Prescription drug shortages plaguing Netherlands

The number of medicines temporarily unavailable in the Netherlands increased sharply over the past years. In five years the shortages quadrupled, according to pharmacists organization KNMP, NU reports. The KNMP started recording drugs that were unavailable nationwide for at least two weeks in 2004. Last year 625 drugs were temporarily unavailable. In 2014 that number was 572 and 426 in 2013. In practice the drugs are often unavailable for six to nine months. "Unfortunately it is daily practice that the pharmacist has to sell 'no'. So far, the pharmacist mostly solves the problem for the patient, but what if it goes wrong. Then the social consequences are incalculable", KNMP chairman Gerben Klein Nulent said to NU. The main reasons for temporary shortages are production problems or a sudden increase in demand. According to the KNMP, 70 percent of the cases involving permanent shortages involve economic reasons. Pharmaceutical companies sometimes do not find it attractive to produce cheap drugs for the small Dutch market. "The Netherlands is, partly due to the small population and the low drug consumption, a relatively uninteresting market", Klein Nulent said. Last week thyroid patients were warned that they will have to temporarily change to another drug due to an impending shortage of Thyrax Doutab. This affects hundreds of thousands of people. In 2015 pharmacists particularly struggled with shortages in antibiotics. Normally patients are given an antibiotic that can only kill a specific bacteria. If the specific antibiotic is unavailable, the patient has to take an antibiotic that kills a wider range of bacteria. This is a problem, because it means that bacteria in the body more quickly become resistant to antibiotics, making infections harder to fight off. The KNMP is advocating that manufacturers be obliged to report potential delivery problems in a timely manner, to give pharmacists more time to look for alternatives. The organization also wants the government to intervene in the case of imminent shortages, and explain the costs to the manufacturers and health insurers. Lastly the KNMP believes that pharmacists should be given the freedom to offer patients the best alternatives, with out financial consequences to the pharmacist or the patient. The Dutch association for general practitioners NHG told broadcaster NOS that this is a worrying situation. The association is concerned that patients regularly needing to change drugs could lead to errors.