Medicine shortages halve in the Netherlands, but millions still at risk
The number of medicine shortages in Dutch pharmacies has halved over the past two years, yet pharmacists warn that patients and healthcare providers still face serious challenges. In 2025, 1,134 medicines were unavailable for more than two weeks, down from 2,292 in 2023, Trouw reported. The number of affected patients fell from 5 million to 3.5 million, and the average duration of shortages decreased slightly to 96 days, according to annual figures from the Dutch pharmacists’ association KNMP.
Despite the decline, the impact reportedly remains severe. KNMP states that forced switching to alternative medications “leads to reduced adherence, more expensive alternatives, incorrect use of medicine, with unnecessary hospitalizations as the most serious consequence.”
Some drugs are on the so-called Red List, for which switching brands, type, or dosage should be avoided. Lithium, used to treat depression or mania, has been in shortage since 2022. KNMP warns that changes in medication could lead to lithium poisoning.
Levothyroxine, a thyroid hormone used by 130,000 patients, has also faced shortages since June. KNMP chair Miriam Stoks said, “Every reduction in medicine shortages is a positive development, but it is not confirmation that we are on the right track.”
Pharmaceutical wholesalers, however, interpret the trend more positively. Their recent report states that “for the first time in years, a clear improvement is visible,” attributing the progress to mandatory stockpiling. Since 2024, wholesalers are required to maintain a two-week supply for medicines under 15 euros and receive subsidies for a four-week supply of critical medicines such as antibiotics. BG Pharma, the wholesalers’ trade association, reported that shortages for stocked medicines fell three times faster in 2025. Critical antibiotics like amoxicillin/clavulanic acid and ciprofloxacin, which were previously scarce, became reliably available.
Still, KNMP argues this is insufficient. The association advocates raising maximum prices for fast-depleting medicines to make local supply more attractive. Currently, the Netherlands often falls last in line when limited supplies are available due to factory problems.
Pharmacists on the front lines report ongoing frustration. Brenda Dorenbos, a pharmacist and board member of Landelijke Eerstelijns Farmacie (LEF), said, “The number of shortages may be declining, but the complexity is increasing.” She highlighted several critical drugs where shortages remain particularly disruptive.
Salbutamol aerosol, a short-acting bronchodilator essential for patients with breathing difficulties, has been scarce for nearly two years. The Dutch Health Care Inspectorate temporarily authorized imports from abroad. Adults can usually switch inhalers, but young children cannot.
Quetiapine, prescribed for psychosis, schizophrenia, and severe depression, is difficult to replace when shortages occur. Production issues across Europe and limited alternative dosages have caused confusion and risk for vulnerable patients. Dorenbos said, “Psychiatric medication is worse to miss for a few days than medication for long-term conditions, such as blood pressure.”
Patients with eczema or psoriasis have struggled to obtain stronger hormone creams. GSK, a manufacturer, said shortages arose after a large production batch was withdrawn, leaving pharmacies scrambling for substitutes, which often run out again.
Dorenbos and LEF propose that insurance companies allow all manufacturers meeting price standards to supply medicines rather than favoring one brand, though implementation remains uncertain. She said, “To get this off the ground, we will need to convince all insurers.”
