The reasons behind medicine shortages from the perspective of pharmaceutical companies and pharmaceutical wholesalers in Finland

Abstract

The aim of this study was to explore the reasons behind medicine shortages from the perspective of pharmaceutical companies and pharmaceutical wholesalers in Finland. The study took the form of semi-structured interviews. Forty-one pharmaceutical companies and pharmaceutical wholesalers were invited to participate in the study. The pharmaceutical companies were the member organizations of Pharma Industry Finland (PIF) (N = 30) and the Finnish Generic Pharmaceutical Association (FGPA) (N = 7). One company which is a central player in the pharmaceutical market in Finland but does not belong to PIF or FGPA was also invited. The pharmaceutical wholesalers were those with a nationwide distribution network (N = 3). A total of 30 interviews were conducted between March and June 2016. The data were subjected to qualitative thematic analysis. The most common reasons behind medicine shortages in Finland were the small size of the pharmaceutical market (29/30), sudden or fluctuating demand (28/30), small stock sizes (25/30), long delivery time (23/30) and a long or complex production chain (23/30). The reasons for the medicine shortages were supply-related more often than demand-related. However, the reasons were often complex and there was more than one reason behind a shortage. Supply-related reasons behind shortages commonly interfaced with the country-specific characteristics of Finland, whereas demand-related reasons were commonly associated with the predictability and attractiveness of the market. Some reasons, such as raw material shortages, were considered global and thus had similar effects on other countries.

Medicine shortages and challenges with the procurement process among public sector hospitals in South Africa; findings and implications

“…The reason for this can be that there is a limited number of raw material suppliers globally with China and India being the major producers of APIs [12]. In the study by Heiskanen et al [2], shortage of raw materials was a common reason for shortage of medicines in agreement with our findings. The shortage of medicines including a lack of APIs has been a challenge in many countries requiring Governments to collaborate and to coordinate efforts and to find global solutions [10].…”

“…Over the years, the shortage of medicines has been a challenge to the effective delivery of quality healthcare services worldwide including South Africa [1][2][3][4][5][6][7][8][9][10], with shortages of even essential medicines becoming a global problem irrespective of the economic status of countries [11][12][13]. More than half of the world's population do not have access to essential services [14], exacerbated by medicine shortages.…”

“…Some of the contributing factors to the shortage of medicines include manufacturing and quality problems, production delays, lack of manufacturing capacity, shortage of raw materials, political instability, and profitability issues [5,6,8,9,18]. Other factors include long lead times, delays in awarding tenders, absence of national contracts on the regional code lists of medicines, the failure of suppliers to meet demand, and the failure to pay suppliers [2,19,20].…”

“…The continuous and adequate supply of medicines is a key element in managing diseases especially chronic diseases [21], with the availability of essential medicines dependent on efficient supply chain systems among other factors [22]. Good systems are the ecosystem of organizations, with people, technologies, and activities brought together to ensure good delivery of medicines from manufacture right through to the end user, the patient, at affordable and acceptable prices [2,6]. The key being to identify and rectify problems as early as possible.…”

New regulatory strategies to manage medicines shortages in Europe

“…Considering that numerous factors cause shortages, a univocal problem-solving strategy cannot be established at the European level. The needs of big-pharmaceutical markets, such as Germany (Said et al, 2018) or Italy (Di Giorgio et al, 2019), are far from those of small ones like as Finland (Heiskanen et al, 2017). Moreover, excessive fragmentation of the National regulatory frameworks may be itself a cause of drug shortage.…”