Vice Chair of Medicines for Ireland, Deirdre Kelly
The problem of medicine shortages remains high, with a latest IPU annual survey revealing that every pharmacy in Ireland has been challenged by medicine shortages in the past four months. The Irish Pharmacy Union (IPU) has said this highlights the need to expedite the planned introduction of a serious shortage protocol under the Health Miscellaneous Bill for all molecules in short supply, and ensure that the legislation will be flexible enough to find solutions for patients.
In the 12 month, The IPU Medicine Shortage Survey found that all pharmacists have experienced medicine shortages in the last 4 months with a considerable 57% (60% in 2023) of pharmacies experiencing more than 40 medicine shortages in that period.
Among the key findings of the Irish Pharmacy Union’s (IPU) Medicine Shortage Survey are:
1. 84% of pharmacists expect this problem to increase over the next 12 months.
2. Irish community pharmacists are spending over 4 hours 37 minutes per week managing medicine shortages, work that often goes unnoticed and not recompensed.
3. 62% believe that allocations imposed by manufacturers is the leading cause of medicine shortages.
Medicine shortages can have a serious impact on patients and their families according to Clare Fitzell, IPU’s Head of Strategic Policy. “Behind each medicine that is in short supply are patients who need them for their health and wellbeing. Medications in short supply this year have included certain steroid creams used to treat eczema, ADHD medication and Ozempic. Medicine availability issues have potential to impact medical conditions and can create considerable stress and inconvenience to patients.
“Pharmacists are highly experienced and work with prescribers to source alternatives where required. However, this process is often time consuming for healthcare providers and takes too long for patients.
The amount of time spent by pharmacies on dealing with shortages has increased significantly since 2018. The average pharmacist spends 4 hours 37 minutes per week dealing with shortages, in 2018, 5-10 hours per month was more typical.
“There is no expectation that this problem will improve in the next year with 84% of pharmacists surveyed predicting it will get worse”, Ms Fitzell said. “This is a global problem and therefore we must look at what Ireland can control and implement this rapidly. In particular, moves to introduce a Serious Shortage Protocol must be expedited to ensure effective use of healthcare professional resource.”
The Health Miscellaneous Provisions Bill 2024 is currently before the Oireachtas. This will allow the Minister for Health to introduce a scheme where pharmacists can appropriate substitute medicines for patients without needing to revert to the prescribing doctor. “This should dramatically speed up the process for both pharmacists and prescribers and crucially will ensure that patients get appropriate medicines quicker.”
Concluding, Ms Fitzell said, “Medicine shortages are a growing and significant problem. The focus in Ireland should be to address what is in our own control and how we can best support patients. There are very obvious and beneficial proposals that can be introduced, and the patients of Ireland cannot afford for these to be delayed any longer.”
Meanwhile, Medicines for Ireland (MFI), the leading representative body for the generic, biosimilar, and value added medicines industry, is highlighting the urgent need for action to address the increasing medicine shortages affecting the Irish population.
A recent Red C survey reveals a concerning trend: 1 in 5 (20%) of individuals have been personally affected by medicine shortages in the past two years. Additionally, 22% report that family members or friends have been impacted totalling 38% of the population either directly or indirectly experiencing the consequences of these shortages.
Commenting on the Red C survey results, Chair of Medicines for Ireland Paul Neill said, “The growing scarcity of essential medicines is more than an inconvenience; it’s a barrier to health and well-being. With 38% of those surveyed expressing that shortages have impacted them or someone close to them, it is a clear and urgent signal that our healthcare system faces a crisis that requires immediate action.”
The impact is felt across various medical treatments, with pain relief medication shortages affecting nearly 2 in 5 (37%) of those impacted. Other areas, such as respiratory, gastroenterology, and rheumatology treatments, also face significant challenges.
Medicines for Ireland, a solutions focused organisation, is proposing a multifaceted approach to address these shortages:
• Implement dynamic pricing policies that encourage competition.
• Policies that incentivise the use of generic medicines, ensuring access to affordable, high-quality, and essential medications.
• Evolve the best-value biologics (BVB) process to ensure the sustainability of best-value medicines and best-value biologics.
• Create a streamlined regulatory and reimbursement pathway for value-added medicines, allowing for medicine repurposing and aligning Ireland with other leading European nations.
Mr Neill emphasises, “There is no single simple solution to addressing the challenges leading to medicine shortages, but we have detailed the solutions that MFI and our members believe can address these challenges in our five-year vision, Looking forward: Building the framework for a sustainable generic, biosimilar and value-added medicines industry in Ireland. By adopting these solutions, we can mitigate the impact of shortages and ensure a robust supply of medicines for all who need them.
“By encouraging the use of generic, biosimilar and value added medicines, we can alleviate the strain on our healthcare system. It’s not just about cost savings; it’s about ensuring that every patient has access to the medicines they need when they need them. Establishing a sustainable pathway for biosimilar medicines and a streamlined regulatory process for value added medicines are critical steps towards a more resilient healthcare system.”
Vice Chair of Medicines for Ireland Deirdre Kelly commented, “Patients are often left waiting, revisiting pharmacies, or accepting alternatives. This is not the standard of care we strive for in Ireland. This data shows that nearly half (49%) of the population recognises the worsening of this issue over the past two years.”
