Medicine shortages are a European-wide issue. In 2016, the European Medicines Agency (EMA) and the Heads of Medicines Agencies (HMA) formed a task force to investigate availability issues, including medicines that are authorized but not marketed, and supply chain disruptions in order to improve the continuity of medicine supply across Europe.
Due to high pressure on prices and the fact that the Czech market is relatively small, there are problems in the supply chain, forecasting the amount of medicines needed in the country, and so on
While the Czech Republic, as part of Europe, shares many of these issues, there are some factors behind Czech drug shortages that are specific to the local market, explains Martin Mátl, executive director of the Czech Association of Pharmaceutical Companies (ČAFF). “This is largely due to the fact that prices here are lower than elsewhere in Europe. Due to high pressure on prices and the fact that the Czech market is relatively small, there are problems in the supply chain, forecasting the amount of medicines needed in the country, and so on. This is the main issue now and it will continue to be in the future”, he explains.
Prices are on average 30 percent lower in the Czech Republic than in countries like Germany. Low prices can reduce the availability of medicines in two main ways. First, they can lead manufacturers to stop distributing certain products on the Czech market. According to a study published by ČAFF, there needs to be at least four suppliers of a given drug to ensure availability. Second, they encourage parallel exports of medicines meant for Czech patients.
In order to increase the availability of medicines in pharmacies, Minister of Health Adam Vojtěch proposed an amendment to the Act on Pharmaceuticals and the Act on Public Health Insurance taking inspiration from Slovakia. The amendment is currently being discussed in Parliament. If approved, it would restrict the export of medicines intended for Czech patients and provide substitute medicines for patients by allowing the import of packaging with an administrative error.
Production is in many cases the root of the problem as many pharmaceutical companies concentrate their production in factories in India, China or other far-flung countries
Moreover, the amendment would introduce the so-called emergency system of supplying pharmacies: drug manufacturers will be obliged to supply any pharmacy in the Czech Republic with the drug prescribed for the patient within two working days. This measure will likely lead to an increase in costs for manufacturers. Finally, a temporary reimbursement will be introduced in order to have the same balance as the original medicine, a measure welcomed by the generics industry.
However, the Czech Republic cannot hope to fix the problem only through national measures and needs to collaborate with European partners. As Vojtěch points out, at the European level, “production is in many cases the root of the problem as many pharmaceutical companies concentrate their production in factories in India, China or other far-flung countries. There, regulatory standards are notoriously lower than here and cannot be supervised as they are outside the EU.”
In his opinion, “the European Commission needs to collaborate in addressing this issue by implementing measures to attract production back to Europe.” He discussed this topic last November at an international meeting of Ministers of Health of the V4 countries (Czech Republic, Slovakia, Poland and Hungary) as well as with his Danish counterpart Magnus Heunick during the OECD Health Forum.
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