Between 2021 and 2024, global medication shortages have significantly impacted sterile injectable generic drugs, including chemotherapy agents, central nervous system stimulants, antimicrobials, hormonal treatments, intravenous fluids, and emergency drugs, with the United States alone reporting a record high of 323 drugs in shortage by early 2024.

In Europe, shortages have affected antibiotics such as amoxicillin and penicillin, pediatric painkillers like paracetamol, and blood pressure medications, with Italy reporting over 3,000 unavailable drugs by late 2022 due to supply chain disruptions and inflation affecting production capacity.

Canada has faced acute shortages of basic painkillers like acetaminophen and ibuprofen, driven by a lack of raw ingredients, increased demand from respiratory viruses, and panic buying during flu seasons, exposing vulnerabilities in global pharmaceutical supply chains.

In Egypt, the shortage of streptokinase, a critical injection for treating acute thromboembolism in cardiac and pulmonary conditions, has left remote provinces like the New Valley Governorate particularly vulnerable due to limited access and the absence of alternatives.

Taiwan has experienced shortages of essential chronic medications, including blood pressure drugs, blood lipid-lowering agents, and magnesium oxide, exacerbated by supply chain disruptions and health insurance price cuts that have limited the availability of these critical treatments.

Global medication shortages during this period have been driven by fragmented supply chains, which hinder the consistent availability of raw materials and active pharmaceutical ingredients, prompting calls for systemic changes in the pharmaceutical industry.

Geopolitical factors, such as the heavy reliance on manufacturing in countries like India and China, have exacerbated shortages due to vulnerabilities like natural disasters, political unrest, and quality control issues, as highlighted in a U.S. Senate report.

Manufacturing issues, including production delays and quality problems, have also played a significant role, with incidents such as the closure of an Indian factory producing active ingredients for generic drugs disrupting global supply chains.

Healthcare systems in developed countries have implemented strategies to address shortages, such as establishing centralized drug shortage treatment centers and optimizing supply chain communication, as seen in Taiwan's efforts during crises like the COVID-19 pandemic.

In Ireland, medication shortages have been mitigated by switching patients to therapeutic alternatives, such as different strengths or brands of the same drug, ensuring continuity of care despite supply chain disruptions.

The European Union has promoted the use of generics, reformulated medications for easier administration, and planned stricter supply obligations and earlier notifications of shortages in upcoming pharmaceutical legislation to improve resilience against production challenges.

Developing countries have faced unique challenges in managing medication shortages, including insufficient production capacity, logistical issues, and poor coordination between supply and demand, particularly in rural areas with limited access.

In Ethiopia, foreign currency limitations have restricted the import of essential drugs and raw materials, leading to reliance on smuggled or substandard medications that pose significant risks to patient safety.

Governments in developing countries have responded by expanding production capacity, prioritizing rural healthcare facilities, and adopting alternative treatments like traditional medicines to alleviate pressure on limited resources.

In the United States, hospitals have faced critical shortages of inexpensive but essential drugs, such as antibiotics and anesthetics, forcing healthcare providers to make difficult decisions about patient care.

The American Society of Health System Pharmacists documented a record high of 323 drug shortages in the first quarter of 2024, with hospitals particularly affected by shortages of sterile injectable drugs, including chemotherapy and emergency medications.

In France, 44% of patients reported experiencing drug shortages in 2024, with oncology professionals highlighting significant impacts on cancer treatment due to disparities in how hospitals and pharmacies managed stock.

Governments and international organizations have established initiatives like the Pandemic Supply Chain Network (PSCN) to anticipate and respond to global healthcare supply chain disruptions, fostering partnerships and improving inventory management systems.

The European Commission has proposed measures such as a voluntary solidarity mechanism, joint procurement of drugs, and the creation of a Critical Medicines Alliance to address shortages, alongside emergency actions like extending drug shelf life.

Taiwan's Ministry of Health and Welfare has developed strategies to address drug shortages, including establishing a permanent drug shortage treatment center and encouraging domestic production of generic drugs to ensure stable supply.

Pharmaceutical companies have been criticized for prioritizing short-term profits over the production of essential medications, exacerbating shortages of life-saving drugs such as chemotherapy treatments and ADHD medications in the United States.

In France, health organizations have accused pharmaceutical companies of abandoning the production of less profitable drugs and maintaining insufficient medicine stocks, worsening shortages of critical medications like oncology drugs and antibiotics.

Efforts to address shortages have included pharmaceutical companies increasing production capacity for high-demand drugs, such as Eli Lilly’s investment to boost the supply of diabetes medications, though intermittent disruptions persist.

Regions such as South Asia, sub-Saharan Africa, and Southeast Asia have been disproportionately affected by medication shortages, with limited healthcare infrastructure and economic challenges exacerbating drug accessibility issues.

Medication shortages have significantly impacted patients with chronic and life-threatening conditions, leading to delays in treatment, rationing of care, and emotional distress, as seen in the widespread shortage of chemotherapy drugs like cisplatin and carboplatin.

Patient testimonials, such as those of diabetic individuals in Egypt, highlight the severe consequences of medication shortages, including the inability to access essential drugs like insulin, forcing patients to reduce dosages or seek alternatives.

In Lebanon, the shortage of multiple sclerosis medications has caused serious health repercussions, including the risk of permanent paralysis, emphasizing the need for organized distribution systems and government support.

Supply chain disruptions, including shortages of raw materials and manufacturing difficulties, have been identified as key contributors to global medication shortages, impacting continuity of care worldwide.

Emerging technologies such as portable near-infrared spectrophotometers (NIR) are being developed to assess drug quality in resource-constrained regions, offering a cost-effective and rapid alternative to traditional laboratory methods.

Capra Biosciences is leveraging AI and modular bioreactor platforms to rapidly scale the production of active pharmaceutical ingredients (APIs), aiming to address supply chain vulnerabilities and reduce dependency on foreign manufacturing.

Mark Cuban's Cost Plus Drug Company has initiated partnerships with health systems to manufacture generic sterile injectables, including epinephrine, at a new facility equipped with robotic manufacturing lines to mitigate shortages.

Primary caretakers can prepare for potential medication shortages by maintaining a reserve supply of critical medications for chronic conditions, ideally enough to cover three to six months, to mitigate disruptions caused by supply chain issues.

Caretakers should stay informed about potential shortages by monitoring updates from health authorities and drug supply platforms, which can provide early warnings and alternative options for missing medications.

Engaging with healthcare providers to discuss alternative treatments or generic substitutes for life-saving drugs can be crucial, especially during prolonged shortages caused by manufacturing or importation challenges.

The American Society of Health System Pharmacists and the University of Utah Drug Information Service maintain a Drug Deficiency Database that tracks medication shortages, providing real-time insights into supply issues in the U.S. healthcare system.

Ethical considerations in allocating scarce medications during shortages include the principle of justice, which emphasizes fair and equitable distribution of resources, balancing individual needs with the common good.

Healthcare providers face difficult ethical decisions in determining which patients receive limited medications, often prioritizing based on the aggressiveness of diseases and the likelihood of treatment success.

The COVID-19 pandemic underscored the need for robust emergency preparedness, with lessons learned including the necessity of maintaining adequate stockpiles and fostering industry partnerships to ensure supply chain continuity during crises.

Between 2021 and 2024, global medication shortages have significantly impacted sterile injectable generic drugs, including chemotherapy agents, central nervous system stimulants, antimicrobials, hormonal treatments, intravenous fluids, and emergency drugs, with the United States alone reporting a record high of 323 drugs in shortage by early 2024.

Title:

Content: General Supervision
Elham Aboul Fath
Editor-in-Chief
Thank you for your patience.
General Supervision
Elham Aboul Fath
Editor-in-Chief
Thank you for your patience.
An Unexpected Catastrophe in the World ’ s Largest Country: The Complete Story of U.S. Drug Shortages
The deficit is at a record level.
According to data from the American Society of Health System Pharmacists and the University of Utah Drug Information Service, organizations began tracking drug shortages for the first time in 2001. Steady since 2021 – now reaching a record high of 323 drugs in the first three months of 2024.
Paul Abramowitz, CEO of the American Society of Health System Pharmacists, wrote in a blog post on Thursday: “It ’ s been a long time to end drug shortages, ” and wrote:“ All drug classes are vulnerable to shortages, some of the most worrisome shortages include sterile injectable generic drugs, including cancer chemotherapy drugs and emergency drugs stored in hospital vans and procedural areas. It is dangerous for doctors and patients. ”
In addition to the 32 chemotherapy drugs that are deficient, the five categories of drugs with the greatest deficiency include central nervous system stimulants, antimicrobials, hormonal agents, and intravenous fluids. [1] The Drug Deficiency Database maintained by the American Society of Health System Pharmacists and the University of Utah is based on voluntary reports from practitioners, patients, and others that have been confirmed by manufacturers. The U.S. drug is in short supply, because it captures broader effects on service providers and patients.
The crisis has lasted a year and a half.
More than half of the treatment shortages have lasted for more than two years, according to an analysis by health consultancy IQVIA, and the average shortage affects at least half a million patients, many of them elderly, according to the US Office of Health and Human Services under the Assistant Secretary for Planning and Evaluation, which shared its analysis with Congress in May.
Growing demand can play a role in drug shortages, as with the recent shortage of weight-loss drugs, but often manufacturing and quality problems, such as supply chain gaps and downtime, are the root cause. And varied.
But the American Society of Health System Pharmacists has “serious concerns ” about parts of this proposal, especially financial sanctions imposed on hospitals that lack the resources to comply with the recommendations, Abramowitz wrote:“ We all know that managing shortages is not enough and is not a sustainable solution to the worsening crisis, and there is still a lot of work to be done at the federal level to fix the root causes of drug shortages. ”
Why Shortage Occurs
Shortages can be caused by high demand, as with the recent shortage of weight-loss drugs, but this is not usually the main problem.
The FDA also blames manufacturing and quality problems, supply chain gaps, and downtime, and Dr. Emily Tucker, a drug shortage expert and an assistant professor of industrial engineering at Clemson University, says that when there is an indication of shortages, large health systems often also proactively place large orders, adding to the system ’ s stress.
“I don ’ t blame anyone.
“When I talk to all the stakeholders – whether it ’ s wholesalers, manufacturers, or the government – everyone wants this problem to end, ” she said.
Lack of transparency
Dr. Julie Grallo, chief medical officer and executive vice president of the American Society of Clinical Oncology, told the House Committee earlier that the shortage puts providers in a terrible position: “The drug shortage crisis is forcing providers to make impossible choices, and it is also hindering the development of new drugs. Health drugs are purchased only on a price basis, and manufacturers do not have to disclose the source of their acquisition of the ingredients.
The shortage of this generic chemical drug came due to the closure of one factory in India that manufactures the active ingredient after a surprise FDA inspection found “significant quality issues, ” says Jarallo:“ We didn ’ t know, and there was no transparency regarding the company ’ s supply of the majority of active pharmaceutical ingredients to all manufacturers across the board.
Knowing this in advance, we could have responded much faster, ” Dr. Steven Schundlemeyer, director of the PRIME Institute of the University of Minnesota School of Pharmacy, which focuses on economic and management issues, told the committee that as with defense contractors in the United States, New Zealand requires manufacturers to disclose their suppliers, and that information is required.
Easily accessible in the database.
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In Europe, shortages have affected antibiotics such as amoxicillin and penicillin, pediatric painkillers like paracetamol, and blood pressure medications, with Italy reporting over 3,000 unavailable drugs by late 2022 due to supply chain disruptions and inflation affecting production capacity.

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Sandoz, one of the largest manufacturers in the European drug market, reported a tense supply situation in the pharmaceutical industry in Europe.
This was reported by Politico on Sunday, January 29.
The authors of the material note that problems in pharmaceutical companies, which began during the coronavirus pandemic, are now complicated by inflation and a serious energy crisis, affecting supplies.
As pointed out by a representative of the company Sandoz, by the end of last year there was a particularly tense situation with supplies.
“The pharmaceutical industry is also affected by the shortage of raw materials and the limitation of production capacity.
The company is currently able to meet demand, but faces difficulties, ” Sandoz said.
Since the end of 2022, many European Union (EU) countries have reported serious problems with the supply of some important medicines.
Thus, the authors write, the Belgian authorities report a shortage of almost 300 names of drugs.
In Germany, this number is 408, and in Austria more than 600 names of drugs can not be bought in pharmacies.
Italy ’ s list is even longer – it includes more than 3,000 drugs.
"Antibiotics, especially amoxicillin, which is used to treat respiratory infections, are in short supply.
Other classes of drugs, including cough syrup, pediatric paracetamol, and blood pressure medications, are also scarce.
Earlier, on January 17, the Minister of health of Italy Orazio Skillaci said that in the country there is a problem of shortage of drugs and the responsibility for this lies with the media.
According to Skillaci, due to the fact that local media spread "alarming information" about the lack of certain drugs, there is a "ricochet effect" - when patients begin to massively buy drugs for future use, which leads to problems with the provision of pharmacies and medical institutions with the necessary drugs.
Earlier, on January 10, Australian pharmacists reported an acute shortage of antibiotics for pneumonia and pharyngitis, which arose due to a violation of the schedule of deliveries from abroad.
The shortage of drugs in mid-December was also reported by the German authorities.
In particular, it was about drugs and antipyretics for children, as well as antibiotics for adults and cancer drugs.
Problems in the economy, accompanied by an energy crisis and rising inflation, have intensified in Western countries after the introduction of anti-Russian sanctions against the background of the special operation of the Russian Federation to protect the Donbass, the beginning of which was announced by Russian President Vladimir Putin on February 24.
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Canada has faced acute shortages of basic painkillers like acetaminophen and ibuprofen, driven by a lack of raw ingredients, increased demand from respiratory viruses, and panic buying during flu seasons, exposing vulnerabilities in global pharmaceutical supply chains.

Title:

Content:
The Shortages Are Coming

by Tyler Durden
Tuesday, Nov 08, 2022 - 09:20 PM

Authored by Michael Snyder via The End of The American Dream blog,

Do you remember in early 2020 when they told us that the shortages that we were experiencing would just be temporary?  Of course some of them were, but then more shortages just kept on erupting.  That wasn’t supposed to happen, and now it appears that our supply chain problems could potentially get a whole lot worse.  In just a few short months, we will be three years away from the beginning of the pandemic in the United States.  But instead of a “return to normal”, more shortages are on the way.  And in some cases, they could even be life threatening.

Let me give you an example.  We need Amoxicillin to treat some of the most common infections that our children experience.  Unfortunately, the FDA is warning us that we are now facing a very serious shortage of Amoxicillin…

Ear infections and strep throat.

Both are common childhood illnesses, for which the go-to prescription is in short supply, according to a recent nationwide alert from the U.S. Food and Drug Administration.

The warning specifically involves the powder, which pharmacists use to mix liquid Amoxicillin for childhood infections.

This is a really big deal.

According to one recent survey, close to two-thirds of all pharmacies in the nation are having difficulty getting Amoxicillin right now, and the national shortage of Adderall is even worse…

Nearly 66% of pharmacies are having challenges obtaining amoxicillin, according to a new National Community Pharmacists Association (NCPA) survey of 8000 pharmacy owners and managers, whereas 89% are realizing a shortage of Adderall.

Of course we are dealing with lots of other drug shortages at this moment as well.

In fact, according to the official FDA drug shortage list there are nationwide shortages of a whopping 183 different drugs in the United States right now.

We truly are in unprecedented territory.

Up in Canada, things are even worse.

If you can believe it, at this point the Canadians are facing “an acute shortage of basic painkillers”

The Canadian healthcare system is experiencing an acute shortage of basic painkillers, particularly acetaminophen and ibuprofen, which are commonly used to relieve pain and fever in children during flu season.

Canada’s Association of Medical Assistance in Dying Assessors and Providers (CAMAP) chose this perhaps awkward moment to roll out a webinar for healthcare professionals that advised them to offer assisted suicide to their suffering patients.

So why don’t the Canadians have enough Acetaminophen and Ibuprofen right now?

Well, we are being told that the primary reason is “a lack of raw ingredients to make the drugs”

CBC News quoted health officials who blamed “a lack of raw ingredients to make the drugs,” “an uptick in respiratory viruses fueled by the relaxed [Chinese coronavirus] measures,” and “panic buying” for the shortage of painkillers for children.

As I have covered in previous articles, most of the basic ingredients that go into our pharmaceutical drugs come from China.

So if you think that things are bad now, just wait until war with China erupts.

Once that happens, our pharmacies will get really empty and our entire healthcare system will experience a historic meltdown.

Switching gears, with Thanksgiving coming up I wanted to talk about the fact that we are now facing a nationwide shortage of turkeys

As CNBC reports, the price of turkey is up 73% from last year, a pretty astonishing figure. Experts attribute it to the bird flu, which has devastated turkey stocks this year. Apparently, the disease normally doesn’t flourish during the summer as farmers get their holiday flocks together. But, you know, the 2020s haven’t been easy so naturally, the flu hit hard right in the middle of the year when it could do the most damage.

The good news, if you want to call it that, is that you will still probably be able to get a turkey if you are willing to pay enough.

The bad news is that supplies of turkey just keep getting tighter and tighter.

One business owner in San Francisco recently stated that it is “like pulling teeth trying to get turkeys from the companies” at this stage…

But it’s not just the Thanksgiving bird that’s at risk — it’s your lunchtime turkey sandwich, too. San Francisco delis and butchers are already feeling the effects of the shortage.

“It’s like pulling teeth trying to get turkeys from the companies,” said Sal Qaqundah, owner of Arguello Market, a San Francisco cult favorite for its “world famous” turkey sandwich.

Unfortunately, we are also facing a shortage of butter in the weeks ahead.

The USDA is urging consumers not to “panic buy” butter so that there will be enough to go around for everyone…

Butter is another area where the war and cost of dairy products has affected supply, as the price of the condiment and baking ingredient has gone up a dollar per pound since January of this year, per Eater. Fearing a full-blown butter shortage, the USDA has asked consumers not to rush or panic buy, but simply secure what they need at a given time, per Best Life.

Did you ever imagine that we would be talking about a butter shortage in late 2022?

Things just keep getting crazier and crazier.

And if the diesel fuel shortages eventually get as bad as some are projecting, we could soon be facing severe shortages of countless products.

Our ships, our trains and our trucks run on diesel fuel.

So if there is not enough diesel fuel, we are going to have a real problem trying to fill up our stores with enough stuff for everybody.

Even now, supplies of diesel fuel are so tight that one big player in the industry just issued a major alert

A major fuel supply and logistics company is raising a red flag on upcoming diesel fuel shortages.

Mansfield Energy issued the alert Friday stating there was a developing diesel fuel shortage in the southeastern region of the United States. The company speculated that the shortage could be generated from “poor pipeline shipping economies” and a historically low supply of diesel reserves.

“Poor pipeline shipping economics and historically low diesel inventories are combining to cause shortages in various markets throughout the Southeast,” the company said. “These have been occurring sporadically, with areas like Tennessee seeing particularly acute challenges.”

There are a number of reasons why supplies of diesel fuel have gotten so tight.

But the biggest is the fact that imports from Russia have been totally cut off

But the primary reason is the cutoff of Russian imports. Prior to Russia’s invasion of Ukraine, the U.S. was importing nearly 700,000 barrels per day (BPD) of petroleum and petroleum products. Most of those imports were finished products and refinery inputs that boosted distillate supplies in the U.S.

The loss of those Russian imports have caused problems for refineries as they struggle to fill holes in their product slates. Refineries do have a small amount of flexibility in shifting gasoline production to diesel production. But it’s a relatively small amount (e.g., ~5% in a refinery I once worked in). That also means that if refiners do shift production, that also potentially creates shortages in the gasoline market.

So why don’t we just produce more ourselves?

Well, thanks to our politicians, the number of refineries in the United States has actually been declining in recent years even as our population has grown.

At this point we simply do not have enough refineries, and this is a problem that is not going away any time soon.

In the months ahead, we aren’t going to completely run out of diesel fuel as some people out there are suggesting.

But supplies may get so tight that it could potentially create widespread supply chain nightmares that are quite severe.

Let us hope that such a scenario does not materialize.

Because the American people are already angry enough about the economy.  In fact, a brand new survey has found that it is the number one issue for U.S. voters at this moment…

The Washington Post and ABC gave Americans eight top issues they will be considering when making their decision in a poll that showed likely voters split between the Democrats and Republicans.

The economy was cited by 26 percent of likely voters as one of the most important factors, followed by abortion with 22 percent and inflation and threats to democracy each by 21 percent.

For decades, we have been able to rely on our supply chains to continuously fill our stores with mountains of cheap goods.

But now our supply chains are breaking down.

In fact, our entire economic system is breaking down and most people are completely and utterly unprepared for the difficult times that are coming.

I know that many of you have been patiently waiting for a long time for life to “return to normal”.

Sadly, that isn’t going to happen.  The incredibly bad decisions that our leaders have been making are now catching up with us in a major way, and a great deal of pain is ahead.

*  *  *

It is finally here! Michael’s new book entitled “End Times” is now available in paperback and for the Kindle on Amazon.

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In Egypt, the shortage of streptokinase, a critical injection for treating acute thromboembolism in cardiac and pulmonary conditions, has left remote provinces like the New Valley Governorate particularly vulnerable due to limited access and the absence of alternatives.

Title:

Content: Chairman of the Board of Directors and Editors
Mohamad Elbaz
Chairman of the Board of Directors and Editors
Mohamad Elbaz
"Health of the Elders" recommends the provision of injections for the treatment of acute thrombosis in the hospitals of the Republic
The Senate Health and Population Committee held a meeting on Monday under the chairmanship of MP Dr. Ali Mehran, Chairman of the Committee, in the presence of MP Dr. Amr Hijab, Undersecretary of the Committee, and Dr. Osama Fahem, Secretary of the Committee, to discuss the proposal submitted by MP Mu ’ min Moath, on "provision of acute thrombosis treatment injections", in the presence of government representatives.
MP Mu ’ min Mu ’ ath, the proponent of the proposal, said that the injection of acute thromboembolism such as cardiac and pulmonary (streptokinase) has a severe shortage in the Egyptian pharmaceutical market, at the governmental and private levels, and is not available in some regions, due to its extreme importance and necessary for the treatment of heart and lung strokes, especially that there is no alternative for saving patients ’ lives. As soon as possible, especially in remote provinces such as the New Valley Governorate.
Demand to support the availability of pharmaceutical needs of the medical sector
MP Mu ’ min Muath called for the need to provide injections to dissolve acute thromboembolism such as cardiac and pulmonary (streptokinase) in all hospitals, especially in remote provinces.
Dr. Rasha Al-Sharqawi, head of the Central Medical Department of Pharmacy, explained that the Ministry of Health and Population seeks to support the availability of pharmaceutical needs of the medical sector and the provision of pharmaceutical services within health facilities through the Central Department of Pharmaceutical Affairs.
Al-Sharqawi stressed that regarding the shortage of some medicines, especially chronic medicines, full and effective communication is made with all concerned parties, especially the Egyptian Unified Procurement Authority and the Egyptian Drug Authority to provide pharmaceuticals in the Egyptian market; to ensure the continuity of the availability of medicines to the Egyptian patient. All parties concerned with the availability of pharmaceuticals.
6 supply orders since January
The head of the Central Medical Department of Pharmacy confirmed that the category of medicine for the treatment of acute heart thromboembolism (streptokinase vial) has been registered for the category through the electronic platform of the Egyptian Authority for Unified Purchase with 6 supply requests since January 2024 until April 30, 2024. Since 20 / 2 / 2024 until 21 / 5 / 2024, four times have been allowed.
In the same context, Dr. Rasha Ziadeh, Assistant Chairman of the Drug Authority for Technical Development and Capacity Development, said that exceptional import approvals are made to solve the global problem related to the shortage of some pharmaceutical items and we are working to overcome the current problem until there is availability in the items. A new system that allows the transfer of medicine from one hospital to another and from one province to another according to the need and consumption rate.
At the end of the meeting, the committee recommended the need to provide and distribute the drug streptokinase to various hospitals nationwide, set a mechanism and specific criteria for its distribution according to need, and speed the provision of alternative drugs and work to localize the manufacture of these drugs in Egypt.

Taiwan has experienced shortages of essential chronic medications, including blood pressure drugs, blood lipid-lowering agents, and magnesium oxide, exacerbated by supply chain disruptions and health insurance price cuts that have limited the availability of these critical treatments.

Title:

Content: The Kuomintang group calls on Chen Chien-jen to take over the government's national security crisis
REPORTER WENG Tzu-kun / Taipei Report
The shortage of drugs in the country continues to burn, the Kuomintang Legislative Yuan group today (1) a press conference called on the Tsai government, do not just want to vote all day, more concerned about the people's health rights, if the Minister of Health and Welfare Xue Ruiyuan, the Food and Drug Administration Director Wu Xiumei do not do well, it will be cut off.
The KMT further demanded that the "Drug Deficiency Monitoring Center" be raised to the level of the Executive Yuan, and called on Premier Chen Jianren to take over the management and treat it as a national security level issue.
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The Kuomintang group today opened a "shortage of drugs! shortage of drugs! When?" press conference, the general convenor Zeng Mingzong said that the shortage of drugs is a structural problem, health insurance to slash the price of drugs, so that the shortage of drugs crisis expanded, local pharmaceutical companies are more reluctant to produce low-cost drugs.
And some people complained, ran 10 drug bureaus did not receive drugs, beat the table to scolding, so that the community pharmacist pressure is great.
Zeng Mingzong pointed out that, for example, muscle relaxants reported a shortage of drugs on March 8, 2021, compound antibiotics, anti-fever pain tablets reported a shortage of drugs on June 6, 2022, blood pressure drugs reported a shortage of drugs on August 25, 2022, blood lipid-lowering drugs reported a shortage of drugs on August 26, 2022. In addition to the election, Tsai's government also cares about the health of the nation's people.
Zeng Mingzong said that the Kuomintang group humbly asked the Tsai government, the current lack of eggs, water, and medicine in the country, the people are asking the government what is wrong? Impairment! Failure! Please the government to come up with a specific plan to solve the problem of shortage of drugs, and ensure the basic health rights of 23 million people.
Hsieh Ying-yi, secretary-general, says that recent shortages of amoxicillin, acetaminophen, magnesium oxide, and ibuprofen in primary pharmacies and clinics have revealed that there are 131 medicines out of stock in Taiwan.
She stressed that in order to solve the problem of drug shortage, the community pharmacy has also set up a "mutual aid association" to find drugs in the way of drug exchange.
He bluntly said that this is a serious national security problem, will it make the burden of health care more heavy?
For a long time, the total amount of health insurance system has been driving down drug prices, but international pharmaceutical companies are facing a global shortage of goods, and will not give priority to imports to Taiwan.
When the National Health Insurance Administration wants to solve the unreasonable drug price difference, does it also solve the problem of drug prices that do not meet the cost?
Xie Yifeng also pointed out that on February 11, Xue Ruiyuan urgently convened a meeting on shortage of drugs, and resolved to persuade drug manufacturers to increase production capacity. If it is not possible to increase production capacity, then strengthen the allocation of hospitals and clinics to pharmacies to solve the problem of shortage of drugs.
How does the Ministry of Health and Welfare assist domestic pharmaceutical companies in obtaining raw materials and mass-producing pharmaceutical products?
Not at all.
Shouldn ’ t the Ministry of Health and Welfare convene meetings across ministries, industries, and pharmaceuticals to coordinate and solve problems?
Hsieh Yi-hung lambasted that after the meeting of the Ministry of Health and Welfare, nothing had been done, and such a meeting would not be held.
The Ministry of Health and Welfare will increase the burden of health insurance to 120 million yuan on April 1, which is expected to affect 1.17 million people.
Please ask Chen Chien-jen and the Ministry of Health and Welfare, in the special budget after the epidemic, to allocate 20 billion yuan for health insurance, why do you need to increase part of the burden?
The Ministry of Health and Welfare should first solve the problem of lack of medicines, and do not want to spend money from the pockets of the people.
On March 29, 2019, Wu Xiumei, who is responsible for managing the national drug administration department, held a meeting on “Drug Shortage ”. The results of the expert meeting on the evaluation of the operation and follow-up mechanism of the meeting were only based on the meeting and the meeting was postponed, and the decisions made after the meeting were not implemented.
"Taiwan's lack of medicine is a problem of management." Lai Shibao pointed out that the Ministry of Health and Welfare has constantly justified itself with problems such as rising raw materials and the Russian-Ukrainian war, but the whole world is affected, and Taiwan alone has a shortage of medicine.
In 1999, the US FDA established a “Drug Deficiency Monitoring Center ”, which stipulates that any drug that is less than 6 months in stock must be monitored and taken countermeasures.
Lai Shih-pao points out that the pharmaceutical and medical sectors in Taiwan have long called on the government to do the same.
Lai Shih-pao also suggested that Chen Chien-jen, the National Health Insurance Administration (NHIA) plans to slash the health insurance drug budget by NT $8.1 billion. Please ask the so-called warm and tenacious cabinet to start caring for humanity and solve the problem of shortage of drugs as soon as possible.
In 2016, Tsai Ying-ying told pharmacists at the All-Union Congress of Pharmacists that it was necessary to make medicines available to the people and replace them with social medicines in 2018. The result was still a shortage of drugs.
Yang Qiong said that magnesium oxide mainly treats gastric and esophageal reflux and constipation, is a common chronic prescription drug. Patients need to use drugs every day. Does the government know? In addition, the first-line commonly used antibiotics Ammonicillin and acetaminophen painkillers are lacking, which increases the risk of physical collapse of first-line medical care.
The government does not know what the problem is, and even the drugs have to go back to the original "drug-for-drugs" era, the "drug-for-drugs monitoring center" must be raised to the level of the Executive Yuan, immediately inventory 131 drug categories, immediately replenish, strengthen the monitoring mechanism, so that the people really have drugs available.
Dr. Shen Caiying, spokesman of the Taiwan Pharmaceutical Marketing and Management Association, said with emotion that Tsai Ing-wen had said that the society has drugs available, and the people will use drugs, which of course is also the responsibility of pharmacists.
During the epidemic, the Ministry of Health and Welfare relied heavily on community pharmacies to issue masks and rapid screening to take on the frontline public health mission, but the Ministry of Health and Welfare seemed indifferent to the serious problem of drug shortage.
Shen Caiying questioned the government, according to Article 15 of the "National Health Insurance Drug Price Adjustment Operation Measures", the directive drug is not allowed to have a floor price, but the Director of Health Insurance Shi Chongliang publicly stated that the directive drug should be set a floor price to solve the problem of drug shortage.
Shen Caiying said that for every US dollar used in the United States on the instructions, it can save 6 to 7 US dollars for health insurance, which can save 10.2 billion US dollars a year.
Shen Caiying suggested that the government, to solve the problem of shortage of drugs, please administer according to law, instruct that drugs should not be paid, cancel the daily drug charge, and pay.
The drug shortage center must combine relevant professional groups, patient groups, and pharmaceutical industry to jointly discuss the problem of drug shortage.
In addition, one of the four vice presidents of the Executive Yuan ’ s Commission for Sustainable Development is Minister Weifu. I wonder if the Minister of Weifu has told the Executive Yuan that there is a serious shortage of drugs?
Or do you want the community pharmacy to suffer silently?
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Global medication shortages during this period have been driven by fragmented supply chains, which hinder the consistent availability of raw materials and active pharmaceutical ingredients, prompting calls for systemic changes in the pharmaceutical industry.

Title:

Content: Meitu
The first quarter of the United States serious drug shortage 323 drugs urgent cancer patients also have to be diverted and rationed!
CHU HENG NETWORK NEWS CENTER 2024-04-16 10: 42
According to the latest data from the American Society of Health System Pharmacists (ASHP) and the Utah Center for Drug Information Services, a total of 323 drugs in the United States were in severe shortages in the first quarter of this year, surpassing the record of 320 in 2014.
Among the drugs affected are the widely used diabetes drugs Ozempic and Mounjaro, the allergy treatment drug adrenaline, the common antibiotic amoxicillin for children, chemotherapy drugs and injections commonly used in hospitals in intensive care.
ASHP CEO Paul Abramowitz said in a statement that almost all categories of drugs are facing shortages, with non-patented sterile injectable drugs, including cancer chemotherapy drugs, and emergency drugs stored in hospital emergency vans and operating areas, the shortage of such drugs is the most worrying.
According to the American Cancer Society, chemotherapy is one of the top five drugs most affected by the shortage, which threatens to have a devastating impact on patients, and some hospitals and clinics say doctors have had to divert patients to ration their medications because of a shortage of some chemotherapy drugs.
In addition, ASHP noted that the continued nationwide shortage of ADHD drugs is “a problem for clinicians and patients. ”
The shortage of popular drugs is even more acute, with Mounjaro, the diabetes drug known as the “slimming pill ”, already in dire straits.
In response, Lilly said that the “unprecedented surge in demand ” for Mounjaro and its similar drug Zepbound has led to a shortage in the market, which the company is struggling to cope with.
Lilly is ramping up investments to boost production at Mounjaro and Zepbound in the second half of 2024.
The company said it expects intermittent supply disruptions in the near term due to unprecedented demand.
How to cure the drug shortage
The last major “drug shortage ” in U.S. history occurred in 2014, and it has only been alleviated in the years since.
Since 2021, the drug shortage situation seems to be increasing, and scholars in the field of medical health and economics in the United States believe that the reason for most drug shortages in the United States is the fragmentation of the drug supply chain.
The White House this month proposed spending between $3.26 billion and $5.11 billion over the next decade to help address the nation ’ s drug shortage.
The bill requires approval and funding from the U.S. Congress.
U.S. researchers and policymakers believe that a complete solution to the “drug shortage ” may require changes to the business model of the U.S. pharmaceutical industry, including measures to increase the price of generic drugs to attract more drug manufacturers.
Policymakers recommend giving the FDA more power to access more information about drug shortages and impending shortages.
Currently, the FDA relies primarily on phone calls to manufacturers asking if they can increase their supply to understand the situation.
The American Society of Health System Pharmacists said it is working with the federal government to advise the government on measures to address the drug shortage, including that Congress should require manufacturers to be more transparent on any supply chain issues and encourage more diversity in supply chains.
According to Abramowitz, “The federal government still has a lot of work to do to fundamentally address drug shortages, and the American Society of Health System Pharmacists will continue to engage regularly with policymakers to guide them in drafting and passing new legislation to address drug shortages and continue to advocate vigorously for proven solutions on behalf of our members. ”

Geopolitical factors, such as the heavy reliance on manufacturing in countries like India and China, have exacerbated shortages due to vulnerabilities like natural disasters, political unrest, and quality control issues, as highlighted in a U.S. Senate report.

Title:

Content: The New York Times Original
Continue reading Growing drug shortage in the United States has become a threat to national security
The shortage of medicines in the United States last year increased compared to 2021 by 30%, according to The New York Times.
However, the article notes that the growing shortage of inexpensive but critical drugs poses a national security threat to the United States.
The growing shortage of inexpensive but critical drugs poses a threat to U.S. national security and forces hospitals to make “terrible ” choices, writes The New York Times, citing a report prepared for hearings in the U.S. Senate.
According to this report, the shortage of medicines last year increased by almost 30% compared to 2021, with an average shortage of medicines observed for 18 months, and for some drugs – 15 years.
Among the drugs in short supply are conventional antibiotics and anesthetics, the article said.
Senator Gary Peters, a Democrat from Michigan and chairman of the Senate Committee on Homeland Security and Government Affairs, said that these problems are related to economic factors, an opaque supply chain and the fact that 80% to 90% of some products are made abroad.
“Taken together, these underlying causes not only raise serious concerns about ensuring proper patient care, but also pose a serious threat to national security, ” Peters said.
Dr. Andrew Schumann, an oncology surgeon from Michigan, told senators at the hearing that the shortage of drugs in his field is "a tragedy occurring in slow motion."
As Schumann noted, recently due to the shortage of one cheap, but well-proven cancer drug, he had to choose which patients will receive this drug.
The article notes that many of the cheapest drugs tend to be made in countries such as India and China, where they are inexpensive to manufacture.
However, this concentration of production capacity creates an additional level of vulnerability to problems such as natural disasters and political unrest, emphasizes The New York Times.
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Manufacturing issues, including production delays and quality problems, have also played a significant role, with incidents such as the closure of an Indian factory producing active ingredients for generic drugs disrupting global supply chains.

Healthcare systems in developed countries have implemented strategies to address shortages, such as establishing centralized drug shortage treatment centers and optimizing supply chain communication, as seen in Taiwan's efforts during crises like the COVID-19 pandemic.

Title:

Content: The lack of medicine continues to burn!
The Ministry of Health and Welfare has proposed a short, medium and long-term strategy to deal with the current 5 coping mechanisms.
Journalist Yen Zhenzhen / Taipei Report
According to the Ministry of Health and Welfare, the shortage of drugs is not a single factor, but includes supply problems, manufacturing problems, clinical demand factors, uneven distribution of drugs, drug use habits and drug prices. In addition to dealing with the relatively high clinical demand items, it is properly allocated to all levels of medical institutions and pharmacies to fully meet the needs of clinical end-use drugs.
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In the face of the shortage of drugs, Wang said, the existing health insurance uses five major coping mechanisms, including 1, a single processing window, a dedicated person to help deal with the problem of drug purchase, and contact the Food and Drug Administration to put relevant information on the website of the NHI. (4) Drug price adjustment mechanism that does not meet the cost can be re-checked according to the way of raising the price of special drugs; (5) Alternative drugs can still declare the cost, if they are not irreplaceable, they can be replaced at the same price or lower than the original prescription drug price.
In addition, Wang pointed out that in the face of the international epidemic, the Russian-Ukrainian war, and labor shortage, drug shortage is a problem facing all countries. In order to strengthen the stable supply mechanism of drugs in China, the Ministry of Health and Welfare continues to actively respond to the short-term strategy to solve the problem of drug shortage. The Food and Drug Administration (FDA) and the pharmaceutical industry have made every effort to actively arrange production lines, strive for early import, increase production / import quantity, and properly distribute to all levels of medical institutions and pharmacies to fully meet the demand for clinical end use drugs.
In addition, to properly handle the issue of drug price adjustment, the Central Health Insurance Administration of the Ministry of Health and Welfare intends to implement the "Universal Health Insurance Cost Distribution Target System (DET)" in April this year, which will adjust the number of drug prices and adjust the quota in a suitable manner, taking into account factors such as the epidemic, the Russian-Ukrainian war and inflation.
In terms of medium-term strategy, Wang said that he will establish a permanent drug shortage treatment center and optimize drug supply information transmission.
In order to speed up the handling of drug shortage incidents, we will adopt dedicated personnel and cross-departmental cooperation to develop drug shortage prevention policies to prevent drug shortage in advance, strengthen cross-departmental data integration and proactive monitoring to detect drug shortage incidents at an early stage, and intervene early through cross-departmental cooperation to stabilize drug supply.
At the same time, the Food and Drug Administration (FDA) continues to disseminate drug supply and alternative drug information through various channels. In addition to posting on the “Drug Supply Information Platform ”, the FDA will notify medical institutions and pharmacies through VPN, and weekly letters to relevant medical associations and public associations to inform members. Management system.
In the long-term strategy section, it includes reviewing the current health insurance drug pricing policy and encouraging the production of domestically manufactured generic drugs.
Wang Bi-sheng pointed out that in the review of the current health insurance drug price policy, including the development of the price protection of indicative drugs, drug price review for the lack of drugs; start the review of drug expenditure target (DET), plan the establishment of a risk control mechanism, plan the national unified procurement trial plan; comprehensively review the health insurance drug price policy, give an appropriate price protection mechanism for necessary drugs, and also target the patent period. To encourage the production of domestic manufacturers to ensure that when there is a shortage of original pharmaceutical products, there are domestic famous drugs to respond.
Wang also stressed that the Food and Drug Administration has set up a "Drug Supply Information Platform" (https: / / dsms.fda.gov.tw /), reporting hotline (02) 27878249. If medical institutions and pharmacies have any shortage of drugs, they can go to the platform for enquiry or notification, and the department will deal with it immediately.
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In Ireland, medication shortages have been mitigated by switching patients to therapeutic alternatives, such as different strengths or brands of the same drug, ensuring continuity of care despite supply chain disruptions.

Title:

Content: Ireland has been suffering a paracetamol shortage as cases of Covid-19 and the winter flu in the country soared over the festive and new year period.

The revelation was made by Health Minister Stephen Donnelly after his department received notification of a supply issue from the Health Products Regulatory Authority.

It is understood the shortage impacted some prescription paracetamol products.

Read More:Irish people complain of ‘worst ever’ winter bug sweeping country that feels like Covid but isn’t

Two suppliers affected have stated that resupply will be sometime in January 2023.

However, there are other prescription paracetamol suppliers with some stock available on the shelves.

Paracetamol is one of the medicines used most often in Ireland and especially for the flu, aches and pain.

But Mr Donnelly pointed out that there are multiple forms of the drug with different strengths and brands available from various sources.

He said: "In the event that there are some supply issues for individual medicines, alternative options such as alternative strengths and brands, generic medicines will usually be available to ensure continuity of treatment.

"In some cases where the medicine initially prescribed for the patient is unavailable, patients may be switched to a suitable therapeutic alternative following appropriate consultation with a healthcare professional."

The Health Minister said medicine shortages have been increasingly prevalent worldwide over the past decade. The causes of such shortages are multifactorial including shortage of raw materials, manufacturing difficulties and industry consolidations.

He stated: "Medicine shortages can originate at any point in the supply chain. They can involve and impact many stakeholders in different ways as the supply models and clinical use of therapies can vary across national health systems.

"Management of medicines shortages necessitates a multi-faceted, multi stakeholder response to ensure patient safety , continuity of care and protection of public health.

"Patients or their carers who have any concerns in relation to temporary alternative products provided because of medical shortages are advised to speak with their pharmacist or other healthcare [professionals] involved in their care."

Mr Donnelly was responding to a number of written Dail questions on the shortage of medicines.

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The European Union has promoted the use of generics, reformulated medications for easier administration, and planned stricter supply obligations and earlier notifications of shortages in upcoming pharmaceutical legislation to improve resilience against production challenges.

Title:

Content: There is not enough medicine in the EU
19 January 2023, 05: 20
ASTANA.
KAZINFORM - The European Union is suffering from a shortage of medicines.
Deficiency of antibiotics, such as amoxicillin, drugs against colds, flu and other respiratory infections, as well as some drugs for children, reports MIA "Kazinform" with reference to euronews.com.
In most countries, the situation is considered critical, but since such goods from pharmacies do not disappear at all, citizens are not advised to make stocks.
Doctors note a weakening in the population of natural immunity due to protection against coronavirus such as social distancing.
The main reasons for the sharp increase in demand, which have been identified, is the high prevalence of respiratory diseases with a lack of production capacity.
As pharmaceutical issues are being addressed at the national level, Governments are already taking steps to overcome the shortage
These measures include the sale of generics and the replacement of requested medicines with similar ones.
In some countries, some formulations have been changed, for example, drugs are offered in the form of syrups instead of tablets, so that children are more willing to take them.
"Pediatric drugs are generally now less available in the form of conventional tablets," said Steffen Tierstrup, chief medical officer of the European Medicines Agency. "Therefore, where children are more ill, the need for pediatric drugs is higher than for adult drugs."
A recent study showed that the shortage of drugs in Spain increased by 38% over the year.
The decline in their production was affected by inflation, high energy prices, shortages of raw materials and the effects of the pandemic.
“We need diversification, ” said Ilaria Passarani, head of the EU Pharmaceutical Group.“ Of course, it would be useful to return to Europe the production of some critical materials, such as active ingredients.
But we can't return all the production of all the materials we use for drugs.
This entails problems such as the increase in pharmacy prices associated with the implementation of environmental laws, labor laws, which are not necessarily enforced in other regions. ”
In March, the European Commission will present a revised version of the EU pharmaceutical legislation, which will include stricter supply obligations, earlier notification of shortages and seizures of medicines, and better informing the public about available stocks.
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Developing countries have faced unique challenges in managing medication shortages, including insufficient production capacity, logistical issues, and poor coordination between supply and demand, particularly in rural areas with limited access.

Title:

Content: Health · Life
How to solve the problem of drug shortage in rural areas?
National Health Commission response
January 07, 2023 17: 26 Source: People 's Daily Online
Beijing, January 7 (Reporter Yan Yan Yan) Today, the joint prevention and control mechanism of the State Council held a press conference to introduce the situation of epidemic prevention and control in rural areas and answer questions from the media.
At the press conference, a reporter asked, recently, many township health centers and village health rooms have a shortage of drugs and other problems, how to properly solve?
Nie Chunlei, director of the grass-roots department of the National Health Commission, said that rural areas are the focus of epidemic prevention and control and are also weak links.
The joint prevention and control mechanism of the State Council has attached great importance to the prevention and control of the epidemic in rural areas and made a lot of arrangements for deployment.
There is a shortage of medicines and other medical supplies in rural areas, for three reasons: First, the production capacity of individual medicines is insufficient, and the supply is in short supply.
Second, the information between the supply and demand sides is not smooth.
Third, logistics reasons, some purchased drugs can not be delivered in time, resulting in a shortage of drugs.
In response to the shortage of drugs, the state has taken a series of measures, Nie Chunlei said. First, the material support group of the joint prevention and control mechanism of the State Council has established a daily dispatch system to coordinate the daily dispatch of drugs and other key medical supplies.
According to the development of the epidemic, priority is given to medical institutions in rural areas, especially in rural areas.
For some drugs that are in short supply, those with insufficient production capacity, actively coordinate and expand production capacity.
Relevant departments have formulated policies to support relevant enterprises to expand production capacity, mobilize the enthusiasm of enterprises, and work overtime to produce relevant drugs.
The second is to strengthen supply and demand docking.
Rural areas have a wide range of points and long supply chains, and if the docking of supply and demand is not smooth, the problems reflected by the grassroots may not be timely feedback.
Local governments are encouraged to focus on procurement.
All localities should strengthen the docking of supply and demand through material support groups to solve the shortage of medicines in a timely manner.
Third, adhere to the combination of Chinese and Western medicine, rational selection of Western medicine, Chinese patent medicine and traditional Chinese medicine decoction.
Local governments, especially in rural areas, should be encouraged to give full play to the characteristics of rural areas, make full use of traditional Chinese medicines, alleviate the problem of insufficient medicines, and reduce the pressure on grass-roots medical care
Nie Chunlei said: "From the current monitoring situation, the shortage of medical supplies is more prominent, but recently with the development of the epidemic and the growth of drug production capacity in various localities, the coordination of material support groups and logistics is smooth, and the local government Strengthen the organization, the problem of drug shortage is gradually improving.
(Editor: Yang Di, Gao Lei)
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In Ethiopia, foreign currency limitations have restricted the import of essential drugs and raw materials, leading to reliance on smuggled or substandard medications that pose significant risks to patient safety.

Title:

Content: HealthIn-Depth AnalysisSocial Affairs
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In-depth: A Dollar a Dose, a Life Saved: The search for safer pharmaceuticals amid the challenge of widespread substandard medications

By Million Beyene @MillionBeyene

Addis Abeba – In the world of illicit trade, a dangerous threat looms in the form of substandard and illegally sold pharmaceuticals that endanger millions of lives worldwide.

A recent study conducted by the World Health Organization (WHO) has uncovered the massive scale of this problem, revealing that the illicit drug trade generates nearly a trillion dollars annually.

Surprisingly, this makes it the second-largest illicit financial stream globally, coming in just behind arms sales. However, the true impact of this hidden industry extends far beyond just monetary value.

In sub-Saharan Africa, including Ethiopia, the cost is counted in human lives.

Every year, almost half a million individuals fall victim to the dangerous consequences of using substandard and counterfeit medical products.

The ramifications of this issue are severe, as individuals often unwittingly procure and consume medications that prove to be ineffectual or even detrimental to their well-being.

The recent experience of Getachew Belay, a resident of Addis Abeba, serves as a poignant illustration of the predicament faced by such individuals.

He told Addis Standard about the distressing ordeal of procuring medications at a substantial cost of 90,000 birr, only to find them ineffective in treating his mother’s liver disease.

Regrettably, despite the doctor’s acknowledgment of the ineffectiveness of the “albumin” medication and subsequent refusal to administer it, this intervention was belated.

“Consequently, my mother succumbed to her condition shortly after discontinuing the ineffective treatment and before a suitable alternative could be provided,” recounted Getachew, reflecting on the most devastating experience of his life.

Dr. Mehari Tesfaye (name changed), a prominent medical director at a public hospital in Addis Abeba, shared insights with Addis Standard regarding Ethiopia’s escalating issue of substandard medications.

According to him, a notable example is “albumin,” a vital medicine employed in treating liver disease.

“The substandard variants of this medication are not only ineffective but also potentially harmful,” he emphasized, underscoring the peril associated with such drugs.

A nationwide study conducted in 2013 found that 7.8% of medications in Ethiopia were substandard.

Nevertheless, medical experts interviewed by Addis Standard disclosed that the incidence of substandard drugs has notably increased in Ethiopia over the past decade.

This observation aligns with research findings.

According to a study published last year, 21.8% of the drugs sampled in Ethiopia exhibited failures in one of the product quality parameters: dissolution, disintegration, identity, or chemical assay.

An anonymous medical expert disclosed the extensive availability of substandard, illicitly manufactured, or imported drugs in numerous pharmacies throughout Addis Abeba.

The expert highlighted a particularly troubling trend: the heightened involvement of licensed drug importers in the illicit drug trade, particularly over the past two years.

In Ethiopia, a particularly troubling issue arises from the presence of ineffective medications, even among those legally imported.

Medical experts have apprised Addis Standard of instances where drugs lack medicinal properties, aligning with public grievances about medications failing to provide therapeutic benefits.

Dr. Solomon Tezera (name changed), an infectious disease specialist, is among the medical professionals who express profound concern regarding the prevalence of ineffective medications.

“These concerns extend beyond smuggled drugs to encompass medications legally imported by some organizations,” he states. “Patients diagnosed through lab tests and prescribed medication often fail to experience improvement due to these defective products, resulting in a frustrating situation for both patients and medical staff.”

Patients diagnosed through lab tests and prescribed medication often fail to experience improvement due to substandard medications.”

An infectious disease specialist

Dr. Solomon further emphasizes the critical role of effective medications in managing chronic conditions such as diabetes, hypertension, and heart disease. He underscores that substandard medications for these illnesses can lead to a rapid exacerbation of symptoms.

“Medical professionals have recently identified and reported these problematic drugs to the appropriate regulatory bodies,” he added.

Recently, the Ethiopian Diabetic Association (EDA) also raised concerns about the efficacy of a medication named ‘Galvanez’.

Tackling substandard medications

The Ethiopian Food and Drug Authority (EFDA), a governmental regulatory body responsible for ensuring the safety, quality, and efficacy of medicines, has addressed these concerns.

Officials from the EFDA have stated that no official reports regarding the specific medication in question have been filed.

Gezahegn Endale, the head of the EFDA’s South East Addis Abeba Branch Office, affirmed, “No reports of substandard or defective medications related to Galvanez have been presented to the authority thus far.”

While no issues with Galvanez have been reported, the EFDA has noted a concerning trend of unauthorized drugs entering the country. These drugs often lack registration, approval from their country of origin, and information about their manufacturers.

Additionally, the EFDA recognizes the ongoing challenge of smuggled medications, particularly those targeting critical areas such as cancer treatment. The Authority has stated its active efforts to strengthen controls at border entry and exit points.

In a recent statement, the EFDA underscored its commitment to “identifying and removing any smuggled drugs to safeguard public health.” The authority highlighted its rigorous protocols for ensuring the safety and efficacy of all medications entering the Ethiopian market.

This includes thorough pre-market registration checks, which meticulously examine a drug’s production methods, ingredient lists, and accompanying scientific documentation before granting a market license.

Furthermore, to ensure quality, imported medications undergo extensive sampling, testing, and verification procedures beyond registration. Additionally, the EFDA conducts physical inspections at entry and exit points to enhance its safeguards.

Acknowledging the challenge of precisely quantifying the volume of smuggled drugs, officials at the EFDA assert that their regulatory measures are more stringent compared to those of neighboring countries. They underscore their “continuous endeavors to ensure the quality, safety, and efficacy of medications” across the entire supply chain.

However, stakeholders emphasize that the shortage of legally imported medications has compelled certain private pharmacies, licensed drug importers, and domestic drug producers to resort to smuggled alternatives.

Dr. Mehari underscored the challenges Ethiopia encounters in securing an adequate supply of legal medications.

“This susceptibility exposes the population to the hazards of smuggled drugs,” he elucidated. “Patients who unwittingly depend on substandard medications are at an elevated risk of complications.”

Gezahegn acknowledges the potential vulnerabilities within the distribution system and unethical practices by some wholesalers, such as auctioning off medications of dubious origin to retailers, which could introduce smuggled or unregistered drugs.

“The recent license revocation of four wholesalers supplying unregistered drugs to St. Paul Millennium Medical College’s Hospital exemplifies the EFDA’s commitment to addressing such practices,” he highlights.

Forex shortage, soaring prices

However, Gezahegn attributes a significant factor in such health risks to the scarcity of foreign currency in the country.

“This limitation restricts the ability of importers to acquire essential medications in sufficient quantities, potentially leading to drug shortages,” he explains.

Ethiopia meets the yearly requirement for medications and medical equipment primarily through imports, as domestic production satisfies only 15% of the national demand.

The Ethiopian Pharmaceuticals Supply Service (EPSS) oversees the acquisition of drugs and medical equipment, whether sourced locally or imported.

The scarcity of foreign currency in the country restricts the ability of importers to acquire essential medications in sufficient quantities, potentially leading to drug shortages.”

Gezahegn Endale, the head of the EFDA’s South East Addis Abeba Branch Office

Annually, EPSS supplies over 1,000 medicines and medical equipment to more than 5,000 public health institutions. In the previous year, it allocated over 40 billion birr for the procurement of drugs and medical equipment, with drug procurement alone amounting to over 15 billion birr.

Dr. Solomon further contends that the limited availability of foreign currency is hampering the capacity of local pharmaceutical manufacturers to import essential raw materials necessary for drug production.

Leaders of the Ethiopian Pharmaceutical Manufacturers Association also attribute their underperformance to the unavailability of foreign currency. They highlighted that 85% of the challenges they face are related to foreign currency shortages.

Mukamil Abdella, vice president of the association, recently stated in a state media interview that foreign currency is not accessible in the required quantity and timeframe for procuring raw materials essential for medicine production, adversely affecting their operations.

Another senior manager from a local pharmaceutical company disclosed that his firm requested $21 million for the acquisition of raw materials and other essentials. However, after an 11-month waiting period, the company was only allocated $5 million, which proved insufficient.

The persistent scarcity of foreign currency in Ethiopia continues to render the nation vulnerable to the influx of smuggled drugs, exacerbated by disruptions in the global supply chain that have led to inflated prices for pharmaceutical products.

Studies indicate that disruptions caused by the COVID-19 pandemic, further compounded by the Russia-Ukraine conflict, have resulted in a more than 200% increase in drug costs.

During his appearance before parliament to present the central bank’s quarterly report in November 2023, Mamo Mihretu, the governor of the National Bank of Ethiopia (NBE), acknowledged the escalating pharmaceutical costs, which are depleting the country’s foreign currency reserves.

According to Mamo, the costs of three key import items for Ethiopia—pharmaceuticals, petroleum, and fertilizers—have more than doubled in the past three years.

Although acknowledging that Ethiopia encounters obstacles in ensuring a consistent provision of legally imported medications due to factors such as limited foreign currency reserves, public health experts contend that these challenges should not serve as justification for the increase in illegal drug trafficking and the availability of substandard drugs in pharmacies.

Officials, however, assert that they are actively addressing the issue of smuggled medications despite the persistent challenge of detecting and eliminating any illicit drugs that may already be present within the country.

“The Authority is intensifying surveillance at entry points to deter smuggling,” stated Gezahegn. AS

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Governments in developing countries have responded by expanding production capacity, prioritizing rural healthcare facilities, and adopting alternative treatments like traditional medicines to alleviate pressure on limited resources.

In the United States, hospitals have faced critical shortages of inexpensive but essential drugs, such as antibiotics and anesthetics, forcing healthcare providers to make difficult decisions about patient care.

The American Society of Health System Pharmacists documented a record high of 323 drug shortages in the first quarter of 2024, with hospitals particularly affected by shortages of sterile injectable drugs, including chemotherapy and emergency medications.

In France, 44% of patients reported experiencing drug shortages in 2024, with oncology professionals highlighting significant impacts on cancer treatment due to disparities in how hospitals and pharmacies managed stock.

Title:

Content: French health groups put forward proposals to limit the damage of worsening drug shortages

Medicines such as cough syrup, lozenges and ointment are seen on a table in an apartment in Berlin, Tuesday, December 20, 2022. Copyright Stephanie Pilick/dpa via AP
Copyright Stephanie Pilick/dpa via AP
By Lauren Chadwick
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Pharmaceutical companies’ lack of transparency leads to rising drug prices and less control over public resources, the group of health organisations say.

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A group of French organisations have called for more transparency from pharmaceutical companies as drug shortages increase.

In a joint report, 14 civil society organisations outlined their recommendations to solve a “situation that has only worsened” since 2018.

The French medicines regulator signalled 4,925 drug shortages in 2023, compared to 3,761 in 2022 and 2,160 in 2021.

A 2024 survey from France Assos Santé, which represents patients, found that 44 per cent of people in France said they had faced a drug shortage this year.

One of the pharmacy unions in France has even planned a strike at the end of the month over drug shortages and what they say is worsening access to care.

Each health organisation contributed an article with recommendations for dealing with the drug shortages.

The League Against Cancer urged complete transparency on drug shortages and potential substitutions for health professionals.

They also called for monitoring of medicine stocks and their location in the country to guarantee equal access.

The organisation found in a survey published in February that 78 per cent of health professionals in oncology had been faced with a drug shortage.

Drug shortages or delays have led to anxiety among cancer patients, lost time, and worsening symptoms, the organisation said.

France Assos Santé, meanwhile, wrote that an urgent response should not be to support “the industrial sector which bears serious responsibilities” for abandoning the production of less profitable drugs, relocating drug production, and keeping insufficient medicine stocks.

They would like any cost increases justified by production costs or the risk of withdrawing a drug from the market due to it being unprofitable. They called for cost evaluations to be made public.

Their concerns also range from the use of public money to bring drug production to Europe to new government plans to prevent shortages.

Some changes at the EU level criticised

Last year, the European Commission announced several measures to reform the pharmaceutical industry and address critical drug shortages.

The European Parliament went on to adopt a position on pharmaceutical reform last month, that included “incentives for innovation” and an effort to limit overuse of antibiotics.

The non-profit organisation Prescrire, which focuses on information about medicine, wrote in a chapter they contributed to the report that while some of the European Commission’s measures were welcome, others were concerning.

One of the many measures they rejected included the Commission’s proposal to reduce the number of days of scientific evaluation of drugs from 210 to 180, which they said was necessary time rather than an “administrative obstacle”.

While the NGO welcomed some measures such as government drug shortage prevention plans, it said the Commission should allow EU states to require pharmaceutical companies to have safety stocks of medicine and sanction those that do not respect them.

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French consumer organisation UFC-Que Choisir and the European Consumer Organisation (BEUC) said that they had hoped MEPs would shorten the length of time for “data protection” to allow generic medicines to be marketed more quickly.

Instead, MEPs approved shortening the period to 7.5 years, “which is almost the same duration as the current 8 years [yet] within the framework of the text adopted by Parliament, companies can gain additional months of protection under certain conditions to reach a total of 8.5 years,” UFC-Que Choisir said.

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Governments and international organizations have established initiatives like the Pandemic Supply Chain Network (PSCN) to anticipate and respond to global healthcare supply chain disruptions, fostering partnerships and improving inventory management systems.

Title:

Content: This came in a panel discussion held during the Forum – which was broadcast on its official website a little while ago – and highlighted that the global pandemic preparedness system needs sustained political will and investments to ensure that the global healthcare supply chain responds effectively to any crisis.
If we don ’ t take pandemic preparedness seriously now, the lives of millions more will be at stake.
The SARS, Ebola and COVID-19 crises have tested the world ’ s ability to deal with outbreaks of epidemics and infectious diseases, and the global pandemic preparedness system needs sustained political will and investments to ensure that the global healthcare supply chain responds effectively to the crisis.
“Eight years ago, when the Ebola outbreak proved that the world was no better prepared for outbreaks, there was more talk and some action, ” participants said.
This included the establishment of the Epidemiological Supply Chain Network (PSCN), by the World Health Organization, the World Economic Forum, the World Bank, the World Food Programme, the US Centers for Disease Control and Prevention and more than 60 companies.
However, nearly three years after the COVID-19 pandemic – the worst global health crisis in a century – many of the same supply chain vulnerabilities remain, and although partnerships, such as PSCN and national efforts have somewhat reduced the severity of supply chain disruptions during the epidemic, efforts to develop a global pandemic preparedness system have not yet mobilized the will. “The sustainable policy and investment needed to ensure that global health care is delivered in a way that can respond effectively to any crisis. ”
The Forum recommended seven key actions to address this issue:
- Providing political will and sustainable financing.
Although crises often lead to an influx of short-term spending, money quickly dries up as memories fade and priorities change.
Genuine global health security requires global financing mechanisms that enable sustainable investment and ultimately break panic and fear.
- Geographical diversification in manufacturing; achieving greater geographical diversity requires more than just investing in new factories.
Long-term contracts and financial guarantees are needed to maintain the manufacturing of important health-care materials in diverse locations.
- Improved inventory management.
In addition to strengthening stocks of personal protective equipment (PPE) at local, regional and national levels, we must manage medical stocks more intelligently.
- Establish platforms for data exchange and enhanced transparency.
Through globally focused PSCN and various national efforts, while progress has been made, encouraging responsible information sharing between public and private partners requires substantial additional funding.
Promote the free flow of goods.
Over the past three years, government restrictions on exports have played an important role in exacerbating the lack of product distribution.
While governments ’ desire to protect their people in times of crisis is understandable, international cooperation to allow the free flow of key products reduces the risk of viral spread.
- Strengthen coordinated early warning systems for epidemics.
Strengthening health systems and improving primary care.
Dr Tedros Adhanom Ghebreyesus, Director-General of WHO, said: “Universal health coverage and health emergencies are cousins – two sides of the same coin.
Significant and sustained investments are needed if we are to reap the benefits of expanded access to care. ”

The European Commission has proposed measures such as a voluntary solidarity mechanism, joint procurement of drugs, and the creation of a Critical Medicines Alliance to address shortages, alongside emergency actions like extending drug shelf life.

Title:

Content: Brussels is planning for EU countries to share vital medicines and take emergency measures to avoid a repeat of shortages that hit the bloc a year ago.

The European Commission is proposing a “voluntary solidarity mechanism” requested by France and Germany and an early warning system flagging when drugs become scarce, according to draft proposals seen by the Financial Times. If insufficient donors come forward, EU capitals will be allowed to tap into an EU-funded stockpile set up during the Covid-19 pandemic and take other emergency measures.

In December and January western countries suffered a shortage of antibiotics including penicillin and amoxicillin, and painkillers such as paracetamol, especially in medicines used by children.

Among the emergency measures floated to prevent a repeat of that crisis, the commission could allow the extension of a drug’s shelf life, fast track approvals of alternative suppliers and support production increases.

Brussels will also encourage joint procurement of drugs from 2024 and medicine swaps with countries in the southern hemisphere, where peak winter demand happens at a different time.

The commission will draw up guidance for national stockpiles in 2024 and establish a Critical Medicines Alliance bringing governments, industry and civil society together. The commission declined to comment.

Three-quarters of countries reported a worsening of drug shortages in 2022, according to an industry survey. EU manufacturing is heavily reliant on imported active pharmaceutical ingredients from China and India.

Rising demand and disruption to supply chains have been compounded by inflation hitting the production of generic drugs, which typically sell at much lower prices than branded versions.

France has been actively encouraging the reshoring of basic medicine supply, with a giant paracetamol factory set to open in the country next year.

The EU is discussing whether to provide more funding for domestic production.

The commission’s proposal is scheduled to be approved on October 25 and could still change. Initially non-binding, it could lead to a Critical Medicines Act, with Brussels drawing up a list of vital medicines by year-end.

The commission also urges member states and the European parliament to approve its overhaul of pharmaceutical legislation, put forward in April. It includes plans to take control of drug production in the event of a public health emergency, a requirement for stockholders to inform Brussels of supply levels and for manufacturers to give early warnings of shortages.

An analysis by the European Medicines Agency and the commission found that unless there is unexpected demand the EU should avoid an antibiotics shortage this year.

“The information available today suggests that — if demand in the coming winter season does not differ significantly from the demand of recent years — the supply to the EU of key antibiotics seems to generally match demand,” the analysis said.

“However, this depends strongly on the compliance of industry with their legal obligations to ensure supply and their ability to adapt.”

Copyright The Financial Times Limited 2023. All rights reserved.
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Taiwan's Ministry of Health and Welfare has developed strategies to address drug shortages, including establishing a permanent drug shortage treatment center and encouraging domestic production of generic drugs to ensure stable supply.

Pharmaceutical companies have been criticized for prioritizing short-term profits over the production of essential medications, exacerbating shortages of life-saving drugs such as chemotherapy treatments and ADHD medications in the United States.

Title:

Content: International
International News
Dependent on foreign raw materials fluctuate, big pharmaceutical companies chase short-term profit loss production
The shortage of ADHD drugs is just the tip of the iceberg of the current drug shortage in the United States. According to the FDA, more than 135 drugs are in short supply, including chemotherapy drugs for cancer.
A survey released by the American Society of Health System Pharmacists (ASHP) in early August showed that one-third of the 1,100 hospitals surveyed had no prescription, delayed or reduced prescriptions due to drug shortages to meet the supply window.
Expert analysis, pharmaceutical companies to pursue short-term profit first business model, so that the production of life-saving drugs and demand out of line, drug shortage problem is difficult to improve.
Experts urge pharmaceutical companies to face social responsibility
Rita Numerof, a medical industry consultant, wrote in Forbes magazine that in order to reduce costs, US pharmaceutical companies have long relied on foreign suppliers such as China, India and Italy to import raw materials for the production of drugs, which is prone to fluctuations in supply. They are looking to develop drugs that are more likely to be used for long-term diseases.
Teva, a manufacturer of ADHD drugs and the world ’ s largest generic drug manufacturer, announced earlier that it would reduce the production of some generic drugs and focus on more profitable products. Rumelove warned that if pharmaceutical companies are unwilling to address their social responsibilities and strengthen supply risk management, public trust in the pharmaceutical industry will continue to weaken, and ultimately public health and safety will pay a heavy price.
Focus on the organization to accelerate the use of new generic drugs to increase production incentives
The American Association for Access to Medicines (AAM) released a report last month, saying that because of restrictions on the supply of generic drugs, the supply price of generic drugs is limited, and the return of investment in new drugs is not high. The situation.
(Forbes / DrugTopics)
(Global Hot Talk)
Related Words: Adderall Drug Shortage Attention Deficit and Hyperactivity Disorder (ADHD)
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In France, health organizations have accused pharmaceutical companies of abandoning the production of less profitable drugs and maintaining insufficient medicine stocks, worsening shortages of critical medications like oncology drugs and antibiotics.

Efforts to address shortages have included pharmaceutical companies increasing production capacity for high-demand drugs, such as Eli Lilly’s investment to boost the supply of diabetes medications, though intermittent disruptions persist.

Regions such as South Asia, sub-Saharan Africa, and Southeast Asia have been disproportionately affected by medication shortages, with limited healthcare infrastructure and economic challenges exacerbating drug accessibility issues.

Title:

Content: A global study by The Lancet found that there are about 6.4 million doctors missing in the world.
To date, more than 12.8 million specialists with a medical diploma work in the field of health care, but much more is needed.
Staffing capacity
The study, titled “Measuring human resource affordability for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study, ” was published May 23 in The Lancet.
The authors studied the number of doctors, nurses and midwives, dental and pharmaceutical staff and found that as of 2019, there were shortages of doctors in 132 countries.
Globally, there are more than 43 million health workers missing when we compare the current level of coverage with the targets needed to achieve universal health coverage.
“This is the most comprehensive and comprehensive assessment to date of the global health workforce.
Adequate numbers of health workers are necessary for the normal functioning of health systems, so it is important to own such data so that countries can make informed decisions and plan for the future, ” said the study ’ s senior author, director of health organization at the Institute of Health Metrics and Assessment (IHME) at the University of Washington School of Medicine, Dr. Rafael Lozano.
As of 2019, there were 104 million healthcare workers worldwide, including 12.8 million doctors, 29.8 million nurses and midwives, 4.6 million dental workers, and 5.2 million pharmacists and pharmacists.
The study revealed more than a tenfold difference in the availability of health workers across regions and between countries.
The greatest shortage of doctors is in South Asia, where there is a shortage of 2.57 million doctors; in sub-Saharan Africa, there is a shortage of about 1.92 million doctors, in Southeast Asia, East Asia and Oceania - 995,000, in North Africa and the Middle East - 636,000 doctors.
On average, there are 16.7 doctors per 10,000 people in the world.
Density ranges from 2.9 physicians per 10,000 population in sub-Saharan Africa to 38.3 per 10,000 in Central and Eastern Europe and Central Asia.
Cuba unexpectedly stands out among other countries with an indicator of 84.4 doctors per 10 thousand people (for comparison: 2.1 doctors per 10 thousand in Haiti).
The availability of health workers in general is closely related to the level of social and economic development of the region, the authors of the study noted.
Health standards
“There are various strategies and policy approaches that can help address staffing shortages, and they need to be tailored to the individual situation in each country.
We hope that these assessments can be used to prioritize policy actions and inform future planning.
Achieving high levels of effective health coverage requires a significant increase in the number of health workers worldwide, ” the press release said.
Experts assessed staffing based on the UN Sustainable Development Goals and the WHO Health Personnel 2030 strategy.
The authors of the study called on the leaders of countries to pay attention to the problem of shortage of medical workers and to develop comprehensive programs to solve it
Overall, experts estimate that an additional 6.4 million doctors, 30.6 million nurses, 3.3 million dentists and 2.9 million pharmacists and pharmacists are required to reach the minimum thresholds.
“We do not consider these minimum thresholds mandatory, rather desirable.
We propose to use them as guidelines, and then the program developers in each country should take into account their own situation and their own experience.
In some places, the healthcare system works better with fewer staff, and in some places worse with more staff.
The threshold is a convenient and innovative metric for determining gaps, but it should be remembered that this is not only a matter of quantity, but also of quality, ” the study says.
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Medication shortages have significantly impacted patients with chronic and life-threatening conditions, leading to delays in treatment, rationing of care, and emotional distress, as seen in the widespread shortage of chemotherapy drugs like cisplatin and carboplatin.

Title:

Content: As drug shortage list grows, many hospitals face tough decisions on rationing care

More than half of hospital pharmacists are reporting a critical shortage of chemotherapy drugs and nearly all are reporting overall medicine supply gaps as prescription drug shortages near an all time high, according to a new survey.

Hospital pharmacists said drug shortages have forced 1 in 3 health systems to delay, cancel or ration care or switch to alternate drugs to continue to treat patients. And 99% are reporting some drug supply shortages, an American Society of Health-System Pharmacists survey of more than 1,000 pharmacists released Thursday found.

The organization reported shortages of 309 drugs, near the all-time high of 320 shortages in 2014. The scarcity of key drugs is prompting hospitals to find or substitute drugs and change treatment plans as needed.

“In some cases, there are no alternatives to the affected drugs, which puts patients at risk," ASHP Chief Executive Officer Paul W. Abramowitz said in a statement. "This issue requires quick action from Congress to address the underlying causes of shortages and ensure patients have the medications they need.”

Cancer drug shortages

In June, the Food and Drug Administration said it will temporarily allow overseas drug manufacturers to import some chemotherapy drugs.

The FDA allowed Qilu Pharmaceutical, a drug manufacturer in China, to import the injectable chemotherapy drug cisplatin in 50-milligram vials. Toronto pharmaceutical company Apotex Corp. will distribute the medication in the United States.

More than a dozen cancer drugs have been in shortage in recent months, including cisplatin and carboplatin, used to treat lung, breast, prostate and gynecologic cancers. The National Cancer Institute said cisplatin and similar drugs are prescribed for 10% to 20% of all cancer patients.

In June, the National Comprehensive Cancer Network released a survey of 27 academic cancer centers that found 93% reported shortages of carboplatin and 70% faced shortages of cisplatin.

When cancer hospitals face such shortages, they attempt to make sure there's enough medication for patients to finish the course of treatment, said Mike Ganio, ASHP's senior director of pharmacy practice and quality.

Cancer hospitals facing such shortages might change medications for new patients starting on chemotherapy, said Ganio, a former pharmacy manager at an academic cancer center.

"You try to keep that patient on the same regimen as much as you can, unless they're failing it for some reason, and then you would switch," Ganio said.

Steroids, hormonal drugs also in short supply

More than 1 in 5 hospital pharmacists also reported shortages for steroids, hormonal drugs and oral liquids such as lidocaine, ibuprofen and amoxicillin.

A smaller number of pharmacists said heart medications, emergency prefilled syringes and drugs used for intensive care unit patients were in short supply. Others reported shortages of attention deficit hyperactivity disorder medicines, antimicrobial drugs and injectable opioids.

In all, about two-thirds of pharmacists said the shortages were "moderately impactful," which means they are managing shortages but patients are affected.

Pharmacists are managing the shortages by offering therapeutic alternatives, buying different vial sizes or concentrations and rationing medicines.

This article originally appeared on USA TODAY: Survey: Drug shortages are widespread, hospitals ration care

Patient testimonials, such as those of diabetic individuals in Egypt, highlight the severe consequences of medication shortages, including the inability to access essential drugs like insulin, forcing patients to reduce dosages or seek alternatives.

Title:

Content: Saturday 13 July 2024
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Dalia Abdul Rahim
Chairman of the Board of Directors and Editorial Board
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Reports & Investigations
A “cure ” for the lack of medicine.
News portal monitors the suffering of health insurance patients..
Health Minister Apologizes to Citizens
Head of the division: Insistence on using the trade name exacerbates the problem
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Hundreds of chronic disease patients from health insurance clinics suffer from a lack of treatments and medicines, especially diabetics; because of the lack of insulin and many other medicines that are not available, where the journey of great suffering begins after the patient leaves the examination room and the doctor writes the necessary treatment in the prescription, to surprise patients that the treatment does not exist and he has to look for it himself.
In this report, "Al-Bawaba News" monitors the suffering of patients looking for medicine in light of the lack of the market of local and imported medicines in health insurance pharmacies and free market pharmacies, where « Al-Bawaba » met "Amina", a 50-year-old woman suffering from diabetes, went to health insurance in the city of Al-Mahalla Al-Kubra, in an attempt to get her treatment to clash with reality. The health insurance deducts a fixed monthly subscription for her treatment, but the head of the pharmacy inside Ibn Sina Clinic in Mahalla Al-Kubra confirmed that the treatment is not currently available, and that the patient must go to three pharmacies affiliated with the Health Insurance Authority, and three pharmacies outside it affiliated with the Health Insurance also, to get the medicine.
"Amina" did not despair of attempts and despite her illness, she went to 6 pharmacies affiliated with health insurance inside and outside the headquarters and did not find sugar medicines available, even she did not find it in the free market in various pharmacies.
The suffering continues.
Amina ’ s condition is not unique in the midst of a hustle of medication shortages, as Menna Magdy from Giza also complained about the lack of insulin and tapes needed for a glucose meter, which has become rare.
“Mina ”, the mother of a diabetic child, said:“ I am a son diagnosed from 1 year and 4 months with diabetes type I take Novo Rapid and sediment, of course we are supposed to take insulin from insurance and imposed according to measurements, but they do not need enough insulin in the middle of the lack of drugs, and when Benji I spend the treatment every two months..
We have to take medicine from other patients. ”
She pointed out that there is a clear suffering that appears in the patient groups and we are trying together to find solutions to the shortage of drugs, insulin and tapes, even in pharmacies in free markets we do not find.
She added in desperation: "We kept reducing the quantities of medicine against our will and from how many days of insulin ended up on the pharmacies of October all so that I find one Novo pen but not you."
In the governorate of Ismailia, despite the application of comprehensive health insurance in the governorate, but she has seen a shortage of medicines inside pharmacies, "Rawda", a mother of two diabetics, says that she suffers from the provision of medicines to her children with immune diabetes, where for the past 3 months she was unable to provide medicine from health insurance.
She added that after suffering a few doses were dispensed and without sugar measurement strips, and added that some substitutes of drugs for diabetes led to double pathological symptoms, where one of her children suffered from a high cumulative rate of up to 15 and enter the intensive care.
She pointed out that the shortage of medicines is not only in health insurance pharmacies and the public sector, but in free pharmacies, where she is looking for medicines in her province and neighboring provinces in order to obtain the prescribed doses of sugar for her sons.
Lack of medicines
Dr. Mahmoud Fouad, Executive Director of the Right to Medicine Association, stressed that there is a shortage of many medicines for many diseases such as immunological diseases, Mediterranean anemia, SLE, Duchenne diseases, muscular dystrophy, neurologic and psychological drugs, in addition to some hormone drugs.
Fouad explained in a statement to "Al-Bawaba News", that diabetics suffer from the lack of availability of some diabetes drugs, especially popular insulin, although there is an increase in the recent drug varieties to more than 30% of the drugs.
Fouad pointed out that there are some traders who store medicines in stores to offer them in the market at new prices, in addition to many problems related to imported medicines, which have also increased their price significantly.
Fouad pointed out that there is a new increase in a large number of items in the coming days by up to 50% and up to 80% for imported medicines.
In the same context, Dr. Ali Auf, head of the medicine division of the Federation of Chambers of Commerce, said that the problem of medicine shortage is not only related to the provision of medicine from the state or pharmaceutical factories, but also related to the culture of the citizen in dealing with these medicines.
The head of the medicine division said in statements to "Al-Bawaba News" that the citizen deals badly with drugs in two cases, the first of which is to store a large amount in the case of a shortage and then provide it in pharmacies; for fear of suffering in obtaining it if shortage, and thus causes this behavior to deprive other patients to get their doses on time.
He added that the other wrong behavior is the use of essential drugs to treat some diseases such as diabetes in the treatment of another disease such as obesity, and therefore drugs are consumed at a higher rate than the production of companies, which makes the period of the end of the crisis longer than necessary.
He pointed out that most sugar medicines (pills) are available under the scientific name and not the commercial name, and that local insulin is manufactured internally and 85% of the insulin available in Egypt is local production, but the production covers the needs of health insurance and hospitals of the Ministry of Health and the government sector.
He added that there is a crisis in imported insulin, where it is available only by 15%, and international factories adhere to a production plan, and therefore in the case of increased consumption of drugs is not increased production in the actual time for the shortage of medicine, and thus patients in the local market resort to Egyptian insulin shows demand for medicine, which is a pressure and shows cases of drug shortage.
He pointed out that there is a near breakthrough to provide medicine, and that it is easy for Egyptians to deal with the scientific name and not commercial, and in case of any drug shortage, call the ambulance pharmacies available in Greater Cairo and the governorates through the hotline 16682 or call the Drug Authority on the hot number 15301; to find out where any medicines are missing and the scientific alternative to it.
For its part, the Drug Authority explained through its official page on Facebook that there are many alternatives to authentic medicines and all of them are safe and have the same effect and effectiveness as the original medicine; pointing out that the alternative medicine, is a medicine composed of an active substance different from the original medicine, but it is used to treat the same disease.
The Egyptian Medicines Authority advised that you should consult your doctor or pharmacist before using an alternative medicine as they can help you ensure that the alternative medicine is suitable for you and that it will not interact with any other medicines you are taking.
In the same context, the Authority said in a press release that Dr. Ali Al-Ghamrawi, President of the Egyptian Drug Authority, received a delegation of representatives of local companies and the Chamber of Pharmaceutical Industry to discuss ways of cooperation between the Authority, companies and the Chamber to provide medicines and necessary supplies in the Egyptian market.
Promises of the new government
In his first remarks to the new government on the crises of medicine, Prime Minister Mostafa Madbouly said today in a press conference that the pharmaceutical sector in Egypt follows the private sector, and that the state is coordinating with the private sector to reduce the prices of medicine, stressing that the state is keen to stabilize the prices of medicine, especially that the Egyptian medicine is cheaper than most countries in the world.
He explained that the state is procuring the dollar to provide raw materials for manufacturing, and that the import of raw material at the daily price of the dollar caused great losses to the state.
Timeline
On the lack of medicine, the Prime Minister said that the drug prices were coordinated by the Drug Authority after developing a plan with the companies for the absence of any shortage of medicines in the coming period, and explained that the drug productivity takes a great time in manufacturing and therefore there is a shortage of medicines in the markets, pointing out that the coming period will witness a great abundance of medicines.
For his part, Dr. Khaled Abdel Ghaffar, Deputy Prime Minister and Minister of Health, revealed that the drug file is important and has a dimension in the Egyptian national security, and affected like any commodity with dollar components during the last year and a half in light of the existence of global crises.
He explained that since the beginning of the crisis and the perception of the lack of currency to cover the needs, priorities have been set so that the citizen does not feel a shortage, stressing that the guests from Gaza and Sudan are all additions that affected the requirements of production and the basics of the pharmaceutical industry of raw materials.
He added that there were deficiencies in some types of medicines, but there are alternative or similar medicines and this culture is not approved by many, in the absence of the medicine written by the doctor they say it is incomplete.
Dr. Khaled Abdel Ghaffar, Deputy Prime Minister and Minister of Health, continued that Egypt is the cheapest country in the world in medicine, and the unable is not affected by the high prices of medicine, adding that the state provides it and the Egyptian pharmaceutical industry covers 95% of the needs.
He added that there are 69 million citizens who are insured in the health insurance system that has existed since the 1960s, in addition to the beneficiaries of treatment decisions at the expense of the state.
Dr. Khaled Abdel Ghaffar, Deputy Prime Minister and Minister of Health, said that the drug pricing procedures are the prerogatives of the Egyptian Drug Authority, pointing out that the increase in drug prices will be in the range of 30 to 35%.
The minister apologized.
The Minister of Health apologized to the citizens for the shortage of some medicines in the markets during the recent period, stressing that during the next few months there will be no shortage of imported or local medicines, as the import of raw materials began to restart production and will be in cooperation with the entire minister to take care of the pharmaceutical industry.
He added that the state is keen to provide all the necessary capabilities for the treatment of patients and the provision of medicines, and that there is an upcoming international cooperation with the international institution "Gustav" for the treatment of tumors in France, which does not have a presence outside France.
It receives patients from all over the world, which is the center of excellence for the treatment of tumors in the world, and the efforts of the Egyptian government have been successful in persuading it to receive the center with all its competencies and expertise to participate the Ministry of Health in the work of a hospital in Egypt.
He explained that Egyptian doctors will be trained abroad to transfer international experiences and expertise to Egypt, stressing that the citizen will be treated at the highest international level without incurring any dime, but paid instead by the state through health insurance.
He stressed the completion of 24 projects to develop hospitals at a cost of 7.34 billion pounds, adding that there are 20 new projects in 11 governorates and these hospitals will operate with a capacity of 2,747 beds.
Dr. Khaled Abdel Ghaffar, Deputy Prime Minister and Minister of Health, said that the presidential initiatives launched by President Sisi led to an increase in the average age of the Egyptian human being.
Dr. Abdul Ghaffar explained that the national projects plan from 2025 to 2026, stressing that it includes 54 projects in 24 governorates in the Republic and will operate with a capacity of 9588 beds.
Dr. Abdel Ghaffar added that the comprehensive health insurance project will end in 2030 and will cover all governorates of the Republic, stressing that Egypt has received thousands of sick and injured cases coming from the Gaza Strip, and will be assisted in rebuilding the health system in the Gaza Strip within the framework of Egyptian assistance to the brothers.

In Lebanon, the shortage of multiple sclerosis medications has caused serious health repercussions, including the risk of permanent paralysis, emphasizing the need for organized distribution systems and government support.

Title:

Content: Wednesday 21 November 1445 AH - 29 May 2024 |
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Captain Bakhash presents the risks of drug shortage to patients with "multiple sclerosis" and its most prominent consequences
The “Lebanese Society of Multiple Sclerosis Patients ” held a press conference at the“ House of the Doctor ” – Furn El Shbak, during which the President of the Lebanese Doctors Association in Beirut, Prof. Youssef Bakhash, spoke about the dangers of the shortage of medicine and its repercussions on the health of the patient.
He said: “This press conference is being held today on the occasion of World MS Day.
This disease and like any chronic disease, the treatment of its patients falls on the responsibility of the state and the Ministry of Health and this is a national and humanitarian duty to care for these patients as we care for every patient who needs care, treatment or support.
Especially those with chronic diseases such as cancer, diabetes, kidney disease and other diseases. ”
He added: “With regard to MS, science, development and studies have discovered 17 drugs to treat these patients, but unfortunately, only three of the 17 drugs in Lebanon are supported by the ministry.
Today, my speech will revolve around three points, the first point that the Ministry of Health withdrew the support for 14 medicines and kept it on three, including one that makes the Lebanese interior, the voice we want to make is the need to make room in the field to support the largest number of these medicines that enable our patients to recover or at least stabilize their situation. ”
He continued: “The second issue is the continued existence of the drug in a way that meets the needs of these patients because any failure leads to serious consequences, the most serious of which is permanent paralysis.
The third point is the need to organize the distribution of the drug and deliver it to the treatment centers and make sure that the beneficiary is the patient who remains the first and most important goal. ”

Supply chain disruptions, including shortages of raw materials and manufacturing difficulties, have been identified as key contributors to global medication shortages, impacting continuity of care worldwide.

Emerging technologies such as portable near-infrared spectrophotometers (NIR) are being developed to assess drug quality in resource-constrained regions, offering a cost-effective and rapid alternative to traditional laboratory methods.

Title:

Content: In a recent study, researchers from the University of Liège and the University of Yaoundé developed a cost-effective method using portable near-infrared spectrophotometers (NIR) to detect low-quality drugs in areas with limited resources.
The study, published in the journal Applied Spectroscopy, demonstrated the successful transfer and application of robust calibration models, offering a promising solution to tackle low-quality drugs in resource-constrained regions.
Scientists have sought to address the growing problem of ineffective drugs in regions with low resources.
They used near-infrared spectroscopy (NIR) as a possible method to solve this problem.
They developed, tested and transmitted methods for quantifying the content of ciprofloxacin and metronidazole tablets using a portable NIR spectrophotometer in transmission mode, known as NIR-M-T1, in combination with chemometrics, in particular the least squares partial regression algorithm (PLSR).
This approach provides an economical and fast alternative to traditional laboratory methods for evaluating the quality of medicines.
Initially, quantitative PLSR models were tested in Belgium, characterized by a temperate oceanic climate.
The models were then moved to Cameroon, a tropical climate zone, where researchers found it difficult to accurately predict new series of validation using the original models.
To overcome this obstacle, two expansion strategies have been developed to make predictive models more resistant to environmental factors.
In a field analysis of samples of ciprofloxacin and metronidazole tablets collected in three different cities in Cameroon, the resulting models were tested.
The content results obtained using both magnification strategies closely matched and did not differ statistically.
However, the first strategy was easier to implement, and the second was superior in terms of model diagnostic indicators and accuracy profiles.
Two samples from the collected tablets were found to be inappropriate in content, and these results were subsequently confirmed using high-performance liquid chromatography (HPLC), which is considered the reference method for analyzing the content of pharmaceuticals.
This study demonstrates the potential of low-cost portable NIR spectrophotometers and reliable calibration models to improve the effectiveness and accuracy of drug quality assessment, ultimately protecting public health.
The researchers believe that this innovative approach could serve as a basis for similar initiatives in other low-resource regions, contributing to the ongoing struggle to ensure the safety and efficacy of pharmaceuticals around the world.
Reference:
Chunga, CAW; Marini, D.; Nga, EN; Hamuli, PC; Mballa, R.N.; Hubert, P.; Ziemons, E.; Sacre, P.-Yu.
Introduction in the field of quantitative methods of the near infrared range for the analysis of drugs in a tropical environment.
Spectroscopy.
2023 as soon as possible.
DOI: 10.1177 / 00037028231201653

Capra Biosciences is leveraging AI and modular bioreactor platforms to rapidly scale the production of active pharmaceutical ingredients (APIs), aiming to address supply chain vulnerabilities and reduce dependency on foreign manufacturing.

Title:

Content: Capra Biosciences Lands $7.5 Million Project Agreement To Demonstrate Platform To Rapidly Scale Pharmaceutical Ingredient Manufacturing

BioMaP-Consortium Project Agreement Will Combine Sustainable Biochemical Production with AI To Demonstrate a Scalable Platform for the Quick Manufacture of Pharmaceutical Ingredients

STERLING, Va., July 19, 2024 (GLOBE NEWSWIRE) -- Many ingredients that make up the pharmaceuticals Americans rely on are manufactured overseas. When supply chain issues or shortages occur, as witnessed during the COVID pandemic, it can negatively impact millions of Americans and affect national security. The White House issued an Executive Order in 2022 to stimulate U.S. biomanufacturing. Increasing American biomanufacturing, will provide more control over pharmaceutical production, boost the economy, and encourage creation of greener manufacturing methods.

Under a new $7.5 million, two-year project agreement awarded to Capra Biosciences through the BioMaP-Consortium, Capra will demonstrate the ability of its platform to rapidly scale and manufacture biologically derived small molecule active pharmaceutical ingredients (APIs). Capra has a demonstrated history of using its biofilm-forming microbes and proprietary bioreactors to transform low-cost feedstocks into a variety of chemicals, including their first commercial product, retinol.

Under this new project agreement, Capra will leverage its bioreactor platform to demonstrate the manufacture of three active pharmaceutical ingredients, to be selected in cooperation the Administration for Strategic Preparedness and Response within the U.S. Department of Health and Human Services.

“Biomanufacturing has the potential to manufacture many of the chemicals we use today not only more sustainably, but also where and when we need them. This is an extraordinary opportunity to apply the Capra platform to the important issue of pharmaceutical ingredient shortages,” said Elizabeth Onderko, Capra’s cofounder and CEO. “We look forward to working with the BioMaP-Consortium, their government sponsors, and our partners to increase pharmaceutical manufacturing accessibility in the U.S.”

Successfully creating the pharmaceutical ingredients using a common platform will further illustrate the potential of Capra’s technology to be easily tailored to create a broad spectrum of molecules in a highly scalable manner.

Leveraging AI and Modeling for Quicker Manufacturing

To address the challenge of rapidly onboarding new products and scaling them, Capra brought together a team of companies, including Next Rung Technology. The team’s expertise spans AI modeling, bioprocess scale up, and biomanufacturing. The team will leverage AI design tools to rapidly design and onboard each of the APIs, as well as predict their viability and scalability before production begins.

Using Capra's modular bioreactors, together with these models, the team will demonstrate production of three target APIs at pilot scale. A strength of biomanufacturing is that the same hardware can be used to rapidly switch between different pharmaceutical ingredients or even other products. With the success of this project, Capra will have a template for rapidly scaling ingredients for pharmaceuticals as well as other applications quickly and cost effectively using their modular platform and locally sourced raw materials.

This project has been funded in whole or in part with federal funds from the U.S. Department of Health and Human Services; Administration for Strategic Preparedness and Response (ASPR); Office of Industrial Base Manufacturing and Supply Chain (IBMSC), under OT number #75A50123D00003.

About Capra Biosciences

Capra Biosciences is venture-backed startup company focused on sustainable production of petrochemical replacements using their biofilm bioreactor platform. Capra Biosciences is located in Manassas, VA. To learn more about the company, visit www.caprabiosciences.com.

About Next Rung Technology

Next Rung Technology provides technology development and commercialization for new sustainable technologies in industries such as water and wastewater, energy, sustainable food and alternative protein, and biochemical sectors.

Media Contact

James Gallagher
Spire Communications
jgallagher@spirecomm.com
919-308-0738

Mark Cuban's Cost Plus Drug Company has initiated partnerships with health systems to manufacture generic sterile injectables, including epinephrine, at a new facility equipped with robotic manufacturing lines to mitigate shortages.

Title:

Content: Mark Cuban's drug company inks first health system partnership to sell directly to Community Health Systems

Mark Cuban Cost Plus Drug Company has found its first national health system buyer for hospital drugs currently in short supply.

Franklin, Tennessee-based for-profit Community Health Systems has signed onto a partnership with the billionaire-backed manufacturer to purchase pharmaceuticals like epinephrine and norepinephrine for its affiliate hospitals in Texas and Pennsylvania. The products are often used in emergency departments and intensive care units, with epinephrine currently listed on the Food and Drug Administration’s list of ongoing drug shortages.

Though the collaboration is beginning with just two states, the companies said they “expect to scale the partnership in numerous and meaningful ways.”

“Our partnership with CHS will give them access to epinephrine and norepinephrine at a transparent cost plus price,” Cuban said in a release. “This is the start of what we know will be an amazing partnership that will reduce drug shortages and drug costs and enhance the care CHS hospitals provide for their patients."

CHS spans 71 hospital affiliates with about 12,000 beds across 15 states and recently reported $12.5 billion in 2023 net operating revenues. It, like other hospitals and health systems across the country, has disclosed rising pharmaceutical spending in recent years.

The companies’ announcement framed the deal as a long-term collaboration “to address critically important issues related to drug supply in the hospital setting.”

Beyond high costs or shortages, these issues can include large amounts of pharmaceutical waste and potential dosage errors when medications need to be measured at the bedside. Cost Plus Drugs can help CHS avoid these by allowing the hospitals “more flexible ordering opportunities” including alternative vial sizes that aren’t offered by other drug manufacturers, the organizations said.

“There are many opportunities for innovation in the healthcare industry, including rethinking, and even disrupting, the way providers purchase products and services,” Lynn Simon, M.D., president of healthcare innovation and chief medical officer at CHS, said in the announcement. “Our relationship with Mark Cuban Cost Plus Drug Company has the potential to generate significant advantages for our affiliated hospitals and for other forward-looking hospital organizations that also want to reduce costs, reduce waste, avoid drug shortages and improve patient care.”

Cost Plus Drug Company currently offers about 2,500 generic medications and works directly with drug manufacturers to bypass middlemen and lower prices. For consumers, the price of each drug includes a 15% markup as a profit margin, a $3 pharmacy handling fee and a $5 shipping fee. Cost Plus also transparently displays what it pays for its medicines.

The company has proven itself a disrupter on both generic drug pricing and the drug benefits market, where it currently works with at least four pharmacy benefit managers and supplanted major names like CVS Health’s Caremark with its inaugural payer deals.

Of note, the CHS partnership announcement comes just days after Cost Plus Drug Company kicked off manufacturing of generic sterile injectables at a new 22,000-square-foot, $11 million facility it built in Dallas. That plant is outfitted with aseptic robotic manufacturing lines and is slated to initially produce commercial batches of epinephrine and norepinephrine with pediatric chemotherapy products next in line.

During a roundtable discussion held this week at the White House, Cuban admitted that that Cost Plus Drug Company is “not making money yet” but promised the business will eventually become self-sustainable.

Primary caretakers can prepare for potential medication shortages by maintaining a reserve supply of critical medications for chronic conditions, ideally enough to cover three to six months, to mitigate disruptions caused by supply chain issues.

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Content: MOSCOW, 19 Mar — PRIME.
Foreign drugs will not disappear from the sale - such prerequisites currently do not exist and, most likely, they will not arise.
At the same time, now there are certain interruptions in supplies, including those associated with high demand, Nikolai Bespalov, Director for Development of RNC Pharma, tells the Prime Agency.
The expert explains that if the demand increases by a factor for some products, then no stocks in the distribution chain will be able to close this hype.
“If earlier five people came to the pharmacy a day for insulin, and now 50-100, it is clear that the distribution chain is not ready for such volumes.
It is also clear that individuals who apply for this product may face the fact that it simply will not be at a particular moment in time, ” he said.
Of course, both distributors and pharmacies "react to this situation, but their capabilities in this regard are limited."
Manufacturers also can not always quickly increase the volume of shipments - this is a logistically difficult task, but in addition, the simultaneous discharge of the entire volume of goods increases the risk of shortages in the future, explains Bespalov.
However, the excitement will not last indefinitely.
“In the next 2-3 weeks, the situation in terms of excitement will fade – people will make stocks for critical positions for life support and maintenance of health in relation to chronic diseases – and the support system will work in a more rhythmic way.
It is unlikely that the situation will be as calm as in pre-crisis times, but deliveries are likely to normalize, ” the expert assured.
In his opinion, the current situation still can not be called a deficit - the goods have both distributors and manufacturers' warehouses.
Under normal conditions, at different stages of the distribution network, up to a six-month need is stored, but in a crisis, these stocks of drugs can be used up relatively quickly.
Therefore, the main task is to prevent the complete washing out of such drugs from warehouses so that they are enough for everyone who really needs them, the expert believes.
"Now there are certain restrictions on the release of certain food products, for example, sugar, perhaps something similar will need to be done in relation to drugs," Bespalov believes.
At the same time, for patients suffering from chronic diseases, a sufficient amount is a reserve, calculated for the period from 3 to 6 months, it allows you to solve problems with possible interruptions in supplies.
“Now it is necessary to minimize the hype, reduce panic — especially, there are no real prerequisites for stopping the supply of pharmaceutical products — none of the significant suppliers does not talk about the possibility of suspending supplies as sanctions.
And if the goods will have manufacturers, it means that it will be in the commodity distribution chain, and the situation with interruptions will be solved in the working mode, "concludes Nikolai Bespalov.

Caretakers should stay informed about potential shortages by monitoring updates from health authorities and drug supply platforms, which can provide early warnings and alternative options for missing medications.

Engaging with healthcare providers to discuss alternative treatments or generic substitutes for life-saving drugs can be crucial, especially during prolonged shortages caused by manufacturing or importation challenges.

Title:

Content: Drug department: it is necessary to inform patients as quickly as possible about the occurrence of a deficiency
Drug department: it is necessary to inform patients as quickly as possible about the occurrence of a deficiency
The end of last year caused a real pharmacy fever: parents could not find children's antipyretic syrups and a number of antibiotics.
People with chronic diseases have lost their feet in search of life-saving drugs.
Public figure Lachin Aliyev asked why representatives of relevant institutions do not try to mitigate the emerging difficulties by informing the population about the probability of a particular deficit.
“Yes, I agree, people need to know in advance what difficulties are expected.
We can think of some alternative solutions, - said Deputy Director General of the Drug Department Ott Lius. - The Drug Department does not deal with the supply of medicines, but we can know in advance about possible supply disruptions. "
Who is responsible for the supply and distribution of medicines?
What to prepare for in the future?
These and other questions will be answered by the heroes and experts of the new issue of the program “Svoya pravda ”, which will air on Monday, February 20, at 20.30 on the channel ETV +.
Presenters: Olesya Lagashina and Elena Solomina.
Key words
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The American Society of Health System Pharmacists and the University of Utah Drug Information Service maintain a Drug Deficiency Database that tracks medication shortages, providing real-time insights into supply issues in the U.S. healthcare system.

Ethical considerations in allocating scarce medications during shortages include the principle of justice, which emphasizes fair and equitable distribution of resources, balancing individual needs with the common good.

Title:

Content: Sacred Heart Hospital in Spokane/Howpper - Wikipedia

Allocating Scarce Resources in the Time of Covid: Who Shall Live When Not Everyone Can Live?

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Allocating Scarce Resources in the Time of Covid: Who Shall Live When Not Everyone Can Live?

By Jody Cramsie

I’m angry.

Life-saving treatment is being denied sick people. Elective surgeries are canceled and on hold. Don’t confuse the benign-sounding term “elective” with frivolous or optional. Elective refers to procedures that are medically necessary but may not be an immediate emergency. Elective surgeries save lives. If they didn’t, doctors would not be justified in performing them. And time does matter, even with elective procedures — hearts might not continue beating with a damaged valve; cancerous tumors may metastasize the longer they are left in the body. These patients are getting sicker, and some are dying.

Why is it happening? Hospitals everywhere, including here, are explicitly rationing healthcare. Hospitals are using their scarce resources treating voluntarily unvaccinated Covid patients. Hospitals are overrun and overwhelmed by the crushing waves of these Covid patients – these people who made personal and socially destructive decisions and now want to go to the head of the line, despite their own culpability in their present condition. And hospitals are agreeing with that, and prioritizing those patients at the expense of others.

Every fiber of my being says this is not fair. But what does fairness have to do with it? Does fairness even matter? What are the biomedical ethical rules and considerations hospitals are using to justify their decisions on this life and death allocation of scarce resources? Are there other ethically defensible decisions that could be made by these organizations in these perilous times?

There are four core principles recognized in biomedical ethics:

1.  Beneficence – the affirmative obligation to act for the benefit of the patient

2.  Nonmaleficence – the obligation not to harm the patient

3.  Autonomy – the recognition that the patient has the power to make decisions and choices by exercising their capacity for self-determination

4.  Justice – the fair and equitable distribution of the benefits and burdens

Autonomy requires consideration of the individual’s right to make free decisions regarding their health. It includes the ability of the individual to understand those choices, including the consequences of the decision. The patient then goes forward voluntarily.

Of course, the autonomy of one person is not unchecked; it can be limited when that person’s autonomous action causes harm to another person or persons. If autonomy is primarily concerned with the rights of the individual, justice requires a balancing of benefits and burdens among all those concerned. It involves social cooperation, serving the common good, and maximizing benefits within the system as a whole, while making the difficult choices in balancing the equities.

Let me be clear: I am speaking of post-vaccine Covid treatment issues. I believe that is a morally relevant distinction within this discussion of allocation of scarce resources. This pandemic may be a crisis of such magnitude that many of the principles of biomedical ethics could/should be challenged.

In many ways, the voluntarily unvaccinated Covid patient made their treatment priorities known. They voluntarily assumed the risk and refused to mitigate any possible future damages, to themselves, their families and society. Why not respect that autonomous decision when having to allocate scarce resources, which at the same time serves the goals of equity and fairness required by justice?

Accordingly, I suggest that hospitals (not individual doctors or nurses) could make an ethically defensible policy to put sick Covid patients in the queue and not automatically give them priority. I believe this could be done by fully respecting the voluntarily unvaccinated Covid patient’s prior decision to refuse medically appropriate and possibly life-saving treatment.

I believe the equities could be balanced by hospitals developing a policy that is planned, principled and justified by an appeal to ethical standards. It would be well reasoned with input from ethicists, legal advisors, risk managers, hospital administrators and staff, and other stakeholders. The policy would be announced and widely disseminated so all people know and understand it is not reactive to any specific individual or group of individuals, but transparent and objective and consistent with the hospital’s mission and responsibility to the entire community.

Government has failed to lead on this issue. It has a vital and legitimate role in alleviating the horrendous conditions under which hospitals are laboring. It has left hospitals and communities with the heavy burden of the moral distress being caused by hospitals’ forced allocation of resources. Government should marshal its resources to set up Covid-specific treatment centers, thus creating space in hospitals for the care of other sick patients.  If hospitals, on their own, are setting up temporary treatment areas in staff rooms, hallways and parking garages (!!), surely appropriate temporary treatment areas should be set up for Covid patients with top priority government action.

Autonomy is crucial. Ever increasing levels of self-determination and development of individual potential is one of the hallmarks of human progress. None of us can live happily or productively without it. But it’s nothing without justice, which is often elusive. This could move the arc of justice a little closer to within society’s reach.

© 2021 SpokaneFāVS

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About Jody Cramsie

Jody Cramsie has a background in history, theology, ethics and law. In her free, time she enjoys music, reading and hosting dinner parties for family and friends. She lives in Spokane but prefers to be on the Olympic Peninsula or in the south of France.

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Healthcare providers face difficult ethical decisions in determining which patients receive limited medications, often prioritizing based on the aggressiveness of diseases and the likelihood of treatment success.

Title:

Content: NORTHAMPTON, Mass. (WWLP) – While this shortage of chemotherapy drugs stretches across the country, 22News looks at how the limited amounts of potentially life-saving drugs are impacting cancer care in our area.

It’s a problem, so acute it was recognized by the Biden Administration just last month. The White House noted there’s a shortage of 15 cancer drugs due to manufacturing and supply chain issues.

22News asked Pharmacy Director Michelle Kososki at Mass General Brigham Cooley Dickinson Hospital, to rate the shortage experienced locally on a scale, 5 being a critical shortage and 1 being no shortage at all, “right now I would probably say it is a four. We only have a very small supply of one particular drug.”

Pharmacy Director Michelle Kososki said drug shortages are not uncommon in the healthcare industry however, when faced with potentially life-saving drugs it can get complicated, “Anytime there is a shortage, there’s a risk of not being able to treat patients. Obviously, that is something we want to avoid and we work to the best of our ability with creative solutions to make sure that doesn’t happen.”

Nurse Manager Lisa Martensson at Mass General Care Center at Cooley Dickinson Hospital told 22News, “There’s always the ethical issues of who gets the drug that’s available. It’s supply and demand as you said and looking at what folks had for their disease which ones needed to be treated faster than others based on the aggressiveness of their disease. Those things played in but it was a really difficult decision to sit down and try and decide who would get the drug. We were never in a position where we had to deny anybody.”

Cancer patient Norman Uzdavinis of Whately said he was very concerned when he first heard of the shortage, “I had wondered where in the chemotherapy I would be at, would it have to be delayed for months or years if possible.”

Uzdavinis has not had his medical care compromised but feels for those who have, “I feel for them. I know what I’m going through and that everything is here so it’s perfect for me, but there’s a lot out there that are not as fortunate. I know that.”

“Healthcare providers here were able to mitigate the shortage by using a couple of different tactics. For example, they could switch up a patient’s medication regimen,” Nurse Manager Lisa Martensson said.

“What we did do was use drugs that were in the same classification but not necessarily that specific drug. There are also drug regimens where we could switch around the order to which we gave the drugs so if there was a drug that wasn’t available we are able to do one of the drugs that was available first and do that second drug second. That was able to work out so people didn’t do without and they were able to get what they needed,” Martensson continued.

According to the FDA, the shortage started when one of the major manufacturers of the chemo drug, Accord Healthcare, a company based in India, had to shut down after problems complying with good manufacturing practices were found during an inspection. Now, there is an increased demand from other companies that make these kinds of drugs.

22News contacted some other of the manufacturers of these drugs. Pfizer said they are increasing production by about 40 percent to meet this increased demand.

Local News

Alanna Flood is a reporter who has been a part of the 22News team since 2022. Follow Alanna on X @alannafloodnews and view her bio to see more of her work.

The COVID-19 pandemic underscored the need for robust emergency preparedness, with lessons learned including the necessity of maintaining adequate stockpiles and fostering industry partnerships to ensure supply chain continuity during crises.

Title:

Content: Clinical Labs' Quick Response to COVID-19 Helped Reduce Hospitalizations and Save Lives

Published: Aug. 29, 2023 at 3:09 PM EDT|Updated: 51 minutes ago

Survey highlights lab experts' heroic response despite limited supplies and staffing shortages—challenges that have worsened since pandemic's onset.

WASHINGTON, Aug. 29, 2023 /PRNewswire/ -- A new survey from the Association for Diagnostics & Laboratory Medicine (formerly AACC) found that clinical labs' robust, rapid response to the COVID-19 pandemic helped to contain the virus and save lives. However, the challenges labs faced with insufficient supplies and staffing shortages have only intensified since 2020. The percentage of laboratory professionals reporting staffing issues rose steadily from 35.4% in May 2020 to 87.5% in January 2022—raising questions about whether labs would have the necessary resources to respond to a similar public health emergency today.

"Globally, it is critical we increase the visibility of the laboratory to healthcare professionals, national and international government agencies, and patients to solve staffing shortages and maintain supply chain continuity in order to ensure successful healthcare options in the future," wrote study authors Drs. Caitlin R. Ondracek, Jonathan R. Genzen, Christina M. Lockwood, Saswati Das, and Stacy E.F. Melanson, and Phillip Kang.

Read the survey here: https://academic.oup.com/jalm/advance-article/doi/10.1093/jalm/jfad049/7251191

Leaders from 191 laboratories responded to 8 surveys between May 2020 and December 2022. Respondents represented 133 labs in the U.S. and 58 from other countries. They worked for a range of institutions, including government/public health laboratories, reference labs, research labs, independent laboratories, and hospital laboratories.

In May 2020—just two months after the national shutdown—more than 70% of respondents were offering COVID-19 diagnostic testing in their laboratories. This increased steadily to 100% in January 2022 and dropped slightly to 98% by December 2022.

Throughout the pandemic, most reported a turnaround time (the period between receiving specimens and generating results) of just 1 to 12 hours or 12 to 24 hours. There was a slight increase in turnaround time, to 24 to 48 hours, in August and September 2020.

"Despite the evolving pandemic, the turnaround time provided by the laboratory allowed for rapid triage of patients and a reduction in hospital transmission rates," the authors wrote.

Still, supply and staffing shortages loom large. In most of the surveys, 55% to 65% of laboratories reported being unable to obtain supplies. Obtaining reagents and test kits was most problematic.

As for staffing challenges: After peaking at 87.5% in January 2022, they remained high throughout the remainder of the survey period, affecting 78.6% of labs in December 2022.

The percentage of laboratories' total testing capacity dedicated to COVID-19 was most frequently 20% or less in 2020. However, by January 2022, more respondents were dedicating greater than 40% of their testing capacity to COVID-19. This shifted back to 0-20% in December 2022.

On average, 82.3% of labs sent their results to their state throughout the pandemic. Less frequently, results were sent to federal or local agencies. Most respondents—between 74.3% and 83.3% throughout the survey period—reported that their laboratory was using U.S. Food and Drug Administration Emergency Use Authorized test kits.

When asked to share their lessons learned during the pandemic, respondents emphasized the need for industry partnerships, standardized educational guidelines, and a sustainable pipeline of medical laboratory scientists.

"Despite the shortages, the resiliency of the laboratory staff during the pandemic was remarkable. While many other professionals were working remotely, the laboratory staff did not have that option. Instead, the staff were adaptable and flexible, and many cross-trained to help with coverage," the authors stated.

About the Association for Diagnostics & Laboratory Medicine (ADLM)
Dedicated to achieving better health through laboratory medicine, ADLM (formerly AACC) brings together more than 70,000 clinical laboratory professionals, physicians, research scientists, and business leaders from around the world focused on clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, lab management, and other areas of progressing laboratory science. Since 1948, ADLM has worked to advance the common interests of the field, providing programs that advance scientific collaboration, knowledge, expertise, and innovation. For more information, visit www.myadlm.org.

Bill Malone
ADLM
Director, Communications & News Publications
(p) 202.835.8756
bmalone@myadlm.org

Molly Polen
ADLM
Senior Director, Communications & PR
(p) 202.420.7612
(c) 703.598.0472
mpolen@myadlm.org

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The above press release was provided courtesy of PRNewswire. The views, opinions and statements in the press release are not endorsed by Gray Media Group nor do they necessarily state or reflect those of Gray Media Group, Inc.