Global medication shortages have escalated into a critical challenge affecting healthcare systems worldwide between 2021 and 2024.

This phenomenon transcends geographic and economic boundaries, impacting both developed and developing nations alike.

The extent and complexity of these shortages are underscored by the increasing number of drugs unavailable or in restricted supply, the diversity of affected therapeutic categories, and the persistent disruption to patient care delivery.

The scope of medication shortages has reached unprecedented levels in some countries.

The United States, for instance, recorded 323 drug shortages in early 2024, surpassing all previous records.

These shortages encompass a broad array of pharmaceutical classes including sterile injectable generic drugs, essential cancer chemotherapy agents, emergency-use medications critical for hospital settings, central nervous system stimulants, antimicrobials, hormonal products, and intravenous fluids.

The protracted nature of the crisis, which has persisted for over eighteen months, has compelled some hospitals to ration limited drug supplies or divert available medications, directly threatening patient outcomes .

Europe has also experienced a worsening shortage scenario, as illustrated by Estonia’s drug shortages that rose from 183 different drugs in shortage in 2021 to 450 by 2023.

Causes include increased demand, raw material shortages, and supply chain issues.

Similarly, Ireland saw a shortage of paracetamol during the winter 2022-2023 COVID-19 and influenza surge; fortunately, the availability of multiple drug forms and brands allowed patients to switch to therapeutic alternatives with professional consultation to mitigate treatment interruptions .

In Egypt, multiple factors, including economic instability, currency depreciation, and illicit smuggling, have led to critical shortages of vital medications, such as insulin, cancer drugs, and anesthetics, despite local pharmaceutical industry efforts .

Affected drug types span a wide spectrum.

For caretakers monitoring chronic, life-threatening conditions, it is important to note the following are commonly impacted:

1. Insulin and other diabetes-related medications (including newer drugs like Mounjaro).

2. Cancer chemotherapy agents, such as cisplatin and carboplatin.

3. Asthma inhalers.

ADHD medications (e.g., Adderall).

Sterile injectable generic drugs.

6. Emergency-use hospital medications.

Central nervous system stimulants.

Antimicrobials, including antibiotics.

Hormonal therapies.

Intravenous fluids essential for hospital care.

These shortages directly impact disease management efficacy and patient safety .

The causes of medication shortages are multifactorial.

Chief among them are manufacturing and quality control problems, unplanned downtimes, and fragmented supply chains.

Heavy dependence on foreign production for active pharmaceutical ingredients (APIs), primarily sourced from India and China, causes fragility in supply chains due to geopolitical tensions, trade disruptions, and logistical bottlenecks.

Increased demand driven by the COVID-19 pandemic and other health emergencies further strains production capacities.

Economic and currency instabilities, as seen in Egypt, exacerbate access issues.

A critical barrier has been the lack of transparency from manufacturers regarding supply disruptions and production stoppages, hampering timely response and mitigation efforts.

The U.S. FDA has addressed this by issuing draft guidelines requiring pharmaceutical manufacturers to provide at least six months’ advance notice of any production halts that could cause shortages.

However, many manufacturers remain reluctant to share detailed information, complicating regulatory and healthcare responses .

Healthcare systems cope with shortages using several strategies.

Rationing medications and prioritizing critically needed drugs is common, especially in hospitals.

Therapeutic substitution is widely employed, with clinicians switching patients to alternative but clinically acceptable medicines or adjusting dosages and formulations.

Price discounts and policy incentives for alternative drugs help ease financial obstacles to access.

Healthcare authorities provide guidance to prescribers and pharmacists on managing shortages and safe use of substitutes.

Despite these measures, shortages persistently endanger treatment quality and safety, underscoring the ongoing strain on healthcare delivery .

For patients and caretakers managing chronic, life-threatening conditions, several practical recommendations have been advanced.

They should routinely consult national or regional drug shortage inventories to monitor current and anticipated shortages.

Early prescription refills, identifying multiple pharmacies, and utilizing digital price comparison and discount platforms (such as GoodRX and RX Saver) can enhance access to needed medications.

Open and frequent dialogue with pharmacists and healthcare professionals is crucial to identify viable therapeutic alternatives and avoid treatment interruptions.

These steps empower caretakers to respond effectively to sudden disruptions in medication availability .

Addressing global medication shortages requires coordinated policy and operational responses.

Increasing transparency in supply chains and diversifying sources of APIs are critical to reducing vulnerability to disruption.

Expanding domestic manufacturing capacity, improving regulatory oversight, and establishing strategic stockpiles of essential medicines can stabilize supply.

Engaging patients and caretakers in decision-making processes ensures greater alignment with patient needs and facilitates more responsive healthcare interventions.

Patient safety and advocacy groups emphasize the need for enhanced communication, transparency, and inclusion to prevent negative clinical impacts of shortages and preserve trust in healthcare systems .

While this report offers a comprehensive overview of the global medication shortage crisis from 2021 to 2024, more detailed country-specific analyses would further clarify how differing economic and political contexts shape shortages and healthcare responses.

Additional data focused on shortages of medications for other chronic conditions, such as cardiovascular, renal, and neurological diseases, could help caretakers managing complex health profiles.

Exploration of innovative supply chain technologies and forecasting tools may provide new avenues to preempt disruptions.

Moreover, studying the psychological and health outcome effects on patients and caregivers experiencing medication interruptions could guide enhanced support strategies during shortages.

In summary, the global medication shortage situation between 2021 and 2024 has intensified, threatening the availability of life-saving and chronic disease treatments.

Multifactorial causes rooted in manufacturing, supply chain fragility, geopolitical events, and regulatory limitations drive the problem.

Healthcare systems and caregivers are adopting mitigation strategies including rationing, therapeutic substitution, and enhanced communication to maintain continuity of care.

Official recommendations emphasize preparedness, vigilance, and stakeholder engagement.

Overcoming this challenge demands sustained policy focus, international cooperation, increased transparency, and active involvement of patients and caregivers to ensure resilient, equitable, and patient-centered pharmaceutical supplies in a complex global environment.

Global medication shortages have escalated into a critical challenge affecting healthcare systems worldwide between 2021 and 2024.

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Content: Drug supply problems have worsened in Estonia
This year, pharmacies in Estonia faced a much larger shortage of drugs than a year earlier.
Problems with supplies are caused by both increased demand and shortage of raw materials, reports rus.err with reference to "Actual chamber".
This spring, parents faced a shortage of antibiotics and antipyretic drugs suitable for children, and in the fall, the Sorbister drug for renal patients had to be issued from the state reserve stock, since it was not enough due to supply problems in pharmacies.
Hospitals are also facing a severe shortage of medicines this year.
“For example, hospitals use very important drugs to treat the consequences of heart attacks and strokes, the supply problems of which have been observed for a year, but thanks to good cooperation, we were able to ensure that no one was left without treatment, ” said Marco Tiisler, head of the Import and Export Supervision Department of the Drug Department.
In 2021, there was a shortage of 183 drugs in pharmacies, last year - 359, as of the end of this year - 450 drugs, and in the case of 130 drugs, the cause of the deficiency is unknown.
The second significant reason was a sudden surge in demand, for example, for the drug Ozempic, which is popular among those who lose weight, but drugs can be in short supply due to problems with production.
- Producers lack the active ingredient.
The active substances come from third countries, they are not always available, this was stated by one of the largest European manufacturers of antibiotics, - said Tiisler.
Drug supply problems put not only patients in a difficult position, but also doctors who have to quickly find replacements, sometimes in conditions of scarce information about alternatives.
If earlier, in the case of a shortage of drugs, the patient had to pay the full cost of the drug prescribed as a substitute, recently the Health Insurance Fund, as an exception, decided to extend the discount to some alternatives.
According to Lee Rootslane, head of the Union of Pharmacies, problems with the supply of medicines are a growing problem throughout Europe.
- This year, in cooperation with the Drug Department and family doctors, we made recommendations so that if a problem arises, we do not solve it after the fact, but try to provide some solutions and avoid panic.
In the case of children ’ s syrups, people read about the shortage of syrup, went to the pharmacy and took two syrups instead of the usual one, ” Rootslane said.
The drug department recommends having a weekly supply of non-prescription drugs and a monthly supply of prescription drugs at home.
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This phenomenon transcends geographic and economic boundaries, impacting both developed and developing nations alike.

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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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The extent and complexity of these shortages are underscored by the increasing number of drugs unavailable or in restricted supply, the diversity of affected therapeutic categories, and the persistent disruption to patient care delivery.

The scope of medication shortages has reached unprecedented levels in some countries.

The United States, for instance, recorded 323 drug shortages in early 2024, surpassing all previous records.

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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.
Related Topics

These shortages encompass a broad array of pharmaceutical classes including sterile injectable generic drugs, essential cancer chemotherapy agents, emergency-use medications critical for hospital settings, central nervous system stimulants, antimicrobials, hormonal products, and intravenous fluids.

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Content: Crowding citizens in front of the ambulance pharmacy reveals the extent of suffering …
6.
The suffering of poor patients is due to the lack of medicines.
Where the pharmaceutical market has been suffering for several consecutive months from a severe shortage in many varieties.. Which prompted citizens to crowd in front of the ambulance pharmacy in long queues to buy those shortcomings after they disappeared from all pharmacies..
Hustle...
Chaos...
Hundreds of men and women crowded in long queues that extend for several hours.. This is the scene in front of the ambulance pharmacy in the center of the country. People with chronic diseases of sugar, pressure, heart, nerves and colon became their only hope to find essential drugs for them in the pharmacy.. The absence of these drugs does not only expose them to more pain but may expose them to death.. They can not do without them..
The drug shortage crisis.
It is not a new crisis, but it has been repeated many times during the previous term of Minister “Khaled Abdel Ghaffar ”.. Instead of trying to solve the crisis, the government is going against the trend, where the Deputy Prime Minister and Minister of Health Dr.“ Khaled Abdel Ghaffar ” in statements after the government statement to parliament to the need to increase the prices of medicine in Egypt because it is the cheapest in the world and sold abroad by 50 times. According to the data of the Medbelle global platform for health care and funded by the European Fund for Regional Development in 2021, Egypt is ranked ninth in the list of cheapest countries in the world in the sale of medicine, and did not come in the first place as mentioned by the minister
Despite the repeated statements of the Prime Minister and the Minister of Health to resolve the crisis and provide the missing medicines, and despite the government ’ s repeated talk about the localization of the pharmaceutical industry in Egypt, the reality is quite the opposite.
There are a number of terrible complaints about the lack of medicine in public hospitals and pharmacies, including a collective complaint from the patients of the university hospitals in Assiut Governorate of the lack of availability of drugs and the absence of dye injections, which puts their lives at risk. Although the patients filed a complaint to the governor two weeks ago, but to no avail. The long queue of two or three hours to win a box of insulin Maxtard despite the increase in the price from 60 pounds to 93 pounds confirms the extent of suffering experienced by patients. Also, the disappearance of Indoxan injections used in chemotherapy sessions threatens oncology patients, where thousands of patients in oncology institutes and hospitals suffer from delayed chemotherapy sessions for lack and disappearance of Indoxan injection. The right to medicine, but the crisis still exists.
There is also a shortage of many drugs, including blood thinners and clots solvents, drugs for the treatment of cancerous tumors, multiple sclerosis drugs, drugs for the treatment of liver diseases, drugs for stomach ulcers and blood pressure, drugs for sinuses, heart and thyroid diseases, dozens of types of analgesics, antibiotics and vitamins, as well as anesthetics used in anesthesia and solutions in public hospitals. Subsidized children, which was exploited by the mafia of the black market to raise prices to double the original price of milk can up to 500 pounds..
All types of treatments for epilepsy, depression, obsessive-compulsive disorder, phobias and hyperactivity disease are still unavailable due to the lack of import of raw materials.
Health Insurance Patients
The crisis is not limited to hospitals and pharmacies only, but the branches of health insurance suffer from a large shortage of medicine and also medical supplies, which led to the closure of the operating rooms in the branches of insurance in the province of Beni Suef..
In the health insurance clinics in Cairo and Giza, many of those who frequent these clinics complained that they come from 7 am to reserve their roles in order to dispense their medicines and end up sitting in the pharmacy waiting for the pharmacist who dispenses them some of them, and the rest of their medicines are separated in new prescriptions to be dispensed from the insurance pharmacies, if any. Blood thinners and thrombotic solvents, some pressure medications, multiple sclerosis medications, stomach ulcer and thyroid medications, sugar, antibiotics, vitamins, Parkinson ’ s medications, and hyperactivity protocol.
Many cases complained of the lack of their medicines, which they have been dispensing for years.. And they were dispensed periodically every two months for a year after the approval of the Drug Committee to dispense those medicines, including a special medicine liquidity imported medicines, and patients with diabetes and blood diseases were their complaint that any imported medicine and its price expensive requires the highest approval of a committee in the Council of Ministers..
Although patients have been dispensing the same medication for several years, this complaint is frequent from universal health insurance patients.
Detention of raw materials
Dr. Ali Auf, head of the pharmaceutical division of the Federation of Chambers of Commerce, said that the reason for the worsening of the shortage of medicines is the detention of raw materials in ports, pointing out that there are about 1000 items that are not available.
Exchange rate
Mahmoud Fouad, Executive Director of the Right to Medicine Association, said that the aggravation of the crisis is due to the companies stockpiling medicines in anticipation of higher prices, explaining that the crisis began about two years ago due to the shortage of raw materials as a result of the high exchange rate and the inability of companies to provide dollar materials to import raw materials.
Fouad stressed that there are more than 1000 drugs whose prices rose during the past year by rates ranging from 25% to 60%, pointing out that the increase reached during the current days to 60% for the local and 80% for the importer.
Fouad described the statements of the Minister of Health about the price of Egyptian medicine as being 50 times lower than abroad as shocking, pointing out that there was a successive movement of prices from the Drug Pricing Committee of the Egyptian Drug Authority starting in 2023, which resulted in the movement of about 1,000 varieties.
He explained that Egypt suffered during the last two years from the phenomenon of medicine shortage due to the shortage of imported raw materials as a result of the economic crisis and the fluctuation of the exchange rate … and the crisis affected items considered life-saving.
Fouad stressed that drug sales in Egypt reached about $3 billion a year in 2023 without the sales of the armed forces and the interior and tenders of the Ministry of Health, which means that Egypt is considered the largest market in the region.
Unfair pricing system
He explained that Egypt had been subject to the pricing of medicines for 10 years according to the decision of the Minister of Health under the system of "lower pricing for neighboring countries" and then the pricing was according to the decision 413 of 1991, which is "calculating the cost and profit margin for companies and distribution and then pharmacies" according to the compulsory pricing that began in 1988.
He explained that the pricing is according to the cheapest price in the reference countries identified by the World Health Organization (WHO) in 36 countries to guide their prices and the minister to take them or not, pointing out that these countries are the major industrial countries and have comprehensive health insurance laws, which Egypt lacks.
Fouad added that this system in pricing is unfair as medicine has become subject to market mechanisms, supply and demand and suspicions of monopoly, the price is controlled by the policy of supply and demand, which makes medicine a commodity sold to those who can, especially since there are more than millions of Egyptian people not participating in the health insurance system, which only 63% of citizens participate.
Fouad pointed out that Egypt has about 17 officially registered medicines, 90% of which are manufactured, 176 companies that own factories, 7 business sector companies, 22 branches of foreign companies and 1,200 commercial companies that do not own a factory.
He stressed that the crisis of medicine shortage and successive rises will make the Egyptian citizen groaning and unable to bear it.
Fouad warned of the danger of the expected increases in drug prices during the coming period.

The protracted nature of the crisis, which has persisted for over eighteen months, has compelled some hospitals to ration limited drug supplies or divert available medications, directly threatening patient outcomes .

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

Europe has also experienced a worsening shortage scenario, as illustrated by Estonia’s drug shortages that rose from 183 different drugs in shortage in 2021 to 450 by 2023.

Causes include increased demand, raw material shortages, and supply chain issues.

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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Similarly, Ireland saw a shortage of paracetamol during the winter 2022-2023 COVID-19 and influenza surge; fortunately, the availability of multiple drug forms and brands allowed patients to switch to therapeutic alternatives with professional consultation to mitigate treatment interruptions .

In Egypt, multiple factors, including economic instability, currency depreciation, and illicit smuggling, have led to critical shortages of vital medications, such as insulin, cancer drugs, and anesthetics, despite local pharmaceutical industry efforts .

Title:

Content: Chairman of Wafd Party
Dr. Abdul Sindh Yamama
Chairman of the Board of Directors
Dr. Ayman is an accountant.
Editor-in-Chief
I'm sorry.
My grandfather, Zainuddin.
Chairman of Wafd Party
Dr. Abdul Sindh Yamama
Chairman of the Board of Directors
Dr. Ayman is an accountant.
Editor-in-Chief
I'm sorry.
My grandfather, Zainuddin.
Smuggling burns drug stability
Libya and Sudan are the main destinations.
And the profits are huge.
Deficiencies include stents, heart medications, diabetes, pressure, and tumors.
It is an undeniable fact that the Egyptian pharmaceutical market is experiencing a crisis of shortage of some vital items on which citizens depend mainly, and at all levels, which exacerbated the suffering of patients in public hospitals affiliated to the government, which receive subsidized medicines at low prices, so that the so-called alternative class becomes a citizen ’ s refuge, to get the necessary dose of medicine, to alleviate his health suffering or save his life.
At a time when it is assumed that more than 90% of medicines are manufactured in Egypt, citizens' complaints about the lack of many medicines and medical supplies in the markets and hospitals are escalating to the extent that deputies submitted a number of requests for briefing through the deputies, stressing that the crisis lies in the raw material itself and imported in dollars.
And the pressure.
Thyroid and sugar.
The main reasons lie in the importation of 95% of raw materials in addition to the presence of “smuggling brokers ” whose mission is to smuggle Egyptian medicine to neighboring conflict countries, especially Libya and Sudan, in order to sell it abroad at exorbitant prices, and to reap huge profits, according to some pharmacists and specialists. In addition to Sudan ’ s import of Egyptian medicine in hard currency, especially with the licenses of Egyptian medicine compared to others and the stopping of factories in neighboring countries because of their conflicts.
According to Ali Abdullah, head of the Egyptian Society for Pharmaceutical Studies (an NGO), the lack of medicines and their disappearance from the local market is a real crisis in case of smuggling, such as insulin, tumors, anesthesia, surgical supplies, serums and vaccines.
The shortage of hard currency in Egypt is also one of the reasons for the disappearance of medicines.
Mahfouz Ramzi, head of the Pharmaceutical Manufacturing Committee at the Cairo Pharmacists Syndicate, pointed out that there are organized gangs that smuggle medicine to countries of conflicts and wars, explaining that “most operations are conducted through land border roads, and the Egyptian Drug Authority is responsible for inspecting companies, factories and any pharmaceutical institution, to ensure that medicines produced in Egypt are in the normal sequence until they reach pharmacies. ”“ Some smuggling professionals deal with drug stores, where they buy large quantities of medicines, take advantage of discounts on them, and then smuggle them abroad to take advantage of the price difference. ”
The Executive Director of the Egyptian Center for the Right to Medicine, Mahmoud Fouad, confirmed that "the drug stores have turned into an illegal business and a back gate for drug smuggling and expired drug trade, as most of them are not licensed and sold without invoices, and are not subject to the umbrella of the Ministry of Health, in addition to the lack of health standards required to practice the profession of pharmacy, after some stores are run from apartments away from the eyes of the Ministry of the control bodies. 90% of its owners are not pharmacists. ”
“Are these stores registered with the Ministry of Health?
And are they subject to pharmaceutical inspection or from the Drug Control and Research Authority? ”, stressing that most of the small pharmacies in the villages “do not have the ability to buy medicine from distribution companies, which makes them resort to buying from stores after agreeing on specific facilities and periods for payment, ” pointing out that“ popular medicines in Egypt are the most smuggled abroad. ” From 250 pounds ($8 at the official exchange rate).
According to Dr. Ashraf Hatem, Chairman of the Health Committee in Parliament, it is a social responsibility, and priorities must be set, and all parties sitting together may help to solve the crisis, in light of the apparent shortage of a number of medical drugs, and his demand that the Drug Authority publish periodically and daily alternatives to the missing medicines in the absence of the original medicine. In addition, the pharmaceutical industry continues to operate and produce.
For all this and for the continuation of the crisis of drug shortage it was necessary to search and investigate the causes and solutions!
During the meeting of Gamal al-Laith, Chairman of the Chamber of Pharmaceutical Industry at the Federation of Industries, in the presence of Minister of Health Dr. Khaled Abdel Ghaffar, the Governor of the Central Bank, Hassan Abdullah, and others, he sent letters of reassurance to the Egyptian people about the existence of a solution to pump the needs of the market of foreign currency to end the shortage of medicines. Or psychologically for the patient.
He said: « The medicines that suffer from the shortage, some of them are sugar drugs and other drugs tumors and drugs of the glands and heart, drugs related to chronic diseases, which is now being secured, and we as factories work with a stock of raw materials enough for 4-6 months, and this stock reached only weeks, and therefore we are now in the stage of risk, and therefore the government began to move ».
He added that the health sector is supported by the provision of foreign exchange resources to provide all needs according to a plan to deal with such circumstances, stressing the importance of full coordination between the unified purchasing authority and the pharmaceutical industry room as well as pharmaceutical companies to face any problems related to the shortage of supplies, medicines and medical consumables.
As well as a detailed presentation on the commitments implemented and not implemented in the period from June 2023 to January 2024, with regard to the provision of (medicines, medical supplies, laboratory supplies, devices, raw materials and packing materials), and the Minister was briefed on the results of the mechanisms established with the Central Bank of Egypt to pay the obligations in foreign currency to meet the demands of the health care sector.
In the end, the official spokesman stressed that the shortage of drugs does not exceed 15% and the drugs directed to tumors are at the forefront of the shortcomings because of their close link to the currency and what faces the supply chains, otherwise all drugs and within them are compatible... The complaints are due in their entirety to the lack of knowledge of citizens with the trade names of medicines.
In addition to the above, a severe shortage of anesthetic drugs, dental pening drugs, nephrology and recovery drugs, which will cause a real disaster that threatens the conduct of surgical operations for patients, and thus increase the waiting lists in hospitals and the occurrence of complications for patients that may result in loss of their lives.
The head of the medicine division of the Federation of Chambers of Commerce, Ali Ouf, revealed that a request will be submitted to the Egyptian Drug Authority early next week to move the prices of 1,500 items in light of what he described as developments in the situation and rising costs.
He pointed out that « the need to raise the wages of workers in the pharmaceutical sector to compensate them for the cost of living and therefore must raise salaries so that they can live in the current conditions and the sector will bear the increase of salaries at the expense of cost and raise the minimum insurance ».
On the shortage of medicines, Amin al-Dabraki, one of the dealers in the pharmaceutical market, said that the main reason for the crisis is the lack of active substances imported by companies.
This is mainly due to the dollar crisis, in addition to the withdrawal of some financial companies from the Egyptian pharmaceutical market.
On the inability of the Ministry of Health to move the prices of medicines with the movement of the exchange rate, he said that the solutions are the intervention of the state by providing a fixed customs dollar for pharmaceutical companies, while moving the prices of medicines, in addition to starting factories to produce active substances inside Egypt.

Affected drug types span a wide spectrum.

For caretakers monitoring chronic, life-threatening conditions, it is important to note the following are commonly impacted:

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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1. Insulin and other diabetes-related medications (including newer drugs like Mounjaro).

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. ”

2. Cancer chemotherapy agents, such as cisplatin and carboplatin.

3. Asthma inhalers.

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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ADHD medications (e.g., Adderall).

Sterile injectable generic drugs.

Title:

Content: Prescription drug shortages lead to higher prices

Reporter: Andryanna Sheppard
Published: Updated:
Lea este artículo en Noticias WINK

Millions of people in the United States depend on prescription drugs to manage pain, treat medical conditions, and even to help them stay alive. However, the country’s drug shortage is making it hard for some people to get the medication they need or pay for the drugs that are available.

Federal Drug Administration data shows 90 percent of prescriptions in the US are for generic drugs. According to the National Institutes of Health, most prescription drugs involved in shortages are generic options.

There are currently more than 250 medications on the nation’s prescription drug shortage list, according to the American Society of Health-System Pharmacists. The organization says 2023 marked the worst year for shortages in about a decade.

Jessica Kahn’s two sons were diagnosed with ADD.

“I would say tricky, tricky to navigate,” Kahn described.

For the past year, Kahn said getting their medication has been frustrating.

“I have my list of all the pharmacies. I’ve even driven all the way up north to Walgreens or a CVS, some random place to go pick up a kids’ prescription,” Kahn added.

According to the FDA, prescription drug shortages are often linked to manufacturing and quality problems, delays, and discontinuations. Two drugs used in chemotherapy, Adderall, lidocaine, and amoxicillin are just a couple of the prescription medications on the shortage list.

When drug supplies are low, prices tend to increase. According to the US Department of Health and Human Services, there is a 16.6 percent increase in the price of drugs involved in a shortage. And in some cases, alternative drugs were priced at least three times higher.

“You got to be very conscientious that it might not be available and that it is not an option,” Kahn advised. “No matter how many places you call, it’s not there.”

Beating the prescription drug shortage

Health experts offer these tips:

  • Check the national drug shortage list for your medication and possible alternatives.
  • Don’t wait until your prescription is almost gone to refill it.
  • Check other pharmacies for availability and if you can’t find the generic version, look for coupons or programs that offer payment help. Some patients have reported that they receive additional help to reduce some prescription costs from $100 to $10, it’s not allowed if you are already on Medicare.
  • Websites and apps like GoodRX, RX Saver and WellRX can help you find the cheapest place that has your medication and coupons for it.

Contributors to this news report include: Lindsay Dailey, Producer; Bob Walko, Editor

Copyright ©2024 Fort Myers Broadcasting. All rights reserved.

This material may not be published, broadcast, rewritten, or redistributed without prior written consent.

6. Emergency-use hospital medications.

Title:

Content: Policy and Inadequate Clinical Engagement Call on Government to Address Drug Deficiency and Enhance Patient Participation Rights
Health Care Network
The World Health Organization (WHO) has designated September 17 every year as World Patient Safety Day (referred to as Patient Safety Day), but patient participation in China is still insufficient from policy to clinical.
The Taiwan Alliance of Patients and Friends (TAPO) today (13th) invited patient groups and medical organizations to celebrate World Patient Safety Day, calling on the government to actively address the crisis of drug shortage and implement three important rights of patients in the medical and health care system: the right to know, the right to choose and the right to participate.
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The Taiwan Alliance of Patients and Friends (TAPO) held a press conference on World Patient Safety Day 2023 on the 13th, inviting the two major competent authorities of the Ministry of Health and Welfare, the Ministry of Health and Welfare, the Ministry of Health and Welfare, the Department of Health, the Association of Pharmacists, the Association of Nurses, the Medical Reform Foundation, and the Pharmaceutical Relief Foundation to jointly advocate for patient safety.
Call on the Ministry of Health and Welfare to actively respond to the drug shortage crisis
Wu Honglai, president of TAPO, pointed out that a stable supply of drugs is the basis of drug safety. At the beginning of this year, the shortage of drugs in China worsened, and the public may not be able to obtain the required drugs in community pharmacies.
The Ministry of Health and Welfare subsequently set up a drug supply notification processing center, but the problem of drug shortage at the grassroots level is still reported.
Now the global shortage of drugs continues to fever, the United States official also confirmed that the lack of drugs for several months, in addition to pain medication, even cancer drugs, antibiotics are in crisis.
Faced with such a challenge, Taiwan is also a small market, low health insurance cost of the country, I am afraid that it will be no small impact, imploring the Ministry of Health and Welfare to put forward a more positive response to the shortage of drugs, so that patients will not suffer from the interruption of treatment.
Chen Wen-wen, CEO of the Drug Harm Relief Foundation, believes that "drug safety" is an important part of maintaining patient safety. From years of experience and research, many serious drug hazards can be prevented beforehand. In all stages of treatment, such as receiving prescriptions, taking drugs, and tracking the effectiveness of treatment, you must have a deep understanding of the relevant information in order to escape the passive acceptance of instructions and actively restore health.
Enhance patient participation and influence
Yan Biwen, deputy executive director of the Cancer Hope Foundation, suggested that the current time point for patients to express their views is worth discussing again, and the expert meeting has completed the drug payment proposal before the expression, for discussion by the Joint Committee, and the views of patients are difficult to exert practical impact.
The government should refer to the practices of leading countries such as the United Kingdom, Australia and Canada to include the views of patients in the medical technology assessment, including subsequent expert meetings and meetings to decide on payment, and have formal representatives of patients to participate in the discussion and resolution.
This year, the Health Insurance Department visited the Cancer New Drug Fund of the United Kingdom and cooperated with NICE in the United Kingdom. It should also follow its patient-centered spirit, enhance the participation of patients and expand the scope and influence of collecting opinions.
“Healthcare is not just about treating diseases, it ’ s about caring for and protecting lives, ” said Su Yuyi, deputy general secretary of the All Union of Physicians. Since 105, doctors have been promoting shared decision-making. Instead, they discuss treatment options, risks and benefits with patients to help them make decisions that meet their values, preferences and goals.
Cai Li-chuan, deputy executive director of the Taiwan Cancer Fund, believes that at present, the participation of patients' representatives in the important decision-making meeting of health insurance is still insufficient. In the "joint drafting" meeting to decide whether drugs should be included in the health insurance payment, there are only two patients present, and informal representatives, there is still a gap in the exercise of the rights of the meeting. Members who have obtained seats by drawing lots, so that the voices of patients are easily ignored.
Competent authorities should plan a more stable and sound system for patient participation, and pay attention to the voice of patients.
Patient safety should be ensured by maintaining a stable ratio of care
According to a study by Linda Aiken, a professor at the School of Nursing at the University of Pennsylvania, the probability of death of surgical patients within 30 days of admission increases by 7%.
Source: Healthnews.com https: / / www.healthnews.com.tw / readnews.php? id = 59248
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Central nervous system stimulants.

Antimicrobials, including antibiotics.

Title:

Content: • March 21, 2022, 13: 33
Health Ministry: shortage of drugs in pharmacies may be caused by increased demand
Deputy head of the Ministry of health: the shortage of drugs in pharmacies is associated with increased demand
The possible shortage of drugs in Russian pharmacies will be associated not with a shortage of drugs, but with increased demand.
This was stated by the Deputy head of the Ministry of health Sergey Glagolev.
Glagolev believes that the shortage of drugs in pharmacies will provoke an increase in demand from both ordinary residents and medical institutions.
“Those possible shortcomings that we see at the stage of the implementation of drugs in pharmacies are not associated with the termination of the supply of medicines, not with the termination of the supply of components, shortage of pharmaceutical substances or excipients, but mainly with increased demand, ” he said.
Glagolev stressed that the Ministry of Health had previously signed contracts for the purchase of a number of medicines under centralized mechanisms.
The number of contracts is 85%.
The list includes medicines for the treatment of tuberculosis and HIV.
Also purchased drugs for sale within the national calendar of preventive vaccinations.
The high demand for medicines is associated with the increase in prices for a number of pharmaceutical and other products.
According to Glagolev, pharmaceutical manufacturers will quickly adapt to new conditions if they apply the experience of the pandemic period.

Hormonal therapies.

Intravenous fluids essential for hospital care.

Title:

Content: Supplement
Sunday WorkShop
Future cities: play a role in the private sector under the epidemic Primary medical network for hospital pressure reduction
[Ming Pao News] In the past, the term "primary health care" may be very boring, and the "primary" among them may also be misinterpreted as describing social class, but now it is easy to understand for example.
When the hospital situation is on the verge of collapse, if mild or even uninfected people can take good care of themselves, the medical system will not be dragged down, and the public will not have to fall into a state of panic.
“If a person has a sense of control over their health and knows that they can make decisions about their health, they don ’ t have to wait passively for the doctor to take care of them every time. ” Primary care refers to not going to the clinic and the first level of the hospital, so that everyone can access community resources, prevent diseases, and manage health.
As a result of the epidemic, various institutions have been closely woven into the network to prove that primary medical care “does work ”, which is also a part of the entire medical system now and in the future.
Community Pharmacy, Neighbourhood Consultation, Interviews with Doctors
In the first episode of "City of the Future", Dr Luk Chi-chung, a former cluster director, discussed the hospital cluster and the public-private hospital partnership. He mentioned that one of the aims of the cluster was to strengthen the link between hospitals and the community. Grassroots doctors can help take care of patients with mild symptoms without forcing them to go to public hospitals, "he says, adding that" if primary care is not done well, the many anti-epidemic centers (dealing with the epidemic) will not do well. "
When it comes to reliable and clear sources, I believe that many people have forwarded information maps and flow charts of “healthcare providers ”. This non-profit organization has been promoting the development of basic medical care. Fan Ning, the founder of a public hospital doctor, said:" This time, people with fever, sore throat, headache, are common symptoms of infection virus, but different classes are thrown out of the sun, good confusion, such as suddenly found that there is no medicine in the house, and many people do not know about Chinese medicine, we also have a lot of information, guidance. "
This reflects that many community policies are not developed in a participatory or empowering way, and that everyone becomes a receiver without learning. ”
There is a “Community Pharmacy ” near Kwai Hing MTR Station. Janet, a lecturer in the Department of Pharmacy and Pharmacy at the University of Hong Kong, is also a pharmacist at the Community Pharmacy. When a person walks in to buy a medicine, they can consult health advice. For example, some patients will regularly visit a public hospital. A" golden opportunity "to see a doctor once in a few months.
"We want to sell the concept that people have the right to have these services in their own community, but in foreign countries, that's basically the case. Why do people in Hong Kong feel that they are prepared to pay to enter the pharmacy?
Hong Kong people can have a place in the community to understand their own health, not to replace doctors, but to connect to doctors. "The organization was originally intended to serve low-income families, ethnic minorities, working people in the region and other different groups," but in Hong Kong, there are fewer such non-profit-making pharmacies, so we are open to the public in Hong Kong. "
Check out your home medicine online.
She said that in the epidemic to learn that professional medical staff also have their own blind spots, "I think the profound is that when paracetamol suddenly become a hot commodity, everyone knows that it is not necessary to buy a certain brand, as long as there is this ingredient can be, we know that this medicine is a lot of hospitals to the elderly, and many drugs have been criticized before the epidemic. For a pair of ingredients, and in my concept, check to scare the house has no medicine to use, is not enough medicine will do the thing, how to expect a good response to the post, many people reprint, at that moment have learned that some of the original return to the basic steps should also be mentioned."
Emily Liao, Director of Community Health Services for Caregivers, said that she will continue to understand the needs of the community from pharmacies and various channels, and then adjust the way and strategy of disseminating information. “We need to use the right information to speak in easy-to-understand and easy-to-follow language, so that stakeholders in the community, including different places such as workplaces and social welfare services, can share different information with employees and audiences.
They use simple tools such as Google drive to classify anti-epidemic data such as infographics according to needs, such as what to do with the diagnosis, and what to do with the family diagnosis, so that different institutions can easily obtain, used to answer queries, "We will also record in addition to text and images, because colleagues who do ethnic minority services think that the information will be received and transmitted better by reading the recorded information."
She stressed that this is a two-way channel, “listening to (demand) and responding all the way, hoping to make them feel that someone is walking the same path as you, so that everyone can bring out their own ability to deal with the problem. ”
Health and Wellness Centre Connected to District Medical Services
Fanning also mentioned a small experiment between SVhk (Hong Kong Social Venture Fund), an organization that promotes social innovation, and the Sham Shui Po District Health Centre, which allowed parents to help each other to take care of themselves, and prevented a group of children from rushing into the hospital to seek medical treatment.
Harmony Lee, the head of SVhk – Community Impact, said that the experiment was a “diagnosis and mutual help circle ”, and the method was very simple. She invited a group of mothers to take care of their children to join a WhatsApp group, sharing problems and countermeasures with each other, and encountered a more severe situation. Call your mom individually and suggest she needs to go to the hospital, how to follow up, what steps to take. ”
However, the mother later because there are other children to take care of at home, did not choose to be sent to the hospital immediately, "we have been communicating, she constantly for the child to cool down, let him drink water, we teach her what needs to be checked, such as every half hour body temperature, blood oxygen to maintain at least 97, 98, the situation of the children after a night is controlled."
Harmony said that these families come from SVhk ’ s community sharing club in Sham Shui Po. They regularly follow up the situation of 350 families with questionnaires, including economic, marital and parent-child relationship, to provide assistance. This time, due to the early investigation of the epidemic, 1 / 5 of the more than 100 questionnaires collected, showed signs or rapid diagnosis. Therefore, I have come up with this method to gather these parents and put forward suggestions to the health centres for co-operation.
In fact, in recent years, the government has invested resources to vigorously develop primary health care. It plans to set up health care centers in each of the 18 districts, each with about $300 million of capital to tender for operation, for a period of three years, and renew the contract according to performance.
There are currently two Kwai Tsing Centre run by the Kwai Tsing Safe Community and Healthy City Association and Sham Shui Po Centre run by the St. James' Settlement. The former commenced operation in September 2019 and the latter in June last year, while the other four, Wong Tai Sin, Tuen Mun, Southern District and Yuen Long, will be operational by the end of this year. A "satellite organization", but not affiliated with a health center, but as a cooperative service point.
The Centre ’ s Chief Nursing Coordinator, Harriet Chung, explained that the Sham Shui Po Centre is a main centre in Shek Kip Mei Estate, with three additional centres at Mei Foo, Fuk Wing Street and the upcoming opening of Sham Shui Po East.
Then spread out to some satellite organizations, looking for institutions serving in the region, such as churches and community organizations, to cooperate, “matching with our philosophy, they will borrow their service points to organize health activities or projects on a regular basis. ”
Provide professional advice to the community innovation organization "Mutual Help Circle"
Harriet said that the establishment of the center will have registered nurses, social workers, physiotherapists, occupational therapists, dietitians, and pharmacists. Instead of signing a contract with the satellite organization to conduct many activities, it will be "weaving a network", which can be promoted by these partners or the center with new ideas.
This time, we also saw them complementing each other. SVhk proposed the plan as a community innovation organization, but it still lacks the strength of the health care professional, and the health center has a role to play.
Another network of health centers is to link local medical services. Harriet said that before they noticed the need for vaccination in the community, they contacted the local private doctors to set up some quotas, so that the center can refer the public to make an appointment for injection, and even some doctors are willing to open Sunday services.
The network of the centre is also linked to hospitals. "Before the outbreak of this epidemic, we have been referring patients to Caritas Medical Centre and Princess Margaret Hospital in the district. They will refer patients for rehabilitation, including stroke and hip fracture, to use our rehabilitation services, such as physiotherapists. Sign the agreement as required by the Food and Health Department.
For example, patients with diabetes and high blood pressure, if we have made an assessment, referred to the network of Western doctors for diagnosis, blood drawing, etc., see the doctor is funded by the government, each neighborhood referred by us will have 250 yuan clinic fee subsidy, that is, if the doctor is charged 250 yuan, the neighborhood will be free, and the neighborhood will pay 50 yuan for 300 yuan. "
However, she admitted that she needed to explain the service concept to the doctor in the early stage, "We signed the doctor with him, some are not very clear, will charge the neighborhood 300 yuan, so the game will be difficult to play, because you received the government 250 yuan, that is, a total of more than 500 yuan."
We will say that we want to leave the neighborhood to see you in the community. At present, many service providers in our network charge 0 yuan. ”
The "Primary Care" Network Must Be Involved
Health care providers are also strategic partners of Sham Shui Po Health Centre. Harriet believes that the principle of cooperation with various organizations is to use the established context and resources of the community, so that the organization does not think that the center is “grabbing ” the service target, and try not to overlap the service, but refers the center members to use the existing resources, and“ win-win ” can weave the network well.
Based on the experience of the three organizations in dealing with the fifth wave of the epidemic, they all mentioned that they should respond quickly and attentively, understand the real needs of the community, and respond in a timely manner.
To prevent patients from rushing to the hospital, sometimes it may not be related to medical services. Harmony mentioned that the WhatsApp mutual help group was started because she knew that the patient or caregiver needed emotional support at the moment, while pharmacist Janet felt that Hong Kong people were growing up from a critical situation.
She said that this wave of epidemic is like a preview of our future, "in the future, the aging of the population is another bomb, when everyone feels that the current medical system is becoming more and more satisfied with me, but instead of thinking, everyone has a part in the medical system, not that the public is not doing enough, but if everyone has the ability and confidence to do more for their health, everyone can help the medical system share."
Looking forward to sharing health data with link workers
In addition to the confidence that the public can continue to learn from this epidemic and increase their awareness of community resources, is there any difficulty in connecting with the hospital network?
Fan Ning admitted, "the public, the Hospital Authority, the Department of Health many staff, do not know what the primary care do, the HA staff angle is often how to deal with acute and serious diseases, but the primary care is mainly control, stability of health problems, everyone's angle is different, there will be coordination and error in cooperation". Harriet, based on the experience of operating the Sham Shui Po Health Center, said that in the epidemic. On how to transfer (offload) some hospital services to primary care, she also understands that "two years of the epidemic hospitals are also very tired, there is a shortage of staff, but we need to look more broadly, and we have to deal with the people who have not happened, and there will be no more patients in five or 10 years."
She believes that if a patient goes to the hospital, “if it is found that the diabetes mellitus or blood pressure is high, the current structure will not arrange for him to go out for a follow-up appointment, but in fact, it can be referred to us to improve the situation, which can delay the emergence of the disease so early ”. Emily, a healthcare practitioner, suggested that the HA ’ s data on social health can be shared more with primary care partners. Or you will see link workers in the outpatient waiting area, link to medical, community resources". On the NHS website, you can find a "social prescribing link worker" for mental health services, describing it as a job that requires careful listening to work, helping people with emotional problems or feeling isolated to find community services, stating that "there are no specific entry requirements for this position. Because your life experience, your personality, your values are usually more important than your qualifications. ”
【 Disaster Response: Primary Care 】
By Vincent Tsang Hsiao-ling
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{Art} Chang Yu-chi
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These shortages directly impact disease management efficacy and patient safety .

The causes of medication shortages are multifactorial.

Chief among them are manufacturing and quality control problems, unplanned downtimes, and fragmented supply chains.

Heavy dependence on foreign production for active pharmaceutical ingredients (APIs), primarily sourced from India and China, causes fragility in supply chains due to geopolitical tensions, trade disruptions, and logistical bottlenecks.

Increased demand driven by the COVID-19 pandemic and other health emergencies further strains production capacities.

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Texan / What Makes Pharmacy Shelves Empty?
Supermarkets and pharmacies in many parts of the United States have recently encountered varying degrees of "drug shortage", many over-the-counter drugs have been snapped up, and online sales channels are also seriously out of stock.
The reasons for this can be broadly divided into the sudden surge in demand, the unfavorable supply situation, and the "panic" caused by the expected future demand for drugs.
Sales of colds at U.S. retailers jumped 35% in November from a year earlier, and sales of throat sprays and throat lotion rose 56%. The recent increase in sales enthusiasm for these drugs is evident.
Even without relying on data, the empty shelves in supermarkets and pharmacies are enough to explain the problem.
In particular, those popular drugs that relieve the symptoms of children's colds are more difficult to find.
The epidemic itself has greatly increased the "need for drugs" as the primary cause.
The impact of COVID-19, influenza, and respiratory syncytial virus (RSV), multiple epidemics have increased the demand for these drugs.
Especially for parents looking after sick children, it is unrealistic to ask them to be patient and wait for medication.
This has also forced these parents to "sweep" around, and the rush for drugs has naturally spread.
In addition to the increase in demand directly caused by the families of the epidemic, the news of the shortage of drugs has also prompted some families who have not been infected to start stocking up on additional drugs in advance.
In parts of the United States, sales of drugs related to coughs, colds, flu and nasal congestion have directly doubled in the past month.
In some areas where drug supply is limited, sales have also been pushed up by 30%.
In addition, from a supply point of view, the tight supply chain of production is also a factor that causes a "short-term drug shortage".
According to a recent study, 84% of the global supply of Acetaminophen (the main component of Tylenol) comes from China and India, with China accounting for nearly two-thirds of the total supply; Ipuprofen also comes from China, accounting for one-third of global production.
Meanwhile, Johnson & Johnson, the parent company of Technol and Merrill Lynch, has pharmaceutical plants in cities such as Shanghai, Beijing and Guangzhou in China.
The capacity of these factories has been limited by China ’ s previous strict epidemic prevention policies.
Even though the control has been almost liberalized recently, the continuous positive performance of workers has also affected factory capacity to a certain extent.
In addition, transportation problems can also lead to drug shortages, and international shipping has not yet returned to pre-pandemic levels.
But despite this, some pharmaceutical companies say that there is no problem with the supply of drugs, there is sufficient stock, but it only takes time to get to the major supermarkets and pharmacies.
When people make decisions, they are more or less unavoidably influenced by their surroundings.
The same is true in the case of drugs.
The recently criticized and controversial supermarket drug purchase behavior is actually the product driven by profit under the "drug demand" and "panic stocking".
Of course, it is not difficult to predict that with the change of time, the flu season slowly ends and the recovery of supply capacity, everything will gradually be on track.
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Economic and currency instabilities, as seen in Egypt, exacerbate access issues.

A critical barrier has been the lack of transparency from manufacturers regarding supply disruptions and production stoppages, hampering timely response and mitigation efforts.

The U.S. FDA has addressed this by issuing draft guidelines requiring pharmaceutical manufacturers to provide at least six months’ advance notice of any production halts that could cause shortages.

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Content: FDA gave instructions to pharmaceutical manufacturers to prevent the risk of defects
The FDA has released a draft guideline that will allow pharmaceutical manufacturers to more accurately report disruptions to the production of drugs and APIs.
In particular, it specifies who should contact the regulator in case of a failure in production and on which products it is necessary to transmit information.
The U.S. Food and Drug Administration (FDA) has issued draft guidelines to pharmaceutical manufacturers to prevent the risk of flaw.
According to the instructions, they will notify the agency of changes in the manufacturing process of drugs, biological products or active pharmaceutical ingredients (API).
In the United States, FD & C. It requires manufacturers to notify the agency of interruptions in the supply of products or APIs.
The FDA ’ s new guidelines provide clarifications.
Manufacturers must submit a notice to the FDA at least six months before stopping drug production, which could lead to their shortages on the market.
If it is not possible to notify the agency six months in advance, it should be done “as soon as possible ”.
If interruptions in production may affect the supply situation, the manufacturer should assess the situation only on the basis of its capabilities.
It should not take into account the capacity of other manufacturers, the amount of product on the market or market demand.
The guidelines also state what specific product or API information manufacturers should report when informing the FDA.
CBS, citing a report from the US Senate, writes that by the end of 2022, the shortage of drugs in the US had reached a five-year peak and affected almost 300 pharmaceutical products.
This is due to the fact that the United States moved production to China, India and other countries.
According to the American Society of Health System Pharmacists, products such as sodium chloride solution, the antibiotic amoxicillin and albuterol inhalation solution are now in short supply.
Nikolay Sokolov
pharmvestnik

However, many manufacturers remain reluctant to share detailed information, complicating regulatory and healthcare responses .

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The shortage of 323 medical drugs is the worst since 2001.
According to the American Society of Health-System Pharmacis (ASHP), 323 medical drugs are currently in short supply, breaking the previous record of 320 shortages in 2014 and the most severe since tracking drug shortages began in 2001.
ASHP ’ s collaborative survey with the Utah Drug Information Service found that drug shortages in the United States are increasing and show no signs of improvement.
The institute said that all kinds of drugs are at risk of being out of stock, and the most worrying is the lack of even general injection disinfection drugs, including cancer chemotherapy drugs, and emergency medicine stores in hospitals and surgery departments.
Adderall, which is used to treat ADHD and narcolepsy, is one of the most difficult drugs to track and has been in short supply since October 2022. The Drug Enforcement Administration said last fall that more than a dozen pharmaceutical companies said they intended to increase adderall production, but ASHP noted that the problem persists to this day.
Members of the Society of Pharmacists say there is a national shortage of drugs to treat ADHD, which is still causing problems for medical personnel and patients.
Adderall will be short of loans, one of the reasons is that during the Covid-19 period, the use of large, delayed production by major manufacturers, and other manufacturers can not meet production targets.
In its quarterly report, ASHP noted that most pharmaceutical companies are reluctant to disclose the cause of the drug supply shortage.
Experts believe that the rapid increase in demand, supply is too late, pharmaceutical companies are limited, and the supply chain of pharmaceutical materials is blocked.
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Healthcare systems cope with shortages using several strategies.

Rationing medications and prioritizing critically needed drugs is common, especially in hospitals.

Therapeutic substitution is widely employed, with clinicians switching patients to alternative but clinically acceptable medicines or adjusting dosages and formulations.

Price discounts and policy incentives for alternative drugs help ease financial obstacles to access.

Healthcare authorities provide guidance to prescribers and pharmacists on managing shortages and safe use of substitutes.

Despite these measures, shortages persistently endanger treatment quality and safety, underscoring the ongoing strain on healthcare delivery .

For patients and caretakers managing chronic, life-threatening conditions, several practical recommendations have been advanced.

They should routinely consult national or regional drug shortage inventories to monitor current and anticipated shortages.

Early prescription refills, identifying multiple pharmacies, and utilizing digital price comparison and discount platforms (such as GoodRX and RX Saver) can enhance access to needed medications.

Open and frequent dialogue with pharmacists and healthcare professionals is crucial to identify viable therapeutic alternatives and avoid treatment interruptions.

These steps empower caretakers to respond effectively to sudden disruptions in medication availability .

Addressing global medication shortages requires coordinated policy and operational responses.

Increasing transparency in supply chains and diversifying sources of APIs are critical to reducing vulnerability to disruption.

Expanding domestic manufacturing capacity, improving regulatory oversight, and establishing strategic stockpiles of essential medicines can stabilize supply.

Engaging patients and caretakers in decision-making processes ensures greater alignment with patient needs and facilitates more responsive healthcare interventions.

Patient safety and advocacy groups emphasize the need for enhanced communication, transparency, and inclusion to prevent negative clinical impacts of shortages and preserve trust in healthcare systems .

While this report offers a comprehensive overview of the global medication shortage crisis from 2021 to 2024, more detailed country-specific analyses would further clarify how differing economic and political contexts shape shortages and healthcare responses.

Additional data focused on shortages of medications for other chronic conditions, such as cardiovascular, renal, and neurological diseases, could help caretakers managing complex health profiles.

Exploration of innovative supply chain technologies and forecasting tools may provide new avenues to preempt disruptions.

Moreover, studying the psychological and health outcome effects on patients and caregivers experiencing medication interruptions could guide enhanced support strategies during shortages.

In summary, the global medication shortage situation between 2021 and 2024 has intensified, threatening the availability of life-saving and chronic disease treatments.

Multifactorial causes rooted in manufacturing, supply chain fragility, geopolitical events, and regulatory limitations drive the problem.

Healthcare systems and caregivers are adopting mitigation strategies including rationing, therapeutic substitution, and enhanced communication to maintain continuity of care.

Official recommendations emphasize preparedness, vigilance, and stakeholder engagement.

Overcoming this challenge demands sustained policy focus, international cooperation, increased transparency, and active involvement of patients and caregivers to ensure resilient, equitable, and patient-centered pharmaceutical supplies in a complex global environment.