We are experiencing a time of change. What about the future of the country? What innovative ideas are there? That is the theme of the major SZ focus “Future Germany”. All articles as well as further analyzes and reports can be found on this page.
It was very lucky for the people at Biontech. When it became more and more apparent how fantastic their vaccine against Covid-19 was working and that they would have to produce many, many millions of doses of it in a very short time, they looked somewhat desperate for additional production capacities. And so they heard that the Swiss pharmaceutical giant Novartis wanted to sell its factory on the site of the venerable Behring works in Marburg. A great opportunity for the small biotech start-up to get into vaccine production on a large scale. The people who had worked there for Novartis up to now could do anything. For years and decades they had manufactured vaccines in the Behring factory. Now they just had to be retrained for mRNA vaccines.
Germany was once the world’s pharmacy
But no matter how lucky Biontech and its incredible success story in the pandemic was at this moment, the sale of the Novartis production facility in Marburg was actually no reason to celebrate. Rather, it is another sign of the departure of pharmaceutical production from Germany as well as from all over Europe. Germany was once considered the pharmacy of the world due to its innovative strength and the many pharmaceutical companies, today hardly any drugs are produced here. Like most countries in the western world, Germany is now dependent on drugs and vaccines being manufactured in sufficient numbers in India and China – and then finding their way to Europe. But they don’t always do that.
The Covid-19 pandemic has shown how problematic it can be with medical care when the situation becomes difficult for political, pandemic or simply production-related reasons. Masks and protective clothing were in short supply early in the pandemic. But when there was finally enough of them, the problems with medical care didn’t stop – and they were immense even before the pandemic.
Medicines for Germany’s clinics and patients are always in short supply. Delivery bottlenecks sometimes affect common drugs such as antihypertensive drugs, gastric acid blockers and even pain relievers such as ibuprofen. These are relatively easy to replace with other ratings, as the Federal Institute for Drugs and Medical Devices (BfArM) never tires of emphasizing – tenor: delivery bottlenecks are not necessarily supply bottlenecks. But vaccines and such sensitive drugs as antidepressants are always in short supply. The absence of these can be a real problem for patients. Anyone who is finally well adjusted to a preparation after weeks and months of testing cannot simply take another remedy. Sometimes there is even a lack of cancer drugs, such as cytarabine, which is vital for leukemia patients. In addition, the supply of the preparation melphalan, which is used in chemotherapy, has recently been repeatedly canceled.
The lack of antidepressants becomes a real problem for patients
Another particularly drastic example: the antidepressant venlafaxine. “Delivery failures of venlafaxine can pose a particular problem for patients and the treating physicians,” says Wolfgang Becker-Brüser, editor of the Remedy telegram. After all, tormenting withdrawal symptoms can be expected relatively often after sudden discontinuation. Even if a single tablet is missed, abnormal sensations occur that feel like electric shocks or electric shocks, says Becker-Brüser. Dizziness, sensory disturbances, insomnia, nausea, headache, tremors, and anxiety are also among the commonly reported reactions.
At the end of October, the BfArM listed a total of 224 drugs Delivery bottlenecks on his homepageincluding the Parkinson’s medication Levobeta and the migraine medication Rizatriptan. It has long been everyday life for pharmacists to have to look for a solution: In 2020, 16.7 million packs of drugs were not available in Germany’s pharmacies. The only ray of hope: It was at least a slight decrease compared to the previous year: in 2019 there were still just under 18 million prescribed drugs – twice as many as in 2018, which also doubled compared to 2017.
But that’s not the whole truth, because the supply bottlenecks are reported by the manufacturers on a voluntary basis. “The BfArM list of current delivery bottlenecks therefore does not realistically reflect the deficits that actually exist”, complains Remedy telegram. “It plays down the actual supply situation and therefore appears to us in this form to be misleading.” The already envisaged obligation of the providers to report delivery deficits to the BfArM must be implemented as soon as possible.
During the pandemic, the precarious situation that had been precarious for years because of the trade restrictions, complained the President of the German Medical Association, Klaus Reinhardt. Doctors had worried that particularly important substances could become scarce, he told the Berliner Daily mirror: “I’m talking about propofol, which is necessary for artificial respiration. Or about adrenaline, which is urgently needed in intensive care medicine, about reserve antibiotics that we rarely but absolutely need in critical situations. If we run out of resources, that would be a really dangerous situation. ” The vaccination against pneumococci, which can cause pneumonia, was temporarily barely possible. “I am very worried about the delivery bottlenecks for vaccines,” said Reinhardt.
Industry interest in some drugs is low
The reasons for this are diverse. Sometimes this is due to contaminated batches, as they sometimes led to delayed deliveries with the Covid-19 vaccines. Sometimes individual raw materials cannot be obtained. But it is also clear that there is little industry interest in some drugs, for example antibiotics. Some drugs, such as antibiotics or vaccines, with which you cannot earn as much money due to their infrequent use (at most once a year per patient) as with drugs for chronic diseases – for example high blood pressure or multiple sclerosis. One of the most important reasons, however, is that drug production now largely takes place in the Far East for cost reasons – and there it is also geared towards a few companies. Working conditions and environmental standards are not as important there as in Europe.
More than 80 percent of all active medical ingredients are now manufactured in China and India. And of 500 prescription drugs that the BfArM classifies as “relevant to supply”, 300 are produced by three or fewer companies, according to the authorities. Some active ingredients are only produced by individual producers – such as the antibiotic piperacillin, which is largely manufactured in a single factory in eastern China. When there was an accident in 2016, piperacillin was hardly available anywhere in the world. And the blood pressure lowering drug valsartan, an absolute box-office hit internationally, was out of action for months when the entire production of a Chinese plant was contaminated with carcinogenic substances.
Hardly anyone doubts that the problem is a serious one: For example, Federal Minister of Economics Peter Altmaier (CDU) said during the pandemic: “It is not a good idea to turn back globalization, but it is the right idea to turn back globalization in sensitive areas To assert sovereignty. ” Federal Minister of Health Jens Spahn (CDU) also thinks this is important. He relies on financial incentives to bring the production of important pharmaceuticals back to Europe. “Europe needs to become more independent of Asia when it comes to pharmaceuticals,” he said recently. “We want to build new supply chains, we need more transparency about delivery bottlenecks and more quality controls.” During the pandemic, the federal government had already pushed ahead with the expansion of the production of medical protective equipment in Germany in order to become more independent.
Germany needs pharmaceutical production in its own country
Thus, the pandemic has shown once again with all urgency: Germany needs secure production of pharmaceuticals in the country. And preferably also to keep them in stock for longer periods of time. So far, the pharmaceutical wholesalers only have to have drugs in stock for two weeks. Some politicians are calling for the deadlines to be extended. But what is still missing: the innovative power that made Germany the world’s pharmacy. As quickly as vaccines against the completely new virus were developed and manufactured during the pandemic, there is still a lack of drugs against Covid-19. There are therefore various plans to set up national research platforms or centers that are supposed to start developing vaccines and therapeutics against the next pandemic virus now. Because that much is clear: the western world just got away with a black eye when it met Sars-CoV-2.