Carnival worsens supply problems Many pharmaceuticals are currently not available in NRW
Düsseldorf · Düsseldorf. Pharmacies report that almost every second prescription in North Rhine-Westphalia is affected by bottlenecks. In one case, a manufacturer delivers paracetamol juice that was actually intended for Ukraine. Doctors and the federal state are calling for reforms.
Carnival season drives up sickness rates, thus worsening the drug shortage. "Supply bottlenecks are increasing. Of the 100 million prescriptions that are handed in to pharmacies in NRW every year, almost every second one is now affected by a bottleneck," says Thomas Preis, head of the North Rhine Pharmacists' Association. Sometimes the medicine is not available at all, sometimes not in the prescribed dosage or dosage form. There is still a shortage of important antipyretics and antibiotics for children in North Rhine-Westphalia, and parents often have to make many visits to pharmacies in order to get a prescription filled.
Doctors and patients are worried. "Regrettably, patients are increasingly feeling the shortage of various medications and in some cases it is leading to a lower quality of care," says the spokesperson for the Association of Statutory Health Insurance Physicians of North Rhine (KV). "Certain medicinal formulations, such as juices, are not available. This particularly affects small children who cannot swallow tablets," complains Oliver Funken, head of the North Rhine association of general practitioners. There are also shortages of antibiotics, blood pressure medication and psychotropic drugs.
The crisis is leading to absurd developments. "The manufacturer of a paracetamol juice for children is now delivering packages to Germany that are actually intended for Ukraine, have a Ukrainian label and a Ukrainian package insert," reports Thomas Preis. Pharmacies have to import the important antibiotic cotrimoxazole individually from Italy or the UK because it is not available through wholesalers. "For Cefuroxime, another antibiotic, pharmacies have to print out and add a user leaflet for each pack, because otherwise the manufacturer would not be able to deliver at all."
Pharmacists try to find alternatives
In the event of a shortage, pharmacies and doctors try to find alternatives or switch therapies. "This means that there is no time for other important tasks," says the KV. The additional expenditure per pharmacy adds up to personnel costs of about 3000 euros per month, the pharmacists' association calculates. There is a fundamental problem outside of consultation hours: "Alternatives may actually only be dispensed after consultation with the doctor," says Preis.
Federal Health Minister Karl Lauterbach (SPD) is now planning a "law to combat supply bottlenecks for patent-free medicines and to improve the supply of paediatric medicines". The state of NRW is dismissive. "This is just a drop in the ocean. It does not create a solution to effectively counteract the crushing effects of supply bottlenecks. The minister only wants to promote three groups, drugs for children and for cancer and antibiotics, but he does not tackle the fundamental problem," says Thomas Preis. This is echoed by the spokesperson for NRW Health Minister Karl-Josef Laumann (CDU): "This law will not solve the shortage problem."
Medication: State demands reform
The state is calling for a fundamental reform. For example, discount contracts for generics should in future contain rules that lead to more diversified production in Germany and Europe. In fact, manufacturers of medicines for which patent protection has expired (generics) produce often only in Asia. "The price level for many drugs is too low. More and more manufacturers are withdrawing from production, although the pharmaceutical industry also has a supply mandate towards patients and pharmacies," warns Preis. GP Funken adds: "We demand that the production of medicines be relocated back to the Schengen zone. Discount contracts resulting in ever cheaper production do not work." It must also be made possible to pass on unused medicines. NRW is calling on Lauterbach to reduce bureaucracy in pharmacies in order to secure supply in rural areas. Pharmacies should also receive adequate remuneration for their bottleneck management, said Laumann's spokesman.
(Original text: Antje Höning / Translation: Jean Lennox)
