It’s business as usual at Arcades Pharmacy in Berlin. Customers come and go, many of them parents looking to stock up on medication to combat fever and pain, which can also be a problem with a COVID-19 infection.
For younger children who can’t swallow pills, there is a sweet-tasting juice that contains acetaminophen or ibuprofen. Typically, more than 10 million small bottles of this drug are sold each year. Now, however, the shelves are starting to look bare.
“Paracetamol juice was already starting to run out a bit at the beginning of the year,” says a chemist, who declined to give her name. “Meanwhile, we are out of stock of ibuprofen juice as well as nasal spray. And supplies of fever suppositories are low.”
What’s more, he adds, no improvement is in sight: “We’ve been stocking up for the winter, which means coordinating deliveries now. And what we’re seeing is that all contracts for painkillers and fever reducers for children have been cancelled.”
This Berlin pharmacy is one of many running out of stock
Short supply, high demand
The Berlin pharmacy is no exception: supply shortages are having an impact across the country. More and more desperate parents are using social media to share their anguish because they are unable to bring down their children’s fever or fight painful fever cramps.
Pharmaceutical companies are missing their scheduled deliveries due to booming demand coupled with raw material shortages.
After the relaxation of anti-COVID-19 restrictions, such as the mandatory wearing of masks, German pediatricians saw many children with respiratory illnesses and runny noses. And pharmacies saw customers buy stock after media reports of serious bottlenecks in supply chains and delays in delivery times.
The pharmaceutical industry is currently facing problems with supply chains as well as a lack of skilled workers. But for years, they have not made money from the production of painkillers for children. Health insurers pay 1.36 euros ($1.39) for a bottle of paracetamol juice. The same amount as ten years ago.
“The rapid increase in the prices of production and active ingredients has turned the production of drugs such as paracetamol juices into a loss-making business,” complains Andreas Burkhardt, general manager of the pharmaceutical company Teva. “No company can sustain that long-term.”
The pharmaceutical giant Ratiopharm still produces these types of drugs. But now they have also canceled orders for winter storage. Due to “unexpected and massively increasing market demand” and “increasing delivery delays among our active ingredient manufacturers.”
Earlier in the year it became clear where it leads when important drugs are no longer available with the breast cancer drug tamoxifen — a drug for which there is no substitute and which is urgently needed by many chronically ill patients.
Here, too, there were serious bottlenecks caused in part by manufacturers who had pulled out of production, citing cost pressure.
Germany suffers from shortage of tamoxifen, a drug for breast cancer patients
In February, the German Federal Institute for Drugs and Medical Devices (BfArM) stepped in and ordered that, in light of the emergency, tamoxifen-based drugs can now also be imported from abroad. This does not solve the supply problem; the next shortage is expected in the second half of 2022.
Chemists remix their own potions
Germany’s BfArM currently lists more than 260 medicines that are currently not available in Germany. These include common antibiotics, thyroid medications, blood pressure reducers, and also medications that are urgently required in hospitals. In some cases, chemists guarantee the supply by producing their own drugs. But for that, they still need the appropriate raw materials.
“Base materials are traded globally and often there are only a few producers of a single active ingredient, mostly in Asia. If, for example, there is a problem in a factory in China, or a country imposes a trade embargo , then many growers are subsequently affected,” says Ursula Sellering of the German Federation of Pharmacists.
There is currently a lot of money to be made from anti-COVID-19 drugs, such as Paxlovid
Paracetamol is also currently difficult to obtain on the global market. “However, if a pharmacy still has stock, they can also produce their own fever-reducing medicine,” says Sellering.
That’s the way it’s likely to stay, he warns. “The production of medicines is time-consuming and understaffed in pharmacies and other sectors.” Not to mention the costs.
Andreas Burkhardt of pharmaceutical company Teva calls for “systematic financial pressure” to be eased, especially for critical drugs that are produced by only a few manufacturers. Contracts under which health insurance companies pay fixed amounts, he says, should be discontinued. until more and new competitors could enter the offer again.
This is not in sight, at least not according to the current ideas of the Federal Ministry of Health. The plan, it seems, is to extend the status quo, until 2026.
This article was originally written in German.
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