneck for 100 clinics considered. This mainly affected cancer drugs and antibiotics. Corresponding delivery bottlenecks were recorded for up to six percent of the medicinal products in the clinics. In most cases, the physicians were able to use alternative medications, but these do not always guarantee the same quality of treatment, report the study authors. In twenty percent of the cases, the alternative drug did not meet the quality of the originally intended drug. They contained different active ingredients, which could endanger the safety of the therapy. The delivery bottlenecks are also associated with an increased organizational effort. In addition, sudden supply bottlenecks could lead to significant cost increases, as replacements would have to be procured at short notice.

Massive criticism of the arguments of the pharmaceutical manufacturers In view of the investigation by the German Hospital Society, the pharmaceutical manufacturers also had no option but to admit the supply bottlenecks for the pharmaceuticals. With the reasons given, however, the companies have dismissed the blame and blamed external causes, such as the unexpectedly high demand or increasing cost pressure. The companies were forced to use all possibilities to increase the efficiency of the production, which led to the concentration on a few manufacturers and the relocation of the production to inexpensive locations outside the European Union. The renowned health economist Professor Gerd Glaeske from the University of Bremen criticized the arguments of the pharmaceutical manufacturers against the "Bavarian Broadcasting Corporation". 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 located in China or India," said Prof. Glaeske. In his view, one should “actually assume that a pharmaceutical company only works with manufacturing companies that can also deliver reliably.” Also, the delivery bottlenecks that have now been uncovered are not a new problem. For years, the clinics have had to struggle with bottlenecks in individual medicines.

Delivery bottlenecks in the hospitals unacceptable In view of the bottlenecks in the delivery of drugs, politicians have also called for a legal requirement for drug manufacturers to oblige the latter to "keep a larger supply of drugs". A demand that meets with massive resistance in the pharmaceutical lobby. If the stock keeping were to be made mandatory, this would be associated with increased costs for the manufacturers. For example, the pharmaceutical industry warns that manufacturers would possibly completely waive the approval of unprofitable pharmaceuticals, which would further deteriorate the quality of care. However, the demand from politicians seems understandable, because unlike ordinary products, delivery bottlenecks for pharmaceuticals in terms of patient health are unacceptable. If, for example, the desired shoes cannot be delivered at Christmas, this is not a major problem. If the required cancer drug is missing in a hospital, this can have fatal consequences. A solution must be found as quickly as possible to avoid corresponding supply bottlenecks in the future. (fp)

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Drug shortages in hospitals

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