News: Drug shortages arise in the Netherlands
The number of drug shortages in the Netherlands has risen to a record high in 2022 – reports the Royal Dutch Society for the Promotion of Pharmacie (KNMP Pharmaco). The association comes to a number of 1,514 in the past year, compared to 1007 in 2021.
Aris Prins of the pharmacist organization KNMP calls the increase of up to 50 percent alarming. ‘At the same time, anyway, now that the government is demanding that additional stocks be built up. It is important that everyone adheres to this. This is absolutely necessary, because patients, pharmacists and other healthcare providers move an extraordinary amount of this every day.‘
Drug shortages can have a major impact. Because they affect a large group of people, are long-lasting, or because any other length of time is complicated for patients. Notable drug shortages in 2022 included methylphenidate tablets, benzbromarone tablets, oxytocin injection fluid, clobazam tablets and chloramphenicol eye drops.
(Source KNMP – 2023)
Aris Prins (1977) Chairman KNMP
Additional stock. In order to limit medicine shortages as much as possible, a policy in effect obliging wholesalers and marketing authorization holders to maintain ‘sufficient stock’ of medicines. The Health and Youth Care Inspectorate (IGJ) monitors this policy rule. To give companies the opportunity to meet the requirements as laid down in the policy rule, 2023 is seen as a transition year. The IGJ indicates that in principle they will not yet be enforced on the stock obligation.
The policy rule stipulates that marketing authorization holders must keep a stock of six weeks for UR medicines, for wholesalers this is two weeks from 1 January 2023 and ultimately four weeks from 1 July 2023. Figures from KNMP Farmanco show that the average duration of a drug shortage in 2022 is 91 days. 57 percent of shortages are resolved within ten weeks.
(Source KNMP Farmanco – 2023)
The number of drug shortages in the Netherlands between 2004-2022. In 2022 it was 1,514. This is the highest number of shortages that Farmanco has ever recorded in a year. 10% of the shortages concern products that have been withdrawn from the market
Medication specialist. In practice, Dutch pharmacists manage to come up with a solution for the patient in more than 99% of the cases with a lot of art and flying. By offering, preparing or importing another product with the same active ingredient or a therapeutic alternative. Pharmacists and their team do their utmost every day to help patients, says Prins. Half an FTE per community pharmacy is working on the problem. The Netherlands has 2,000 public pharmacies. This means a solid undertaking for the profession. The shortages of medicines also play a major role for pharmacists in hospitals.
Prince: ‘We stand for good pharmaceutical care. If the prescriber designates an active substance, the pharmacist, as a medication specialist, can very well find the right resources. We owe this to the high level of pharmaceutical care in the Netherlands.‘
Europe. The KNMP is working on a confirmation of the production of medicines to be brought back to Europe. Prince: ‘We are vulnerable. The Netherlands is dependent on distant countries such as China and India.‘ As far as the KNMP is concerned, another option is a modernization of the purchasing policy. Once the prices are this low, and they are now, several resources can be designated as preferred for a longer period of time.‘
Cause. Drug shortages mainly arise from problems with production, distribution and quality. There are also economic reasons. Our country is not an attractive sales area due to the low prices for manufacturers and the limited number of inhabitants. KNMP Farmanco maps out the medicine shortages on a daily basis for the pharmacist organisation. If a medicine is not available nationwide for at least fourteen days, KNMP Farmanco notes a new shortage for the annual overview. Reports by pharmacists are verified by the manufacturers. Farmanco has been keeping statistics on medicine shortages in the Netherlands for 19 years. Look at here also the infographic of this theme. Look at here Farmanco’s overview of all medicine shortages in the Netherlands