Pharmacists in the Region, like those in all of Spain, suffer from a growing shortage that the Ministry is trying to tackle
Just as it happened with masks or respirators, the pandemic has exposed the latent problem of the health industry to guarantee stocks of all medicines in Spain. Although similar episodes had occurred in previous years, several factors explain the shortage of certain medicines suffered by pharmacies this 2022. On the one hand, the closure of Asian laboratories, due to the draconian anti-Covid measures established by governments such as the Chinese, and the collapse of the ports of that continent, where a large part of the production of medicines has been relocated for decades. On the other hand, the fact that some pharmaceutical companies have stopped producing certain drugs because they are sold so cheaply that they no longer provide benefits.
In addition, geopolitical instability, with the war in Ukraine as the most prominent event, has caused specific distortions in supply chains that may increase in the coming years if some key countries in the complex manufacturing process of medicines (specialized producers of early assets, packaging experts or logistics key points) suffer from internal conflicts. For now, it has not been a serious problem because pharmacists offer alternatives that have a similar composition, but the Ministry of Health, together with the Spanish Agency for Medicines and Health Products (Aemps), has established a list of 508 strategic drugs , which contain 264 active principles, which have been granted special protection.
In the wake of the World Health Organization (WHO) and the European Commission, which have identified a global problem of lack of certain medicines, Aemps defines strategic medicines as “a subgroup of critical medicines for which it is considered It is necessary to adopt additional measures, whether regulatory, economic or of another nature, to guarantee its maintenance in the market, both because of its need for basic health care and because of the vulnerability of its supply chain”. And the main measure is to bring its production closer. The Ministry of Health has adopted initiatives “aimed at the regulatory protection of these drugs, stimulating the interest of the national pharmaceutical industry in their manufacture and marketing and promoting their authorization in Spain.”
Europe has been losing the production of many active ingredients in favor of China and India
Amoxicillin, an antibiotic used mainly in children, has suffered supply problems this fall, but it does not appear on the list of strategic medicines prepared by Health, which in any case is open to updates. Diazepam does, which is marketed under the name Valium and is intended to treat anxiety or sedate, among other uses, and also includes fentanyl citrate (for patients with chronic cancer pain), sodium heparin (to stop thrombi) or nitroglycerin (a vasodilator used in heart attacks and heart failure).
long term vision
In its latest report, published this summer, Aemps notes that drug supply problems have grown by 38% in just one year. Specifically, 1,105 drug presentations, more than 3% of those available, have suffered some incident between January and June 2022. «The lack of certain drugs is a problem that will not disappear, and it is good that we have information about it », highlights the vice president of the General Council of Pharmaceutical Colleges, Juan Pedro Rísquez. “Currently, in 90% of cases, the pharmacist can replace the drug with another similar one, but we need to have a long-term vision,” says Rísquez.
In the Region of Murcia, the College of Pharmacists asks for “tools to be able to change pharmaceutical forms, for example, from sachets to tablets, or to syrup”, when there is a shortage. The vice-president of the College, José Miguel Ruiz, stresses that the work of pharmacists is “to give peace of mind and safety to the patient, and seek solutions with doctors.” The Murcian Health Service (SMS) has implemented some measures, such as the activation of alerts in the electronic prescription system in amoxicillin presentations of which there are no ‘stocks’.
The situation in Asia is now the main cause for concern. “If the Covid-19 spreads and that continent closes drastically, the whole world will suffer supply problems,” they point out from the pharmaceutical sector. Farmaindustria stresses that during the pandemic the production of medicines in Spain was “accelerated” “with contingency plans that allowed the capacity of the plants to be increased” and, in addition, it prevented “the import chain from other countries” from breaking. “In any case, the lessons learned advise strengthening the strategic capacities for the production of essential medicines,” highlights the employers’ association of pharmaceutical companies.
According to their data, Spain has 82 drug factories for human use, although they only manufacture some essential drugs. Most of them are produced in China and India. “Europe has been losing the production of many active ingredients and also of many of these medicines in favor of those countries,” they state, and although they admit that it is impossible for Spain, or any country, to be “totally autonomous” in manufacturing essential medicines, They do believe that there is a possibility, thanks to European funds, to “recover part of the production.”
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