The shortage of medicines is entrenched in Spanish pharmacies

The drug supply problems of the spanish pharmacies have worsened in recent years. This Friday, January 27, the number of active supply problems has reached a total of 674. In 2018, the Spanish Agency for Medicines and Health Products (AEMPS) registered a total of affected references of only 250 and 536 at the end of 2019. In four years the increase in shortage it has been 169% without clear reasons for it. Wholesale distributors and laboratories they are behind a complex situation shielded both by commercial and industrial reasons.

For example, two affected products are popular cholesterol and blood pressure drugs: simvastatin and telmisartan. According to the AEMPS, the normalization of the supply is not expected until March, and in some cases until June, but there are treatment alternatives, so it is not considered a general health alert. The list of products is varied. Daparox, Cholestagel, Budesonide, Cytarabine, Iberogast… or aspirin or paracetamol, for example. The AEMPS It notes on its website that “there are other medicines with the same active ingredients and for the same route of administration”, or that “it can be requested as a foreign medicine”, or that “alternative treatments not subject to prescription” are marketed. Or simply that it is a “temporary shortage”.

According to AEMPS, the supply problem “It is a situation in which the available units of a medication in the pharmaceutical channel are lower than the consumption needs”, which is generally due to “manufacturing or distribution problems”. The problem does not pose a health risk, since there are treatment alternatives. In addition, each pharmacy seeks to solve its specific stock problems with multiple commercial ties with distributors that supply them with product several times a day. For some time now, pharmacies have joined cooperatives or various distribution companies (usually up to three for each point of sale), thereby minimizing dependence on the storage capacity of a single wholesaler.

If a pharmaceutical laboratory (holder of the marketing authorization for the drug, TAC) perceives that any abnormal restriction may occur in the supply of his drugs, he is obliged to notify the AEMPS in advance. The health authorities of the autonomous communities also collaborate in the early detection and communication of these problems.

Pharmacies have become relatively used to the situation and recognize that they solve the supply problem with therapeutic alternatives. In 10% of cases they acknowledge that they have to refer the patient to the primary care service so that the doctor can assess the situation and seek alternative treatment.

The pharmaceutical industry has repeatedly proposed that the public sector encourage the production of basic pharmaceutical principles in Spain to minimize distribution problems. The Strategic Plan for the Pharmaceutical Industry agreed at the end of last year should minimize stock-outs in pharmacies. Within the framework of a public-private collaboration, the idea is to promote a solid innovation ecosystem and a sustained investment in health that allows rapid and equitable access to new treatments and consolidates supplies.

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Within the framework of this general plan, the pharmaceutical industry announced in December 2022 investments of more than 8,000 million euros in Spain in the next three years to promote biomedical research, digitization and the strategic production of medicines. It is this last aspect that should improve the provision of basic principles. Support for the competitiveness of the pharmaceutical industry will be included in the priorities of the Spanish Presidency of the Council of the EU in 2023.

Despite these efforts, pharmaceutical firms are free to scale the production and sales of their products in Europe. For this reason, these occasional shortages of specific products can be consolidated as a result of the fact that prices can fluctuate in the different EU countries, which discourages their sale in certain markets in favor of others.