Do Medicine Shortages Reduce Access and Increase Pharmaceutical Expenditure? A Retrospective Analysis of Switzerland 2015-2020

Blankart, Katharina; Felder, Stefan

doi:10.1016/j.jval.2021.12.017

Cited by 12 publications

(8 citation statements)

References 20 publications

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“…We must note, however, that this finding might be caused by a reporting bias resulting from specific reporting obligations in Germany. Certainly, results in other countries might differ but prior research indicates qualitatively similar insights (Blankart and Felder, 2022;Cameron and Bushell, 2021).…”

Section: Discussionmentioning

confidence: 95%

“…This paper finds the effect of government policy change (reduction in reimbursement) on the shortage of treatment drugs. Blankart and Felder (2022) find that the incidence and duration of medicine shortages increased using data for Switzerland and quantify the national impact of shortages to be 0.3% of pharmaceutical expenditures. Cameron and Bushell (2021) explore drug shortages in different countries and find that drug shortages are largely country-specific, e.g.…”

Section: Literature Reviewmentioning

confidence: 96%

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On the drivers of drug shortages: empirical evidence from Germany

Francas

Mohr

Hoberg

2023

IJOPM

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PurposeDisruptions and shortages of drugs have become severe problems in recent years, which has triggered strong media and public interest in the topic. However, little is known about the factors that can be associated with the increased frequency of shortages. In this paper, the authors analyze the drivers of drug shortages using empirical data for Germany, the fourth largest pharmaceutical market.Design/methodology/approachThe authors use a dataset provided by the German Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte [BfArM]) with 425 reported shortages for drug substances (DSs) in the 24-month period between May 2017 and April 2019 and enrich the data with information from additional sources. Using logistic and negative binomial regression models, the authors analyze the impact of (1) market characteristics, (2) drug substance characteristics and (3) regulatory characteristics on the likelihood of a shortage.FindingsThe authors find that factors like market concentration, patent situation, manufacturing processes or dosage form are significantly associated with the odds of a shortage. The authors discuss the implications of these findings to reduce the frequency and severity of shortages.Originality/valueThe authors contribute to the empirical research on drug shortages by analyzing the impact of market characteristics, DS characteristics and regulatory characteristics on the reported shortages. The authors’ analysis provides a starting point for better prioritizing efforts to strengthen drug supply as it is currently intensely discussed healthcare authorities.

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Section: Discussionmentioning

confidence: 95%

Section: Literature Reviewmentioning

confidence: 96%

On the drivers of drug shortages: empirical evidence from Germany

Francas

Mohr

Hoberg

2023

IJOPM

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“…These results are consistent with earlier studies conducted in Finland ( Heiskanen et al, 2015 ; Tapanila et al, 2021 ) and other countries (e.g., Pauwels et al, 2014 ; Dave et al, 2018 ; Videau et al, 2019 ; Benhabib et al, 2020 ; Clark et al, 2020 ). Even though shortages can often be resolved with alternative, interchangeable products and patients are rarely left without medicines ( Heiskanen et al, 2015 ; Tapanila et al, 2021 ), they still burden the health care system and health professionals in their daily work, resulting also to possible increase in medicine prices ( Fox and Tyler 2017 ) and undoubtedly an increase to pharmaceutical expenditure ( Blankart and Felder 2022 ). Our results, together with previous results, pinpoint the fact that despite extensive discussion and the implementation of mitigation strategies (e.g., Clark et al, 2020 ; Musazzi et al, 2020 ; Shukar et al, 2021 ), medicine shortages continue to pose a significant threat to pharmaceutical care.…”

Section: Discussionmentioning

confidence: 99%

Medicine shortages: Product life cycle phases and characteristics of medicines in short supply—A register study

2022

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Introduction: Product life cycle refers to all phases of a product from development to active market phase and finally the phase in which products possibly exit the market. The product life cycle of medicines in short supply has not been studied in depth, although there is some indication of mature products and products with lower prices and profit margins being exposed to shortages more often. The aim of this study was to examine the product life cycle phases and characteristics of medicines in short supply as well as the features of medicine shortages in Finland from 2017 to 2019.Material and methods: Register data on medicine shortages of human medicinal products from 2017 to 2019 was combined with timely data on marketing authorizations and reimbursement status to gain data on product life cycle phases and characteristics (e.g., the age and the reimbursement status) of medicines in short supply and the features of medicine shortages. The data were analyzed in descriptive manner using appropriate statistical testing.Results: 3,526 shortages were reported during the 3-year study period and the number of shortages increased annually. The average duration of a shortage was 83 days and shortages affected 660 active pharmaceutical ingredients. Most often, shortages occurred with medicines affecting the nervous system, the cardiovascular system, and the genitourinary system. A majority of shortages (n = 2,689) was reported in the reimbursable medicines group, where shortages increased as the number of patients receiving reimbursements increased (p < 0.001). In the reimbursable medicines group, shortages most commonly involved medicines aged 15–19, 20–24, and 25–29, whereas with both reimbursable and non-reimbursable products the shortages most often occurred in medicines aged 50–54. The frequency of shortages differed between the groups (p < 0.001) when both age and reimbursement status were taken into account.Conclusion: Medicine shortages are common and affect commonly used medicines. Product life cycle phase has an effect on the frequency of shortages: Reimbursable medicines and medicines exposed to changes in life cycle are more likely to face a shortage. The impacts of product life cycle on the availability of medicines and medicine shortages should be studied in more detail.

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“…Aufgrund der zunehmenden Verlagerung der Arzneimittelproduktion nach China und Indien bei gleichzeitiger Minimierung der lokalen Lagerkapazitäten, ist der Pharmamarkt in der Schweiz für Versorgungsengpässe vulnerabel geworden [2]. Eine systematische Beobachtung der Engpässe bei kassenpflichtigen Arzneimitteln in der Schweiz im Zeitraum zwischen 2015 und Mitte 2020 zeigte, dass etwa die Hälfte aller Produkte im Untersuchungszeitraum von Verknappungen oder gar einem Ausfall des Angebots betroffen war [3]…”

Section: Introductionunclassified

Medikamentenumstellung bei Patienten unter Opioidagonisten-Therapie

Felleiter,

Denoth,

Gabriel

2024

Swiss Arch Neurol Psychiatr Psychother

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In the Swiss pharmaceutical market, supply shortages for individual medicines are becoming increasingly frequent. In 2021, this affected Sevre-Long ® , a drug used for many patients under opioid agonist therapy (OAT). Due to the exhaustion of local stock quantities at Lucerne Psychiatry, the affected patients had to be switched to the only other approved morphine preparation effective over 24 hours (Kapanol ® ) in spring 2022. We retrospectively investigated the type and frequency of complications as well as subjectively described problems of under-or overdose in the period of four weeks after this forced switch of the opioid agonist. A four-week observation period was used to record whether there was a refusal to dispense due to signs of overdose or an inpatient admission due to withdrawal symptoms or opioid overdose. Secondary dose changes due to subjective reporting of under-or overdoses were also recorded. The median dose of morphine was 600 mg/day both before and after conversion. During the observation period, none of the 124 patients included were refused the opioid agonist due to signs of overdose, and none were hospitalized during the observation period. A total of 15 patients (12%) came forward and requested a change in their newly prescribed medication. Eight of the patients complained of reduced effectiveness of the medication, and seven patients requested a reduction in dosage. No complications occurred during a period of four weeks after the forced change of substitution medication. Most patients did not report side effects. For patients who complained about over-or underdosing, the problems could be solved without complications in almost all cases and satisfaction with the drug treatment could be restored.

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Do Medicine Shortages Reduce Access and Increase Pharmaceutical Expenditure? A Retrospective Analysis of Switzerland 2015-2020

Cited by 12 publications

References 20 publications

On the drivers of drug shortages: empirical evidence from Germany

On the drivers of drug shortages: empirical evidence from Germany

Medicine shortages: Product life cycle phases and characteristics of medicines in short supply—A register study

Medikamentenumstellung bei Patienten unter Opioidagonisten-Therapie

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