Medicine shortages in the EU: causes and solutions 

 
 

Find out why there is a shortage of medicines, the impact of the coronavirus pandemic and how Parliament wants to improve the situation.

The Covid-19 health crisis has highlighted a growing problem: shortages of medicines and medical equipment that put patients at risk and national health systems under pressure.


In April 2020, the European University Hospital Alliance warned that rising demand in intensive care units for certain anaesthetics, antibiotics, muscle relaxants and medicines used in a way they were not originally approved for to treat Covid-19 could mean stocks run out.


Decreased production, logistical problems, export bans and stockpiling due to the health crisis further increased the risk of bottlenecks.


On 14 July, Parliament’s environment and publich health committee adopted a report calling for European health “independence” by securing supplies, restoring local drug manufacturing and ensuring better EU coordination of national health strategies.


What causes medicine shortages?


Between 2000 and 2018, shortages in the EU increased 20-fold and according to a note by the European Commission are rising for widely used essential products.

More than 50%  ; Medicines to treat cancer, infections and disorders of the nervous system (epilepsy, Parkinson’s) account for more than half of those in short supply

The reasons are complex, ranging from manufacturing problems, industry quotas, legal parallel trade and unexpected peaks in demand following epidemics or natural disasters to pricing, which is decided at national level.


The EU is increasingly dependent on non-EU countries - mainly India and China - when it comes to the production of active pharmaceutical ingredients, chemical raw materials and medicines.


The geopolitical dimension of medicine shortages 
  • 80% of active pharmaceutical ingredients are sourced from India and China 
  • 40% of finished medicines sold in Europe come from China and India 
  • China and India produce 60% of the world’s paracetamol, 90% of its penicillin and 50% of its ibuprofen 

What solutions is Parliament proposing?


The report by the environment and public health committee identifies three areas for action:


  • A return to EU independence, securing supplies of medicine and equipment
  • Stronger EU coordination, complementing national measures to guarantee affordable and high-quality health services
  • Closer cooperation between EU countries

MEPs have welcomed the new programme EU4Health, aiming to make medicines and medical equipment more available and call for more action at European level to tackle shortages, developing innovative and coordinated health strategies, including the further use of joint EU procurement of medicines.


The report calls for the following steps:


  • Identify potential production sites for EU pharmaceutical manufacturing, giving priority to essential and strategic medicines
  • Introduce financial incentives to encourage producers to locate in Europe
  • Create an EU contingency reserve of medicines of strategic importance, which would function as “an emergency European pharmacy”, reducing the risk of shortages
  • Exchange good practices in stock management, ensure transparency and just distribution
  • Use innovative digital tools to share information about shortages
  • Facilitate the movement of medicines between EU countries
  • Support investment in research

Parliament had already called for better traceability of research and development costs, public funding and market expenditure to make medicines more affordable in a resolution adopted in 2017.


The Commission issued guidelines to tackle shortages due to the coronavirus outbreak in April. It called on member states to lift export bans and avoid stockpiling; increase and reorganise production; ensure optimal use in hospitals by reallocating stocks; consider alternative medicines; and optimise sales in pharmacies.


EU pharmaceutical strategy


The report calls on the Commission to address the issue of medicine availability and accessibility and import dependency in the upcoming EU pharmaceutical strategy.


It is expected to propose measures to help improve and accelerate access to safe and affordable medicines, support innovation in the EU pharmaceutical industry, fill market gaps (for exampled new antimicrobials) and reduce direct dependence on raw materials from non-EU countries.


Next steps


MEPs are expected to vote on the report during the September plenary session.