Why are we experiencing shortages of essential medicines in Ireland?

A medicines shortage can be defined as a situation whereby the supply of a medicine does not meet public health or patient needs. Medicines shortages can occur for a variety of reasons, such as regulatory issues, manufacturing delays, an unexpected increase in demand, product quality issues and lack of commercial viability.

Global and local medicine shortages impact

Recent global events, such as the Covid-19 pandemic, the war in Ukraine and financial pressures, including inflation, have added to the challenges affecting the pharmaceutical industry both in Ireland and internationally. Shortages of medicines can impact patient health outcomes and impose burdens on wholesalers and pharmacies tasked with finding alternative sources. In Ireland, nearly 40% of people in the last two years have been affected by medicine shortages.¹

Medicines in short supply have included treatments for pain, blood pressure, respiratory illnesses, digestive conditions and arthritis.

Low prices can jeopardise medicines supply

Medicines for Ireland, which includes a number of generics manufacturers, supplies approximately 60% of the medicines in Ireland^.2 Companies supplying generic medicines in Ireland have delivered significant savings to the state in the last two decades. While cost savings have benefited the drugs budget, very low prices pose a risk to Ireland’s international pharmaceutical companies’ viability to supply due to drug acquisition costs. Ireland has experienced the withdrawal of many of the branded ‘originator’ products that have lost patent exclusivity, due to a lack of commercial viability. This leaves the market supported by generic companies that compete on small margins and typically do not carry large amounts of stock. Unsustainably low pricing for many off-patent medications is one of the main factors creating vulnerability in the supply of medicines.³ Failure to act increases the likelihood of more manufacturers leaving the market.

How to tackle the medicines shortage

Ireland has a medicine shortage framework, which is operated by the Health Products Regulatory Authority (HPRA) on behalf of the Department of Health. Since its introduction, the number of medicine shortages has fallen. While individual brands or strengths of a medication may be temporarily unavailable, for many medicines, there are appropriate substitutions. These include different strengths, brands, or similar classes of medicines.⁴ This effort may not be enough. Another way of tackling medicine shortages is for manufacturers and stakeholders to better communicate and coordinate their efforts for the benefit of patients in Ireland.