20 proposals received for alleviation of drug shortages

Market participants convened to discuss how to address global drug supply difficulties.
Market participants convened to discuss how to address global drug supply difficulties. Source: Karin Koppel

Speaking at a roundtable convened by Minister of Social Affairs Tanel Kiik (Centre), market participants offered up a total of 20 proposals, ranging from reducing bureaucracy to easily applicable IT solutions, regarding how to alleviate the situation in Estonia in conditions of global drug supply difficulties.

Drug supply difficulties aren't a problem exclusive to Estonia, but rather a global issue; however, the small size of Estonia's market leaves it in a weaker position. Batches of drugs first go to countries with greater needs; Estonia, meanwhile, remains at the far end of the food chain.

All of Europe is currently gripped with drug shortages. Drug producers' bigger production facilities are located in China and India, and if and when production there is delayed or reduced, this affects everyone else in turn.

A few things can be done to help mitigate the situation, however, which is why the minister of social affairs convened a roundtable for all market players, including the State Agency of Medicines and doctors' unions to representatives and wholesalers of drug manufacturers.

The drug trade is very strictly regulated in Estonia, which leads to a situation in which bureaucracy is one factor preventing fast temporary measures from being implemented to alleviate the drug shortage. This nonetheless isn't the only factor.

Following the roundtable, which lasted more than two and a half hours, Kiik highlighted that the current problem can be mitigated on several fronts, and some 20 proposals for doing so were offered up by roundtable participants.

"Among them were bureaucracy, information exchange and IT solution-related matters," Kiik said. "On the legislative level as well: we discussed hospital pharmacies' opportunities for importing drugs. Opportunities exist in pharmacies' everyday work as well — at what point exactly are they informed about supply difficulties, and how do registries communicate with one another."

All proposals to be reviewed

All proposals made at the roundtable will be systematized and elaborated on in terms of what is necessary for their implementation and who would be responsible for them. According to the minister, this should take about a week.

"Some solutions are a little simpler, and only require an agreement between market participants or a simpler sort of IT solution," Kiik explained. "Some also require a regulation, a decision by the government."

At its meeting next week, the government will move forward with discussions regarding allowing hospital pharmacies, with the authorization of the State Agency of Medicines, to supply drugs by way of exception. In order to allow this, it must first be agreed upon how to reduce the risks involved in the use of drugs not authorized for sale as well as with inventory surpluses once supply difficulties for the right drugs have been cleared up.

Kiik believes that requirements for compulsory stocks of certain vital drugs should be fleshed out as well.

"The law currently states in abstract form that wholesalers are required to ensure the availability of drugs, but does not include specific amounts that should be ensured," he noted. "The opportunity exists to move in the direction of concrete proposals."

The minister admitted that despite the improvement of information exchange and mitigating measures, it is nonetheless not possible to fully prevent or avoid drug supply difficulties, but cooperation between market participants nonetheless needs improvement in order to better tackle supply issues in the future.

Increase stocks of vital drugs

Ülle Einberg, a pediatrician who took part in the roundtable, said that doctors have been faced for years with the fact that drugs don't reach Estonia on time.

"But patients cannot suffer," Einberg said. "We need to do everything we can to ensure that vital drugs are available in Estonia. In order to do so, we need to reduce bureaucracy — to ensure that drugs make it from producers to patients, and that this journey is as easy and simple as possible."

Doctors will be teaming up with the State Agency of Medicines to expand and update the list of vital drugs. This list will be used as the basis for the designation of specific required drug stocks and for the establishment of opportunities for reduced-bureaucracy supply in cases of drug crises.

"If certain drugs don't have good substitutes on hand, it would be reasonable to increase stocks thereof so that in case of supply difficulties, it would be possible to still dispense these drugs to people from these stocks, and once supplying resumes, then we can continue our normal, everyday work," Kiik explained. "I'm talking here about critical drugs that don't have any substitutes on the market — that are based on specific active ingredients, with no substitutes — not cough and cold medicines."


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Editor: Aili Vahtla

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