FAQ
Status: 15.12.2022 4:00 p.m
Fever syrup, painkillers or antibiotics: Many medicines are in short supply in Germany, especially medicines for children. How could this happen – and what can help now?
the initial situation
Cough, runny nose, sore throat, flu, corona or other infections: everyone in Germany seems to know someone who is sick. Or you are affected yourself. The health insurance companies record an above-average number of sick leave. A wave of respiratory infections in children is pushing hospitals and paediatricians to the limit – and now medicines are also missing.
What is missing?
Fever syrups, painkillers, antibiotics, anticancer drugs or even antihypertensive and diabetic drugs: the shortage has long affected not only niche products, but many common drugs. On the Delivery bottleneck list of the Federal Institute for Drugs and Medical Devices (BfArm) currently 313 medicinal products are listed. Since only prescription drugs are listed there and reporting supply bottlenecks is voluntary, it can be assumed that the number is much higher.
Where is the bottleneck coming from?
Above all, problems with the supply chain are mentioned. But the situation is more complicated: According to many experts, the cause lies in the German procurement practice. The president of the professional association of paediatricians, Thomas Fischbach, criticizes in the “Rheinische Post” that the fixed price regulation in Germany has led to production moving to low-wage countries such as China and India. “There are now supply chain problems there, which in turn leads to supply bottlenecks.”
The background: There are fixed amounts for medicines that are paid by statutory health insurance companies. If the selling price is higher, patients usually have to pay the difference themselves or take a therapeutically equivalent but cheaper drug. The health insurance companies are therefore forced to buy medicines and active ingredients where they are cheapest, which has led to a high level of dependence on active ingredient suppliers, for example in China.
In addition, there are discount agreements: Health insurance companies can agree price reductions with manufacturers and thus reduce costs. Then they only refund the drug from this manufacturer and receive a discount in return. The result: competition with the same drug then restricts its range.
Due to the current high demand as a result of the wave of illnesses, the shortage of medicines is now becoming particularly clear.
What do experts ask for?
Pediatrician Fischbach calls for immediate action by the federal government. “A procurement campaign pushed by politicians is needed in order to quickly get fever juice, certain antibiotics and other preparations for small children that have become rare in an emergency, as was the case at the beginning of the corona pandemic”. The German Association of Pharmacists is calling for special regulations from the pandemic to be maintained, which enable the pharmacy to switch to preparations with the same active ingredient in the event of delivery problems. The situation is very dramatic in many cases, said the chairman of the North Rhine pharmacists’ association, Thomas Preis, on Deutschlandfunk. He and many of his colleagues have now been in the profession for 30 years and have never experienced anything like this. It is assumed that more than 1000 drugs are currently missing. The deficiency is obvious in children, but medications for adults are also often affected.
How are politicians reacting?
The federal government wants to change the procurement law. A spokesman for the Ministry of Health said at the end of November that the aim is to broaden supply chains so that the dependence on individual manufacturers decreases. The situation is unsatisfactory despite existing instruments for alternative preparations in the event of bottlenecks. Lauterbach had that ARD Capital Studio said, the health insurance companies should no longer be forced to buy medicines and active ingredients where they are cheapest.
The Union calls for a crisis meeting of the federal and state governments. “Before the end of the year, there must be a federal and state procurement summit in which immediate measures for this winter are coordinated,” said the health policy spokesman for the Union faction, Tino Sorge, on the “t-online” news portal. Health Minister Karl Lauterbach must coordinate “as soon as possible” with countries, manufacturers and wholesalers, seek temporary deliveries from neighboring countries and set up a planning and procurement team as quickly as possible, said Sorge. Important children’s medicines, especially fever reducers, antibiotics or cough medicine, should now be bought, stored and distributed centrally by the Federal Ministry of Health.