A shortage of EpiPens, vital for people who, for example, get an allergic reaction after a wasp sting or eating nuts. It’s a new chapter when it comes to drug shortages. “There is always another product that is not available. And now we do indeed have a problem with the EpiPen”, sighs Stefan Emmen, pharmacist in Roosendaal and spokesperson on behalf of the pharmacists’ association Midden- en West-Brabant.
“When I order them now, they’re not there. And it’s hard to say when they will.” Pharmacist Emmen tries to get the pens from abroad, but that is not easy. “After all, the demand is great now, given the wasp season.” If you have a pen in your pocket that is actually already expired, don’t throw it away yet,” the pharmacist soberly advises.
Colleague Jan-Willem ten Pas, pharmacist in Uden and chairman of BrabantFarma, an umbrella organization of pharmacists in the Oss, Uden and Veghel region, was not yet fully aware of the problems with the delivery of the EpiPen on Monday morning – just back from vacation. . But our question made him curious. A look into the system in which he can see what the delivery time for certain medicines is, indeed teaches him that the EpiPen is no longer available. And there was an alternative available on Monday morning. On Monday afternoon, he announced that that alternative was no longer available either.
“Certain medicines will not be available again until 2023.”
Ten Pas is now unable to prepare about a hundred prescriptions every day because medicines or certain raw materials are not available. “When it comes to a few days it is still manageable. But when I look in the system, I now see that certain medicines will only be available again in 2023.” A problem that, according to his colleague in Roosendaal, pharmacists have been suffering from for much longer.
“The shortage of medicines means that we increasingly have to look for an alternative. That takes a lot of time, but that is not the worst thing. You prefer not to switch medicines,” says Ten Pas. medicines for Parkinson’s patients. “That is very precise. Every change causes problems”, he knows. “Very annoying.”
Light at the end of the tunnel, neither pharmacists really see yet. “Maybe it will be a little better from next year,” they indicate cautiously. They are referring to Health Minister Ernst Kuipers who has decided to draw up a list as of 2023 of medicines for which traders are obliged to keep a stock of two and a half months. That’s going to help. Though it certainly won’t solve all problems.
“As soon as production starts up again after a shortage, the Netherlands is often at the back of the queue.”
The problem is complex, according to the two pharmacists. Drug shortages are caused by problems with production, distribution and quality. “We depend on a number of manufacturers, often in China,” says Ten Pas. There are also economic reasons, he says. “As soon as production starts up again after a shortage, the Netherlands is often at the back of the queue. The Netherlands is not an attractive market for manufacturers due to the low prices for manufacturers and the limited number of inhabitants,” said pharmacists’ organization KNMP about this earlier.
According to the pharmacists, another factor that plays a role is the preferential policy of health insurers. This means that they only reimburse the cheapest variant of certain medicines. “I understand that health insurers have a budget to monitor. And that has also paid off: the costs of medicines have fallen. But we need each other now to solve this complex problem. Working on mutual trust between health insurers and pharmacists is therefore necessary now more than ever,” says Ten Pas.
“People don’t understand and I get that to a certain extent.”
Especially because, in addition to the medicine shortage, another problem looms for pharmacists: a staff shortage. Motivated by an aging population, but also because aggression at the counter is a reason for pharmacy assistants to stop. This was shown by a recent KNMP study. Emmen and Ten Pas also sometimes have to deal with angry and rude patients at the counter.
They cite the unavailability of certain medicines as the main cause of frustration. In this way, the drug shortage also causes problems. “People don’t understand. And I understand that to a certain extent,” Emmen says.
Are you in trouble now that the EpiPen is out of stock? Let us know.