There are frequent shortages in some medicines in Europe, and Belgium is one of the countries that suffer most from this problem, which raises the dissatisfaction of pharmacists and the concern of patients who criticize the European Union’s slowness in finding solutions to this phenomenon.
Didier Roncin, a pharmacist in Brussels, told Agence France-Presse: “Frankly, this consumes a lot of our energy. I often spend an hour a day making phone calls, inquiring about medications, apologizing to the patient for not having his medication available, and then calling him back to inform him that it has arrived, or that he will not be able to obtain it.”
He added, “It’s okay if the matter is limited to one or two medications, but often dozens of medications are missing at the same time, which makes the matter more and more complicated for us.”
A report published by the European Court of Accounts last month counted 136 cases of severe drug shortages in the European Union between January 2022 and October 2024, including antibiotics and medications for heart attacks.
This problem persists in Belgium more than any other European country, as in 2024 the European Medicines Agency was informed of about 12 cases of severe shortages of medicines for which there are no alternatives.
The Audit Bureau explained that this “chronic disease” that Europe suffers from is primarily due to problems in the supply chain, and to the fact that the production of many medicines and their active ingredients takes place in low-cost countries outside the continent.
Europe depends on Asian suppliers for 70% of its active ingredients and 79% of its precursors (the biochemicals used in its manufacture).
Much of this dependence is in relation to common painkillers such as paracetamol, ibuprofen, some antibiotics and salbutamol (particularly sold under the brand name Ventoline).
But this crisis is also partly due to an internal imbalance within the ranks of the European Union.
Price differences and packaging
Drug prices vary from one member state to another and are subject to negotiation by national health authorities, explained Olivier Delier, director of the distribution company Vibelco, which supplies medicines to about 40% of pharmacies in Belgium.
Therefore, manufacturers prefer to prioritize supplying to countries that pay them more.
This prompts them to supply more precisely calculated quantities to countries with lower prices, fearing that middlemen will enrich themselves at their expense by reselling their products in countries with higher selling prices.
The European Court of Accounts explained that most medicines are subject to national permits, and their packaging must be compatible with the regulations of each country.
Delaire stated that these regulatory and packaging restrictions sometimes cause “local shortages,” as, for example, the drug may only be available in one country, while it is completely available in neighboring countries.
Vibelco director Olivier Delaire noted that it is a “growing problem,” noting that 70% of the one million customer orders his teams process annually are related to shortages, which causes “a huge workload and a waste of energy.”
Financial incentives
The problem has become so widespread that in 2024, a European pharmacist will spend an average of 11 hours a week addressing the shortage issue, three times what he spent 10 years ago, according to the Pharmaceutical Group of the European Union (PGEU).
While this problem causes concern for patients about not receiving their treatments on time, the European Union is seeking to find solutions to it, but it has not found a panacea.
In March, the European Commission proposed a law aimed at boosting the production of essential medicines through financial incentives. In July, it also launched a “supply strategy” to coordinate stocks and build crisis reserves.
A UNHCR spokesperson expressed confidence that these measures “will make a real impact” in “helping to reduce the problem.”
However, these measures require the approval of the European Parliament and the 27 member states, a process that may take a long time.
Roncin, who can see the Commission’s headquarters from his office, lamented, “They are trying to find solutions, but it is still very slow.”