Medicines are becoming scarce in Switzerland – the medicine bottleneck on 4 points

He sniffs, coughs and has a fever all over the country. But those who drag themselves to a pharmacy with chills may have to go home without any medication to calm them down. Because the shelves in pharmacies all over Switzerland are getting thinner.

And not only since today.

There has been a medicine shortage for quite some time, but the situation is currently escalating. That is what Enea Martinelli, chief pharmacist at the FMI hospitals and board member of the pharmacist association Pharmasuisse, says to Watson.

An overview:

According to Pharmasuisse, many cold, cough and flu medicines are facing a supply shortage due to the rampant flu epidemic. For example, there is a particular question right now Ibuprofen Syrups for children like fever reducer or cough syrup. And also classics for adults, such as neocitranare no longer available in many places.

“We have been warning about the situation for years,” says Martinelli. As a hospital pharmacist, he is regularly confronted with patients who suffer from bottlenecks in the delivery of medicines. In the past, hospitals in particular were affected by drug shortages, for example due to a lack of injection or infusion solutions. And for a number of years, chronically ill patients have also been increasingly bothered by medication passports, for example epileptic, people with Parkinson’s, cancer, mental illness or chronic pain.

And now – due to the seasonal high demand and the simultaneous low supply quantity of flu medication – so the general population faces the problem.

Although the Federal Bureau of National Economic Supply (BWL) maintains a publicly accessible database of medicines that cannot be supplied, only “essential medicines for humans” are listed here. Mentioned are for example antibiotics or Opioids for severe pain.

More than half of the products on this list are subject to mandatory storage, the Federal Public Service of the Interior (FDHA) and the Federal Public Service of Public Health (BAG) write in a February 2022 report.

A more comprehensive online database has been initiated by Martinelli: drugshortage.ch. Manufacturers, doctors or pharmacists can report here if a prescribed medicine cannot be delivered. The list is long – it contains more than 900 positions. More than 360 active ingredients are affected. About a third of these supply shortages lasted longer than a year.

Be on the list more than 8 percent of all medicines that health insurers would reimburse“If they still existed,” says Martinelli.

Drugs that affect the nervous system (such as epilepsy drugs or psychotropic drugs) or the cardiovascular system (such as blood pressure drugs) are most affected by supply bottlenecks. However, Drugshortage.ch also provides information about HIV Medication, or recipe Paracetamol tablets and opioids.

Many drugs are listed on drugshortage.ch as completely sold out. Of these medicines, nearly 420 are on the World Health Organization (WHO) List of Essential Medicines (as of December 29, 2022). Thus, they are recommended to meet the most pressing medical needs of a population. And this number is developing very dynamically, according to Martinelli.

The EDI and BAG report of February 2022 also speaks of an “increase in serious bottlenecks”. vaccines warned. These include those against rabies, diphtheria or tetanus.

And how about an overview of those medicines that you can get directly from the pharmacy for the flu or a cold? Chief pharmacist Martinelli summarizes:

The acute drug bottleneck for over-the-counter drugs is therefore not only exhausting for the sick. It is a gigantic job, especially for the specialized employees behind the pharmacy counter. Nicole Demierre Rossier of Pharmasuisse writes at Watson’s request:

A single particularly affected group cannot be identified. On the contrary, anyone can be affected by a drug shortage – even outside of the flu. Martinelli speaks plainly:

The pharmacist is also concerned about the lack of those medicines survival in the short term. For example, the preparation Actilyse, which is used to treat strokes – and which is currently very scarce worldwide.

But the lack of antibiotics is also problematic. In addition to increasing resistance, some antibiotics are also affected by supply bottlenecks – including those for children. Some of them were missing “across the board,” says Martinelli.

The flu epidemic is sweeping across the country and the lack of flu medication is putting a great strain on the health care system, which is already at its peak.

On the one hand, sick people or parents of sick children are not always given over-the-counter drugs in pharmacies to relieve symptoms or very high fevers. On the other hand, many general practitioners and pediatric practices are currently closed for the holidays or only offer reduced consultation hours. Therefore, for many, the last option is to go to the hospital in an emergency, for example to get fever reducers – or to be admitted due to infections.

Some parents of sick children are feeling another direct consequence of the bottleneck in over-the-counter medications right in their pockets: The bottleneck in ibuprofen syrups has caused some pharmacists to manufacture the drug themselves in the lab. But even when a doctor’s prescription for an ibuprofen syrup is available, sometimes the pharmacist’s replacements have to be paid for by the patient themselves – because not all health insurance companies will take over in this case.

When it comes to prescription drugs, the word “triage” is already on the table. For example, the federal government has restricted the use of the stroke drug Actilyse by regulation. Martinelli says:

But according to the pharmacist, it is mainly the hospitals that are challenged here.

Demierre Rossier believes it is very difficult to predict what long-term consequences the current situation could have. Because “the situation is not limited to Switzerland, it is an international problem”.

The Pharmasuisse spokeswoman reminds that with regard to the long-term consequences, the individual patient should not be forgotten: “It depends on the drug, on the disease and also on the patient.” According to Martinelli, treatment options in Switzerland have been lost in the long term due to the lack of medication, which has been affecting children and elderly patients in particular for several months.

“There are many reasons for these bottlenecks,” says Demierre Rossier. That is an important problem many medical goods are manufactured in Asia for cost reasons. That is why there are supply bottlenecks, because certain active ingredients are due to the long Covid lockdowns in China are simply not available at the moment, writes Demierre Rossier.

Because there are usually only one or two manufacturers of an important component of medicines. If this fails, the entire production will be delayed or made impossible.

In addition China is currently restricting drug exports and there is a general supply shortage due to the Covid-19 pandemic, the war in Ukraine and the energy crisis, the Pharmasuisse spokeswoman said.

A mockery to many sick people: Sometimes medicines cannot be delivered because packaging materials such as cardboard or aluminum foil are missing.

Chief pharmacist Martinelli sees politics as a duty to solve long-term medicine shortages, at least in Switzerland. So far, however, the discussions there have mainly focused on the prices of medicines and not on the availability of the products to patients. You have to keep both in mind, he says.

“There is a bouquet of opportunities to support service providers in the short term in the current situation,” says Martinelli. Among other things, there were no guidelines to simply replace missing medicines with others. Moreover, a look at other countries such as Belgium can show promising approaches that are very active in this field. Because there, pharmacies are allowed to make children’s medicines from medicines for adults – which are then also paid for by the health insurers.

In its February report, the Confederation examined and proposed measures for the long-term supply of medicines in Switzerland. Various politicians from left to right have submitted approaches to the problem. Some have already been dealt with, others are pending.

Martinelli is therefore optimistic. Drug shortages will continue in the future, he says. “But we will learn to manage it better and avoid it.”