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Medicine shortages

Generic medicines have proven to be pivotal in increasing patient access and preventing medicine shortages through increased choice and availability of treatments. However, generic medicines policies have recently focused exclusively on reducing prices thereby increasing the risk of medicine shortages.

The sustainability of healthcare budgets in Europe has been intensely pressured by multiple factors, such as a growing and ageing population, an increased disease burden, the introduction and increased cost of new innovative medicines[1],[2],[3]. To overcome these challenges, several national authorities have adopted austerity measures and applied short-term cost-containment measures to pharmaceuticals, including to generic medicines despite their low cost (around 4% of total healthcare expenditure in Europe) and their relevance for care (62% of medicines dispensed today in Europe are generic medicines).  Short-term cost-cutting measures, such as ad-hoc price cuts, external reference pricing, payback, tendering, etc. have driven the prices of some off-patent medicines to unsustainably low levels. This causes manufacturers of generic medicines to withdraw from the market, resulting in the increased risk of medicine shortages[4],[5],[6]. The evidence now shows that many national markets across Europe are relying on too few suppliers for essential life-saving medicines in both the hospital and ambulatory sectors. Tackling medicines shortages in a multi-source context, requires an approach that addresses both the root causes of medicines shortages and mitigates medicine shortages once they occur. Addressing the economic causes of shortages to ensure market predictability and competition, improving regulatory efficiency, improving transparency in supply chain and a proper and controlled communication are important measures to tackle medicine shortages. Please find more information on Medicines for Europe key recommendations to tackle medicines shortages here and the Economist Intelligence Unit report on medicine shortages here.

Industry Supply Chain Resilience (Damien Holly – Sandoz – December 2020)
Executive letter
Position paper
Addressing the root causes of medicines shortages
The Economist Intelligence Unit report “Addressing medicine shortages in Europe”
Infographic: Medicines Shortages: Causes and Recommendations
Infographic: Medicines Shortages: Causes and Recommendations Explained

Medicine Shortages Webinar: Damian Holly, Supply Chain Resilience Overview presentation

Procurement and security of supply

Joint procurement

[1] The Parliament Magazine. 2015. Available at:-

[2] Eurostat Population Statistics

[3] OECD, Fiscal Sustainability of Health Systems: Bridging Health and Finance Perspectives. 2015.

[4] SFK (Foundation for Pharmaceutical Statistics), Pharmaceutisch Weekblad. 2014.

[5] APM Health 2015. Available at:

[6] QuintilesIMS Health. An International Comparison of Best Practice Approaches to Drug Shortages. 2015.