It costs only a few cents but it is currently in short supply: saline solution has become a scarce commodity in German hospitals and pharmacies – but it is still urgently needed for operations, irrigation and infusion procedures. According to North Rhine Chamber of Pharmacists President Thomas Press, the situation has worsened dramatically in recent months.
“What was already a major problem for months in hospitals is now also affecting outpatient care,” he warned the Düsseldorf-based newspaper. Renish post.
North Rhine-Westphalia’s Ministry of Health confirmed that there are supply disruptions. It said that for several months “clinics in North Rhine-Westphalia and Germany received only 80% of requirements” and recently this has fallen to around 50%. According to the Federal Institute for Medicines and Medical Devices (BfArM), the situation will continue for the coming months.
Especially the lack of antibiotics
Germany has experienced frequent shortages of medicines in recent years, particularly antibiotics and children’s medicine. Consequences are dire: a survey of members of the German pediatric professional association (BVKJ) in the spring of 2024 found that about a third believed that the quality of treatment was at risk.
The survey also found that treatment takes longer because doctors have to check in advance what drugs are available. According to the German Association of Pharmacists (DAV), problems have already arisen for around 500 different prescription drugs.
Other EU countries are also affected by the shortage. According to the 2023 survey conducted by the Pharmaceutical Group of the European Union (PGEU)The situation has worsened in several member states, including Sweden, Portugal and Spain.
Active ingredients from China and India
The reasons for the shortage are complex, as is drug production. While Germany, home to pharmaceutical giants such as Bayer, BASF, Boehringer Ingelheim and BioNTech, was once considered the “pharmaceutical of the world,” manufacturing now takes place worldwide. Supply chains are long and prone to disruption.
Most of the active ingredients are now produced in China and India. Not only are wages lower here, but environmental regulations are less stringent than in the EU. Mass production and monopolies have focused on making drugs cheaper. So, a small number of suppliers produce large quantities all the time.
“While we used to have 10 suppliers of paracetamol syrup for fever, today there is only one main supplier,” Professor David Francas, a supply chain expert at Worms University of Applied Sciences, explained to DW.
“That’s why we’re only dependent on a few manufacturers. And if one of them stops, the whole supply chain stops,” said Professor Ulrich Holzgrab, an expert in medicinal and medicinal chemistry at the University of Würzburg.
“If there are small disasters along the supply route, such as a closed port in Shanghai during the Covid-19 pandemic or a ship blocking the Suez Canal, the goods don’t reach us,” she told DW.
Just in time production does not help
Limited inventory and just-in-time production only exacerbate the problem when temporary shortfalls in the production line are not compensated for. But experts believe that it is difficult to maintain again. Storage facilities cost money and it is never certain that stored drugs will actually be sold.
Fluctuations in demand are huge: during the COVID-19 pandemic, for example, demand in Infectopharm fell as widespread mask wearing led to sharp declines in several other infectious diseases. The company had to get rid of expensive antibiotic juice for children because they couldn’t sell it. Two years later, the demand increased again.
The price problem is particularly acute with generics, which account for 70 to 80% of the basic drug supply. “The margins for producing these types of products are very low,” Holzgrab said. Manufacturers are required to produce as cheaply as possible by rebate agreements and other deals that were introduced into the German healthcare system a few years ago.
Although many have applied, it will be difficult to bring production back fully to the EU. One reason is that it would be complicated to produce the chemicals needed for the active ingredients. “We’ve created environmental laws that make that almost impossible,” Holzgrab said.
Even if it is possible, it will not be a solution for next winter. “Rebuilding production facilities will take at least five years,” Francis said.
This article is translated from German.
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