Medicinal products supply problems are an issue everywhere in Europe and Estonia is no exception, with pharmacies experiencing more shortages in 2023 than last year.
This spring, parents scoured pharmacies for antibiotics and antipyretics suitable for children, while shortages of the drug Sorbister used to treat kidney conditions caused Estonia to tap into the national crisis reserve of medicines. Hospitals have also been plagued by a serious drug shortage this year.
"For example, hospitals need key medicines used in cases of heart attack or stroke the supply of which has been problematic for the past year. But good cooperation has made sure no patient has gone untreated," said Marko Tiisler, head of drug delivery monitoring for the State Agency of Medicines.
If in 2021 pharmacies experienced shortages of 183 drugs, this had grown to 359 different products by last year. Shortages of 450 drugs have been experienced in 2023 even before the year's end, whereas the reason for the supply difficulties is not clear in 130 cases. Spikes in demand for certain medicines, such as Ozempic, which is popular among people looking to lose weight, are one reason for shortages, while manufacturing problems are another.
"Pharmaceutical companies do not have enough active ingredients. The latter come from third countries and are not consistently available, which one of Europe's largest antibiotics manufacturers has confirmed," Tiisler said.
Supply difficulties impact both patients and doctors who need to find an alternative quickly in the conditions of information shortage.
"Sometimes we need to be Dr. Watsons or Sherlock Holmes – look for clues, at the treatment guidelines, see what's available and then make decisions accordingly," family physician Argo Lätt said.
While patients had to pay the full price for alternative medicines in case of shortages of the original drug until recently, the Health Insurance Fund has introduced an exception where discount prices now apply to some alternative drugs. Ly Rootslane, head of pharmacist-run drugstores in Estonia, said that medicines supply difficulties are a deepening problem everywhere in Europe.
"We have put together guidelines this year, working with the State Agency of Medicines and family doctors, for a proactive approach and how to avoid panic should we see supply issues developing. We saw it with children's cough syrups, how people read about a shortage and bought two bottles instead of one at the pharmacy," Rootslane said.
The State Agency of Medicines recommends having a week's supply of over the counter drugs and a month's supply of prescription medicines.
Editor: Marko Tooming, Marcus Turovski