The shortage of medicines in the Netherlands was about 50 percent greater last year than in 2022. That is the highest shortage ever, the pharmacy organization KNMP said on Tuesday.
According to the pharmacists, 2,292 types of medicines were unavailable for at least two weeks in 2023. A year earlier, this still applied to 1,514 medicines. That was already a record at the time.
According to the KNMP, about 5 million of the 13 million Dutch medicine users have been affected by the shortage. The shortages affected patients with conditions as diverse as infections, tetanus, diabetes, epilepsy and cancer. On average, a shortage was resolved within 107 days. That is sixteen days later than in 2022. Almost half of the missing medicines could be delivered again within ten weeks.
Small sales market
The Netherlands has been dealing with major medicine shortages for years. At the end of last month, pharmacists raised the alarm about a shortage of crucial antibiotics. There are various reasons for this: sometimes it is international trade problems that make supply difficult, or there are production stops at factories in India and China where many active ingredients are made.
Other explanations are specific to the Netherlands: because the sales market is relatively small and pharmaceutical companies receive low prices for basic medicines, it is not attractive to produce for the Dutch market. Due to a complex tender system, the price of medicines in the Netherlands has fallen significantly in recent years. In principle, this is nice for the user, but as a result, manufacturers prefer to send ‘rare’ medicines to Germany, for example, if a factory in India shuts down.
In the meantime, the shortage is burdening pharmacy staff. There is a lot of “art and craft” involved in finding alternatives or other brands, according to KNMP chairman Aris Prins. According to him, this takes a lot of time. According to a survey by the organization, many pharmacies have someone working full-time to resolve shortages.
Being forced to switch to another medication also causes anxiety to drug users. Even vulnerable patients on the ‘red list’ of medications that should not be changed are sometimes affected, according to Prins.
The KNMP advocates more production of crucial medicines closer to home. This has been discussed within the European Union for some time, but arranging this is complex and expensive. European drug manufacturers now mainly make niche products, while bulk products such as paracetamol are made in Asia. The KNMP also wants to adjust the financing system, which will give the market a greater role and make it more attractive for producers to produce in the Netherlands.
Buying medicines may become more expensive, but it is important to realize that the shortages also cost a lot of money, Wout Dullaert, professor of supply chain logistics at VU Amsterdam, previously said. NRC. He also pointed out the time that pharmacists and general practitioners spend on alternative treatments when a medicine is not available.
Dullaert previously advocated a new tender system, in which, for example, a medicine is purchased from two suppliers. This way, there is always an alternative flow if problems arise in one chain.