Medicine Shortages in Serbia: Pharmacists’ Standpoint and Potential Solutions for a Non-EU Country

Abstract

Medicine shortages in Serbia have evidently been present for several decades, but literature data are scarce. The aim of our study was to get an insight on the present situation in Serbia, review the EU actions when managing shortages, and discern a set of potential measures. A short survey was conducted among 500 pharmacists in public pharmacies, in 23 cities in Serbia. The survey questions addressed frequency of drug shortages, professional actions in the event of shortages, main consequences to patients and pharmacies, putative causes, and pivotal measures for the prevention/mitigation of drug shortages under current conditions. Moreover, a Panel of Experts was organized, whose suggestions and opinions were used to analyze the present situation and to form a set of potential solutions and effective measures to mitigate shortages of medicines. In-depth analysis of current Serbian legislation was conducted, with emphasis on specific steps to be made within the actual legal framework. Examples of good practice in the EU, applicable to a country such as Serbia, were examined. Our research showed that although Serbia is, in some aspects, behind EU countries regarding the approaches to overcome medicine shortages, progress can be made within short period of time, by specific well-targeted actions. Both patients and pharmacists would benefit from it.

Exploring Drug Shortages in the United Kingdom

“…This is in line with what has been reported by major pharmacy organizations that have also investigated this issue [27,32,33]. Furthermore, the prevalence of drug shortages in community pharmacies according to this study is similar to the Finnish, Polish and Serbian studies [29][30][31]. The time spent on dealing with drug shortages comes at a difficult time, particularly in the UK, when funding and contractual obligations are increasingly based on the provision of clinical services.…”

“…In a later bigger study in Serbia in 2021, which surveyed 500 public pharmacists, almost all pharmacists were experiencing drug shortages [30]. In surveys asking pharmacists about drug shortages, most respondents felt that drug shortages were on the increase and that they spent up to 6 h per week dealing with them [26,31,32]. From these studies, there appears to be some general consensus that pharmacists spend around an hour a day on average dealing with drug shortages.…”

Evaluation of the type and frequency of extemporaneous formulations dispensed in hospital and community pharmacies

“…, 15. , 16 Extemporaneous compounding therefore has diverse applications and is critical for continuity of patient care and in optimizing treatment outcomes.…”

Medicine shortages in the hospital setting: analysis of the trend in five Italian centres during the three waves of the SARS-CoV-2 pandemic

“… 3 The issue has been addressed by identifying overlapping alternative therapies, or by importation or even by making extemporaneous substitute preparations. 4 At the centres run by our regional health authority (two hospitals and three prisons), an analysis was conducted to assess the trend in the phenomenon in the three waves of the pandemic, considering medicines included in the therapeutic formulary (TF). The aim of the research was to determine the daily impact of the shortages on clinical practice and on the work of hospital pharmacists, and the development of further preventive strategies used to counter it.…”