Drug shortages have been identified as a public health problem in an increasing number of countries. This can negatively impact on the quality and efficiency of patient care, as well as contribute to increases in the cost of treatment and the workload of health care providers. Shortages also raise ethical and political issues. The scientific evidence on drug shortages is still scarce, but many lessons can be drawn from cross-country analyses. The objective of this study was to characterize, compare, and evaluate the current systemic measures and legislative and organizational frameworks aimed at preventing or mitigating drug shortages within health care systems across a range of European and Western Asian countries. The study design was retrospective, cross-sectional, descriptive, and observational. Information was gathered through a survey distributed among senior personnel from ministries of health, state medicines agencies, local health authorities, other health or pharmaceutical pricing and reimbursement authorities, health insurance companies and academic institutions, with knowledge of the pharmaceutical markets in the 28 countries studied. Our study found that formal definitions of drug shortages currently exist in only a few countries. The characteristics of drug shortages, including their assortment, duration, frequency, and dynamics, were found to be variable and sometimes difficult to assess. Numerous information hubs were identified. Providing public access to information on drug shortages to the maximum possible extent is a prerequisite for performing more advanced studies on the problem and identifying solutions. Imposing public service obligations, providing the formal possibility to prescribe unlicensed medicines, and temporary bans on parallel exports are widespread measures. A positive finding of our study was the identification of numerous bottom-up initiatives and organizational frameworks aimed at preventing or mitigating drug shortages. The experiences and lessons drawn from these initiatives should be carefully evaluated, monitored, and presented to a wider international audience for careful appraisal. To be able to find solutions to the problem of drug shortages, there is an urgent need to develop a set of agreed definitions for drug shortages, as well as methodologies for their evaluation and monitoring. This is being progressed.
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http://dx.doi.org/10.3389/fphar.2017.00942 | DOI Listing |
J Family Med Prim Care
December 2024
Department of Pharmacology, All India Institute of Medical Sciences (AIIMS) Kalyani, Kalyani, West Bengal, India.
The novel approach of "Community Pharmacology" integrates pharmacological principles with community health to achieve the "Health for all" goal through safe and efficient health care. Pharmacovigilance, medication errors (ME), irrational prescriptions, and antimicrobial resistance in the community could be the key areas. Though life expectancy and other health indicators have improved in India, the disparity between rural and urban quality healthcare access should be addressed.
View Article and Find Full Text PDFBull World Health Organ
January 2025
Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
Objective: To investigate access to essential anticancer medicines for children throughout China.
Methods: We obtained cross-sectional drug use data for 2021 from 55 tertiary children's hospitals in seven geographical regions (one third of public children's hospitals in mainland China). Affordability was assessed by comparing the single-day copayment for each medicine with the same generic name and route of administration (i.
BMJ Support Palliat Care
January 2025
Palliative Care, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Patients with advanced cancer often experience bothersome symptoms requiring specialist palliative care input. Oncology clinical trials commonly include a list of prohibited medications while on trial, to avoid potential drug interactions with the investigational product. This case series illustrates how recent opioid shortages combined with prohibited opioids in clinical trials significantly impacted cancer pain control and quality of life.
View Article and Find Full Text PDFN Engl J Med
January 2025
From the Council on Foreign Relations, Washington, DC (T.J.B., C.S.); and the Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston (S.N.N., A.S.K.).
Pathogens
November 2024
Department of Cardiac Surgery, Centre Cardiologique du Nord, 93200 Saint-Denis, France.
Prosthetic valve endocarditis (PVE) is the medical term used to describe a focus of infection involving a valvular substitute within the heart. It is a significant concern in the field of cardiology, and the epidemiology of PVE has seen notable developments over the last five decades. The disease currently affects an older demographic and is becoming increasingly prevalent in patients with transcatheter-implanted valves.
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