Doctors: Lives at risk due to pediatric pharmaceuticals shortage

Tallinn Children's Hospital.
Tallinn Children's Hospital. Source: Konstantin Sednev/Postimees/Scanpix

The low supply of children's medicines is unpreceded and is putting children's lives at risk, the Estonian Pediatric Association wrote in a letter to the state, adding that in some cases medicine meant for adults has to be prescribed for children instead.

The Estonian Pediatric Association has complained to the Ministry of Social Affairs, the State Agency of Medicines, and the Health Insurance Board. 

One example they gave concerned stocks of vitamin K, which is administered to newborn babies, which has run out in several hospitals.

Paediatricians said the lack of vitamin K put at least 100 newborn babies at risk this year as they could not receive an injection and it could not be prescribed to be taken orally either.

"This drug is also used to treat life-threatening bleeding in older children and adults. So it should always be available," the association said.

Another example is Kreon, a vital daily treatment for children with cystic fibrosis, which had been unavailable on the market for a long time. There is also a lack of commercially available anti-allergy medicine, opatanol, at the time of writing.

"The list could go on. For example, there is currently no injectable penicillin at Tallinn Children's Hospital due to supply difficulties," the association said.

Problems have arisen due to the small size of the drug market in Estonia. Many of the child-friendly dosage forms available in other European countries, such as syrups, drops or suppositories, are not available in Estonia and pills and treatments for adults need to be prescribed instead.

The association mentioned this is currently the case for Tamiflu, prednisolone, spironolactone, furosemide, ranitidine, anti-allergics, anti-spasmodics, anti-convulsants, and several others.

Paediatricians say it is problematic that many medicines needed for children are only available in Estonia upon request of a professional association. When a child needs an unlicensed drug because of the nature of their illness, it takes a long time to coordinate between the different authorities. If this is the case the medicine will not be available to the child for several weeks or even months.

"We propose to initiate a formal discussion in Estonia and to convene an appropriate commission to address the situation. We consider it important to provide children with evidence-based prophylaxis and treatment and to accelerate the delivery of medicines to the patient," the doctors said.

Minister of Social Affairs Tanel Kiik said drug supply difficulties are a concern in wider Europe and that inevitably Estonia will be affected too.

"We have agreed in our ministry to invite representatives of paediatricians as well as family physicians who have previously approached the same topic, and more broadly, representatives of the Estonian Health Insurance Fund, and the medicines agency, as well as pharmaceutical importers, wholesalers and pharmacies, to bring these issues together to discuss, "he said.

Kiik added, the Ministry of Social Affairs would like to have a preliminary overview of the causes of the supply difficulties, the timeframe and possible solutions. Ideally, a meeting would take place in January, he said.


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Editor: Helen Wright

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