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Call for action as list of medicines with supply issues jumps 87%

Ireland should compile essential medicines list and use available pricing tools to make market more attractive, says generics specialist Azure Pharma

Ireland should introduce a list of essential medicines in an effort to combat growing issues with supply shortages of key therapies in the market, according to a new report. It comes as the latest Medicines Shortages Index shows that Ireland’s ongoing issue with medicine supply is worsening. This time last year the list featured 178 types of medicine pack; that has now risen to 332, a rise of almost 87 per cent.

Not all are individual drugs as the list also considers pack size and supply issues with one supplier when there may be several companies selling the drug in the Irish market.

However, it says that 43 per cent of medicines on the list have only one supplier into the Irish market, compared to an EU average of a quarter. According to its latest list 144 of the 332 medicines subject to supply constraints come from single suppliers, up from 63 of 178 this time last year.

Other European nations including Germany, the UK, Sweden, Switzerland, Portugal and Denmark have adopted a range of national policy measures to address the issue of medicine shortages, according to Azure Pharmaceuticals, which publishes the index that is based on the Medicines Shortage List compiled by the Irish medicines regulator, the Health Products Regulatory Authority (HPRA).


Those measures range from interventions related to pricing to stockpiling of essential medicines. Azure, which specialises in providing older, generic medicines that are still in common use but which are subject to supply issues in certain markets, says 137 countries now have an essential medicines list, with France most recently introducing one this year in response to ongoing drug supply problems.

It says that while the Government has convened meetings of stakeholders here on the issue of medicine shortages, no new policy measures have been taken on medicine shortages to date.

“Despite the gravity of the situation in Ireland the Government’s response has been lacking, and our policymakers have mistakenly perceived the medicine shortages crisis as an inevitable unresolvable consequence of a broader global problem,” said Azure chief executive Sandra Gannon, a veteran of the generics medicine sector.

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She noted that in September Germany, Europe’s largest market for medicines, asked wholesalers to start stockpiling drugs for winter. It has also passed a law allowing manufacturers to increase prices of low-cost paediatric medicines by up to 50 per cent.

Ms Gannon said it would be some time before it became clear what impact the stockpiling initiative would have on smaller markets this winter, including Ireland.

A nine-point action plan proposed by Azure includes urging the HSE to use powers already at its disposal to raise prices for medicines where supply issues indicate market viability is an issue.

It says the health service should also move more quickly to make pricing decisions on essential medicines under its Hardship Scheme where supply is at risk, and add medicines to its list of interchangeable products more quickly once patent protection of branded drugs has expired.

Ms Gannon says recurring price cuts on already low cost but commonly-used generic products by governments under pressure to lower health budgets or find money for new, high-cost treatments means the market is no longer viable for manufacturers.

“These medicines sell for so little here that suppliers choose other markets where volume and reimbursement is significantly higher.”

The HSE has said consistently that price is not an issue affecting medicine supply in Ireland, and noted that the products listed amount to just a fraction of the near 10,000 medicines available in the Irish market.

HPRA director Gráinne Power has said the issues affecting the Irish market were common across Europe, and she added that 20 per cent of expected shortages notified to it by suppliers as required were prevented through its collection of the information and subsequent working with suppliers to avert problems.

The HPRA list featured 325 products as of Sunday.

Dominic Coyle

Dominic Coyle

Dominic Coyle is Deputy Business Editor of The Irish Times