Between 2021 and 2024, medication and medical supply shortages have intensified globally, impacting essential drugs critical for chronic and life-threatening conditions.

This growing crisis affects hospitals, pharmacies, and patients across developed and developing regions, with shortages seen in a wide spectrum of medications including generics, emergency treatments, antibiotics, chemotherapeutics, and sterile injectables.

In the United States, shortages reached record proportions by early 2024, with 323 drugs reported in limited or unavailable supply—a historic peak.

Affected medications include diabetes treatments such as Ozempic and Mounjaro; emergency drugs like adrenaline and albuterol inhalation solution; pediatric antibiotics, notably amoxicillin; various chemotherapy agents; and sterile injectable solutions such as sodium chloride, which is fundamental for fluid management.

Other impacted drug classes include ADHD medications and anesthetics.

These generics shortages have led to steep price increases, sometimes tripling or more, significantly raising patient costs and straining healthcare budgets.

The widespread scarcity forces hospitals to ration supplies or use less-preferred alternatives, often with limited evidence on equivalency, raising concerns over optimal care for vulnerable patients.

The crisis roots in a fragmented supply chain and a manufacturer base unable to meet surging demand.

The US government plans to invest billions into strengthening domestic production capacity, revising generic drug pricing models, and enhancing regulatory oversight, including mandatory advance notification of production discontinuations .

European nations have also experienced serious shortages.

Ireland reported paracetamol shortfalls during Covid-19 and influenza surges in 2022-2023, affecting even some prescription strengths, due mainly to raw material constraints, production disruptions, and pharmaceutical industry consolidation.

Estonia’s drug shortage list ballooned from 183 drugs in 2022 to 450 in 2023.

Critical medications for heart attack (myocardial infarction) and stroke treatment were among those scarce, alongside drugs like insulin for diabetes, anticancer agents, and other essential chronic disease medicines.

Estonia responded with programs extending discounts to substitute drugs and advising patients to maintain supply buffers—specifically, a recommended weekly supply for non-prescription and a monthly supply for prescription medications to enhance preparedness.

However, while substitution schemes and discounts can alleviate some burden, actual availability of safe therapeutic alternatives may remain markedly limited, particularly for drugs with narrow substitution options or specialized administration requirements .

In the Middle East and North Africa, Egypt and neighboring countries are challenged by raw material shortages, inflation-driven production cost hikes, currency fluctuations, and ongoing supply chain disruptions.

Egypt produces most (91%) of its medicines domestically, yet shortages persist, especially for chronic disease drugs such as those for diabetes, hypertension, and cardiovascular conditions.

Egyptian authorities enforce pricing controls, inspect manufacturing facilities closely, prioritize availability of chronic disease medications, and recommend therapeutic alternatives where feasible.

In the broader Arab region, Jordan maintains relatively stable pharmaceutical supplies due to prudent policies and investments but faces similar structural vulnerabilities.

Regional industry efforts aim to incorporate advanced manufacturing technologies and foster cross-border partnerships to enhance resilience, though global dependencies on external raw materials and API suppliers continue to pose risks .

Taiwan exemplifies proactive policy responses in Asia.

Its Ministry of Health and Welfare has established dedicated drug shortage centers, enhanced platforms for real-time information sharing, implemented pricing reforms to encourage domestic generic production, and mandated timely manufacturer reporting of supply disruptions.

This multidimensional approach addresses the complex factors causing shortages, including production interruptions, fluctuating clinical demand, pricing constraints, and global disruptions stemming from the COVID-19 pandemic and geopolitical conflicts such as the Russia-Ukraine war .

The global causes of medication shortages are multifactorial.

Production relies heavily on limited sources of APIs and raw materials concentrated in countries like India and China.

Quality control failures or regulatory closures of manufacturing plants cause sudden, severe supply gaps.

Economic pressures—low generic drug prices, inflation, currency devaluation—discourage sustained production investments.

The COVID-19 pandemic and geopolitical tensions have caused logistic slowdowns and raw material scarcities.

Industry consolidation reduces manufacturing redundancy, heightening vulnerability to localized disruptions.

A critical issue remains the lack of supply chain transparency and weak early warning systems for impending shortages, impeding timely interventions and contingency planning .

Healthcare systems and pharmacies have responded by adopting therapeutic substitution guidelines, rationing protocols where necessary, price subsidy extensions (as in Estonia), and engaging in interdisciplinary collaboration to optimize scarce resources.

Regulatory agencies have introduced policies aimed at increasing transparency and accountability, such as the FDA’s draft guidance requiring manufacturers to report potential production interruptions six months in advance or as soon as possible when unplanned.

Governments invest in domestic manufacturing expansion and supply chain diversification to reduce dependence on foreign suppliers and improve resilience .

For primary caregivers, especially those responsible for persons with chronic, life-threatening illnesses, practical preparation involves multiple coordinated steps.

Authorities in Estonia, for instance, recommend maintaining a weekly stock of non-prescription medications and a monthly supply of prescription medicines to buffer against sudden shortages .

The US advice includes monitoring national shortage lists regularly, requesting early prescription refills, checking availability across several pharmacies, and utilizing platforms like GoodRX to find affordable alternatives .

Caregivers should maintain open communication with healthcare providers to safely identify and discuss therapeutic alternatives or dosing adjustments before shortages result in treatment interruptions .

However, it is important to recognize that despite available mitigation strategies, many patients face limited options for safe substitutes—particularly for drugs where equivalent alternatives are scarce, specialized, or require complex administration—meaning ongoing risk persists for those dependent on narrowly substitutable, life-saving medications.

Global health agencies reinforce these guidance points, emphasizing the importance of multi-stakeholder engagement and transparent supply chains.

The World Health Organization advocates for coordinated international efforts to improve data sharing and support countries in managing shortages, recommending caregivers stay well-informed and connected with health professionals for medication management during shortages.

The European Medicines Agency (EMA) calls for enhanced cooperation between pharmaceutical companies, healthcare providers, and regulators across member states to anticipate and mitigate shortage impacts.

EMA further encourages patients and caregivers to work closely with pharmacists and clinicians when facing medication disruptions, highlighting that official shortage lists and advisory communications are vital resources to monitor .

In conclusion, from 2021 through 2024, medication shortages present a complex, global challenge threatening access to essential medicines for chronic and acute care.

Rooted in fragile, opaque supply chains and compounded by economic and geopolitical factors, these shortages affect therapeutic areas beyond diabetes, chemotherapy, and antibiotics, including emergency and cardiovascular drugs.

Different countries have adopted regulatory reforms, domestic production incentives, and data transparency measures to mitigate risks.

For caregivers, awareness, proactive prescription management, and consultation with healthcare providers are key to navigating shortages safely.

Despite these efforts, persistent gaps in available therapeutic alternatives underscore the ongoing vulnerability of patients reliant on narrowly substitutable life-saving medications.

Expanding access to timely, comprehensive shortage information and continued global cooperation remain critical to improving resilience and safeguarding patient care.

This report lays a foundation to guide caregivers seeking to understand and prepare for medication shortages while highlighting areas—such as detailed substitution protocols, patient support systems, and regional manufacturing initiatives—for future elaboration to maximize practical relevance and reach comprehensive coverage.

Between 2021 and 2024, medication and medical supply shortages have intensified globally, impacting essential drugs critical for chronic and life-threatening conditions.

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Content: Thursday 18-07-2024
Medication crisis in regional markets.
The Jordan Golden Box
The history of the pharmaceutical industry dates back to the Middle Ages, where the first Islamic pharmaceutical store was established in Baghdad in 754, while the Arab pharmaceutical industry dates back to 1938, where the first Arab pharmaceutical industry was established in Egypt, followed by Syria in 1956, Jordan in 1960, Saudi Arabia and the Arab Gulf countries in 1980.
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In the 19th century, pharmaceutical industries developed in Europe and America, and in the 1950s, the development of industries began to develop a more sophisticated scientific and systematic approach until the introduction of innovative pharmaceutical, biological and biological analogs, including vaccines, in addition to the recent introduction of artificial intelligence in manufacturing, production and marketing and all components of the health system.
Most Arab pharmaceutical industries have not been able to enter this field due to the high cost and lack of infrastructure sometimes and their dependence on the production of sexual and similar products in addition to flooding the markets with similar products by local companies. In the future, most pharmaceutical industries will continue to enter this field as it is the most important element of progress and the gate of scientific and technical investment.
It is worth mentioning that the size of the global pharmaceutical market is about 1.5 trillion dollars, while the size of the Arab pharmaceutical market is about 38 billion dollars, the Gulf is about 18 billion dollars, the Saudi market is the largest with about 9.2 billion dollars and the UAE 4.5 billion dollars, while the size of the Turkish market is 33 billion dollars, the African 100 billion dollars and the Egyptian about 8 billion dollars. Pharmaceuticals from various European and American companies, which account for more than 65% of the global market share, and a quick look at the volume of investment in the pharmaceutical sector in Turkey, where the volume of investment in the pharmaceutical sector is 6 billion dollars through 760 pharmaceutical factories and 11 factories of raw materials.
In Egypt, where the volume of investment in the pharmaceutical sector is 3 billion dollars, there are 191 factories, 799 production lines, hundreds of manufacturers, 81 thousand pharmacies and 1200 pharmaceutical warehouses. In Saudi Arabia, where she leads a major campaign to encourage and localize investments in the pharmaceutical and biotechnology industries and focuses on research and development. The UAE is also working to promote investment in the pharmaceutical sector inside and outside the country, where the volume of the pharmaceutical market is close to $4 billion.
In the past years, the pharmaceutical authorities in more than 27 European countries reported a shortage and loss of medicines and the crisis has extended since 2022 and worsened in the other two years to reach the neighboring markets in Egypt, Turkey and Lebanon, where more than 500 drugs have been lost in Tunisia, 1000 drugs in the Egyptian market and 2000 drugs in the Turkish market. Supply and demand are dead, or regional instability and refugee flows.
Drug security is an essential component of a country ’ s national security system.
Although some countries have moved to take protective measures to ensure the drug reaches those who deserve it, the series of drug outages has remained a nightmare for their governments and could last for five years.
Locally, the Jordanian pharmaceutical market is about 1.3 billion, and the volume of employment in the pharmaceutical sector is about 35,000, and the volume of foreign investment is modest, not exceeding $100 million.
In Jordan, the most prestigious country in the pharmaceutical industry, which began since 1960 without interruption, and the Jordanian medicine gained consumer confidence and was able to enter more than eighty Arab and international pharmaceutical markets, where there are 23 factories, 61 production lines, 4000 pharmacies and 500 pharmaceutical warehouses.
In spite of the regional circumstances, the Jordanian pharmaceutical market remained stable as a result of the golden box, which is represented by the prudent government procedures in dealing with the refugee file and the Corona pandemic, the stability of the legislative environment, the modernization of the investment environment legislation and the continuous official support for local industries. Keeping pace with global developments and meet attracting more investments and the needs of the local and regional market to ensure the entry of new investments and work to localize them and not to waste available opportunities and expand the umbrella of reference pricing and review profits in the pharmaceutical sector to facilitate the entry of investments to the local market and simplify procedures and encourage the rational use of medicines. The destruction of infrastructure, the collapse of the health system and the displacement of the people of Gaza, and this requires taking the initiative to complete Jordan's leading and preventive role, especially as Jordan has stability in legislation and transparency in the pharmaceutical sector and move towards localizing more investments in the field of innovative medicines and biotechnologies and building local and international partnerships instead of imitating similar industries.
There is nothing to prevent the entry of sovereign investment funds to the state from entering this field, as these funds do in Saudi Arabia and the UAE.
It has become a necessary and important step in the golden box to accelerate the establishment of a platform to lead the transformation in the pharmaceutical and biotechnology industries, build strategic partnerships, introduce artificial intelligence system in the pharmaceutical and pharmaceutical sector, and attract investments to enhance national and regional Arab pharmaceutical security before it is too late.

This growing crisis affects hospitals, pharmacies, and patients across developed and developing regions, with shortages seen in a wide spectrum of medications including generics, emergency treatments, antibiotics, chemotherapeutics, and sterile injectables.

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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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In the United States, shortages reached record proportions by early 2024, with 323 drugs reported in limited or unavailable supply—a historic peak.

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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

Affected medications include diabetes treatments such as Ozempic and Mounjaro; emergency drugs like adrenaline and albuterol inhalation solution; pediatric antibiotics, notably amoxicillin; various chemotherapy agents; and sterile injectable solutions such as sodium chloride, which is fundamental for fluid management.

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. ”

Other impacted drug classes include ADHD medications and anesthetics.

These generics shortages have led to steep price increases, sometimes tripling or more, significantly raising patient costs and straining healthcare budgets.

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Content: Prescription drug shortages lead to higher prices

Reporter: Andryanna Sheppard
Published: Updated:
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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.

The widespread scarcity forces hospitals to ration supplies or use less-preferred alternatives, often with limited evidence on equivalency, raising concerns over optimal care for vulnerable patients.

The crisis roots in a fragmented supply chain and a manufacturer base unable to meet surging demand.

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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 US government plans to invest billions into strengthening domestic production capacity, revising generic drug pricing models, and enhancing regulatory oversight, including mandatory advance notification of production discontinuations .

European nations have also experienced serious shortages.

Ireland reported paracetamol shortfalls during Covid-19 and influenza surges in 2022-2023, affecting even some prescription strengths, due mainly to raw material constraints, production disruptions, and pharmaceutical industry consolidation.

Estonia’s drug shortage list ballooned from 183 drugs in 2022 to 450 in 2023.

Critical medications for heart attack (myocardial infarction) and stroke treatment were among those scarce, alongside drugs like insulin for diabetes, anticancer agents, and other essential chronic disease medicines.

Estonia responded with programs extending discounts to substitute drugs and advising patients to maintain supply buffers—specifically, a recommended weekly supply for non-prescription and a monthly supply for prescription medications to enhance preparedness.

However, while substitution schemes and discounts can alleviate some burden, actual availability of safe therapeutic alternatives may remain markedly limited, particularly for drugs with narrow substitution options or specialized administration requirements .

In the Middle East and North Africa, Egypt and neighboring countries are challenged by raw material shortages, inflation-driven production cost hikes, currency fluctuations, and ongoing supply chain disruptions.

Egypt produces most (91%) of its medicines domestically, yet shortages persist, especially for chronic disease drugs such as those for diabetes, hypertension, and cardiovascular conditions.

Egyptian authorities enforce pricing controls, inspect manufacturing facilities closely, prioritize availability of chronic disease medications, and recommend therapeutic alternatives where feasible.

Title:

Content: Chairman of the Board of Directors and Editors
Mohamad Elbaz
Chairman of the Board of Directors and Editors
Mohamad Elbaz
Egypt is the cheapest and the crisis will be resolved in two months.
Details of the press conference of the President of the Drug
Dr. Ali Al-Ghamrawi, head of the Drug Authority, said that the phenomenon of drug shortages exists globally and is not limited to Egypt, pointing out that a country like Saudi Arabia has 1372 drugs that are deficient according to an official statistics there.
This came during the press conference held by the President of the Drug Authority, today, to announce all developments related to the drug file, at the headquarters of the Egyptian Drug Authority in Mansouria.
He added that Ecovia gives statistics on the drug market month by month in Egypt with an accuracy of 92%, which confirmed that the shortage rate in Egypt is 7% in 2023 compared to 2022.
Al-Ghamrawi said that the reasons for the shortcomings are due to several reasons, most notably the shortage of raw materials, the rise of spare parts for production machines, in addition to the increase in the dollar exchange rate, stressing that inflation rates and the increase in the interest rate directly affect the price of medicine, pointing out that all these factors directly affect the price of the product.
He explained that the increase in the dollar price led to the tendency of companies to consume their strategic stocks for the production of pharmaceutical items, and after the easing of the dollar crisis and with the increase in the exchange rate, by extension, increased the price of imported raw materials and therefore increased the prices of pharmaceuticals.
He stressed that there will be a breakthrough in the crisis of drug shortages in two or two and a half months at the latest, after the availability of raw materials in the supply chains of companies.
Al-Ghamrawi explained that Egypt is the cheapest price of medicine in the world, pointing out that the raw materials that are imported from abroad at a time when the exchange rate of the dollar was less than the current time, which caused a difference in the price at the present time.
The President of the Drug Authority said that the Authority is negotiating with the drug companies to reduce the prices of some of their medicines and there is a response from a number of companies, adding that today a decision was signed to reduce the prices of medicines for two companies.
He stressed that there are drugs that will see a decrease during the coming period, and not only an increase, and the Authority aims to achieve the general interest of the patient.
He pointed out that there is a rule to increase the prices of medicine, so applications are not considered if the foreign exchange rate increases or decreases by 5% or 7%.
Reasons for requests to raise the price of medicine
Al-Ghamrawi stressed that the Authority is discussing with the pharmaceutical companies the reasons for their requests to raise the price of the drug, and the requests go through nine steps, until the final pricing is reached and the drug is not priced in a moment, but all aspects of the reasons for the price increase are discussed.
He explained that the importance of the Authority is the availability of medicines that are missing in the market, explaining that the Authority has a priority in the provision of medicines, which are medicines for chronic diseases.
Al-Ghamrawi explained that there is continuous control by the inspectors of the Authority on the factories during production, which determines the pricing of the drug through several important factors determined by the Authority with the companies.
He revealed the total campaigns launched during the period from January to protect the control of the pharmaceutical market, pointing out that 46 thousand inspection campaigns were launched on pharmacies and stores resulted in 5,700 violations, and 264 administrative closures, stressing that the Authority has a very strong inspection apparatus.
He stressed that Egypt has great potential in the manufacture of medicine, pointing out that Egypt is number one in the manufacture of medicine in the African continent.
He explained that Egypt has a large number of factories that produce medicine, making it one of the most important countries that make the impossible in Egypt.
He pointed out that there are agreements between the Egyptian Drug Authority and some African countries to provide medicines in Egypt, pointing out that there are five countries have agreements between them and the Authority and there is an expansion in the African market during the coming period.
The head of the Egyptian Pharmaceutical Authority confirmed that the private sector contributes 95% of the production in Egypt and 5% of the production is owned by the government sector.
Al-Ghamrawi explained that this percentage does not cause any crisis because there is continuous cooperation between the local private sector and the Authority in the provision and distribution of medicines, pointing out that 91% of every 100 medicine packs in the market are manufactured in Egypt by factories owned by local pharmaceutical companies (74%) and 26% by international companies.
He pointed out that there are 12 examples of drugs, pointing out that if there is no specific class there are examples and alternatives available, which must be addressed by the citizen, which is the search for analogues and not for the trade name.

In the broader Arab region, Jordan maintains relatively stable pharmaceutical supplies due to prudent policies and investments but faces similar structural vulnerabilities.

Regional industry efforts aim to incorporate advanced manufacturing technologies and foster cross-border partnerships to enhance resilience, though global dependencies on external raw materials and API suppliers continue to pose risks .

Taiwan exemplifies proactive policy responses in Asia.

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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Its Ministry of Health and Welfare has established dedicated drug shortage centers, enhanced platforms for real-time information sharing, implemented pricing reforms to encourage domestic generic production, and mandated timely manufacturer reporting of supply disruptions.

This multidimensional approach addresses the complex factors causing shortages, including production interruptions, fluctuating clinical demand, pricing constraints, and global disruptions stemming from the COVID-19 pandemic and geopolitical conflicts such as the Russia-Ukraine war .

The global causes of medication shortages are multifactorial.

Production relies heavily on limited sources of APIs and raw materials concentrated in countries like India and China.

Quality control failures or regulatory closures of manufacturing plants cause sudden, severe supply gaps.

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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Economic pressures—low generic drug prices, inflation, currency devaluation—discourage sustained production investments.

The COVID-19 pandemic and geopolitical tensions have caused logistic slowdowns and raw material scarcities.

Industry consolidation reduces manufacturing redundancy, heightening vulnerability to localized disruptions.

A critical issue remains the lack of supply chain transparency and weak early warning systems for impending shortages, impeding timely interventions and contingency planning .

Healthcare systems and pharmacies have responded by adopting therapeutic substitution guidelines, rationing protocols where necessary, price subsidy extensions (as in Estonia), and engaging in interdisciplinary collaboration to optimize scarce resources.

Regulatory agencies have introduced policies aimed at increasing transparency and accountability, such as the FDA’s draft guidance requiring manufacturers to report potential production interruptions six months in advance or as soon as possible when unplanned.

Governments invest in domestic manufacturing expansion and supply chain diversification to reduce dependence on foreign suppliers and improve resilience .

For primary caregivers, especially those responsible for persons with chronic, life-threatening illnesses, practical preparation involves multiple coordinated steps.

Authorities in Estonia, for instance, recommend maintaining a weekly stock of non-prescription medications and a monthly supply of prescription medicines to buffer against sudden shortages .

The US advice includes monitoring national shortage lists regularly, requesting early prescription refills, checking availability across several pharmacies, and utilizing platforms like GoodRX to find affordable alternatives .

Caregivers should maintain open communication with healthcare providers to safely identify and discuss therapeutic alternatives or dosing adjustments before shortages result in treatment interruptions .

However, it is important to recognize that despite available mitigation strategies, many patients face limited options for safe substitutes—particularly for drugs where equivalent alternatives are scarce, specialized, or require complex administration—meaning ongoing risk persists for those dependent on narrowly substitutable, life-saving medications.

Global health agencies reinforce these guidance points, emphasizing the importance of multi-stakeholder engagement and transparent supply chains.

The World Health Organization advocates for coordinated international efforts to improve data sharing and support countries in managing shortages, recommending caregivers stay well-informed and connected with health professionals for medication management during shortages.

The European Medicines Agency (EMA) calls for enhanced cooperation between pharmaceutical companies, healthcare providers, and regulators across member states to anticipate and mitigate shortage impacts.

EMA further encourages patients and caregivers to work closely with pharmacists and clinicians when facing medication disruptions, highlighting that official shortage lists and advisory communications are vital resources to monitor .

In conclusion, from 2021 through 2024, medication shortages present a complex, global challenge threatening access to essential medicines for chronic and acute care.

Rooted in fragile, opaque supply chains and compounded by economic and geopolitical factors, these shortages affect therapeutic areas beyond diabetes, chemotherapy, and antibiotics, including emergency and cardiovascular drugs.

Different countries have adopted regulatory reforms, domestic production incentives, and data transparency measures to mitigate risks.

For caregivers, awareness, proactive prescription management, and consultation with healthcare providers are key to navigating shortages safely.

Despite these efforts, persistent gaps in available therapeutic alternatives underscore the ongoing vulnerability of patients reliant on narrowly substitutable life-saving medications.

Expanding access to timely, comprehensive shortage information and continued global cooperation remain critical to improving resilience and safeguarding patient care.

This report lays a foundation to guide caregivers seeking to understand and prepare for medication shortages while highlighting areas—such as detailed substitution protocols, patient support systems, and regional manufacturing initiatives—for future elaboration to maximize practical relevance and reach comprehensive coverage.