Medicine shortages in Finland – trends in 2020

Typical medicine in short supply is an older and more affordable product for which there are one or more substitutes on the market. Less than a fifth of the products are included in the essential medicines list.

Medicine shortages are a global and increasing problem. In 2020, marketing authorisation holders reported 2093 medicine shortages to national authority Finnish Medicines Agency (Fimea). In a study published in Finnish Medical Journal, we evaluated characteristics and criticality of medicine shortages during spring 2020 in Finland.

We analysed medicine shortage notices reported to Fimea and available at Fimea’s public webpage from February to April 2020. The data comprised of 879 notices, of which 829 were human and 50 veterinary medicines. Human medicines were divided to medicines used in outpatient care (n=748) and hospital care (n=81). Furthermore, medicines used in outpatient care were grouped into prescription (n=654) and over-the-counter (n=94) medicines.

Typical medicine in short supply is old, cheap and generic

Characteristics of a typical prescription medicine in short supply are presented in Figure 1. A medicine in short supply is often older and more affordable product for which there are one or more substitutes on the market. The majority (73%) of drugs in short supply can be substituted at community pharmacies. One-fifth were critical from the health care system perspective, as these medicines were listed on the WHO’s list of essential medicines and/or on the Finnish Medicines Agency’s list of products to be stocked as mandatory reserve supplies.

The estimated mean duration of a shortage was 132 days. The most common groups of medicines in short supply were cardiovascular and nervous system medicines, and the most common chemical substances were olanzapine, rosuvastatin, and oxycodone.

 

Figure 1.

Dealing with medicine shortages is time-consuming for health care professionals and a risk for patient safety

Impacts of medicine shortages are extensive as shortages affect patients, health care professionals and health systems. For patients, shortages may for example cause delay in starting a necessary therapy, or lead to a need for switching to another medication that is not suitable for a patient. Indeed, medicine shortages increase the workload of clinicians, pharmacists and nurses, who need to try to identify and purchase alternative treatments for patient. Shortages have an effect on the global pharmaceutical market, and policy makers and authorities are required to make decisions and actions that ensure best possible patient safety and continuity of care in situations affected by medicine shortages.

Our results showed that in Finland in spring 2020 a replacement medicine was available in most short supply cases. However, this might change in the future. International and national strategies and systems to improve management of shortage situations should be developed and implemented in order to minimize harm for the patients, health care professionals and health systems.

To get a more comprehensive view of the topic, please refer to Finnish Medical Journal.

Tapanila T, Kari H, Koskinen H. A replacement medicine is available in most drug shortage cases. Suomen Lääkärilehti. 2021;76(18):29­–34. [In Finnish]

Heini Kari
Senior researcher, Kela
Twitter: @heinikari

Hanna Koskinen
Head of research team, Kela
Twitter: @hannakkoskin

Kati Sarnola
Senior researcher, Kela
Twitter: @KatiSarnola