More than 700 medicines are currently affected by supply bottlenecks in Switzerland, according to drugshortage.ch, a platform run by Enea Martinelli, a hospital pharmacist. Mr Martinelli is also behind a popular initiative that would require the federal government to do more to secure the supply of medicines. The proposal, backed by a broad coalition from the health-care sector, was debated in the National Council this week.
The site tracks shortages of individual medicine packs. Much of its information comes from pharmaceutical companies and from a wholesaler that supplies medicines to health-care providers. Mr Martinelli set up the platform because he regarded the federal government’s monitoring as too narrow. The authorities collect information on shortages and interruptions, but mainly for medicines deemed essential. His database casts a wider net.
An analysis of the platform identifies 67 medicines, containing 42 distinct active ingredients, for which shortages are classified as critical or very critical. Ten of the active ingredients are used in cancer treatment, five to treat bacterial or other infections, five for eye conditions and five for blood disorders. Four are used in neurology, three for pain relief, three for heart disease, two for addiction treatment and one in psychiatry. Several others are used in areas such as endocrinology, obstetrics, anaesthesia and supportive care.
The problem is not uniquely Swiss. Drug shortages have become increasingly common across developed countries as pharmaceutical supply chains have become more concentrated. Many active ingredients and finished medicines are produced by only a handful of manufacturers. A quality failure, production delay, shortage of raw materials, transport disruption or sudden increase in demand at a single plant can therefore affect supplies across several countries. Older generic medicines, antibiotics, injectable cancer drugs and opioids can be particularly vulnerable because they often have few suppliers or require complex manufacturing.
Switzerland nevertheless has characteristics that can make such disruptions more severe. It is a relatively small market, which can make it less attractive for manufacturers to maintain several suppliers or to prioritise deliveries when stocks are scarce. It also depends heavily on international production. Some medicines on the Swiss shortage list are already being supplied from mandatory reserves, illustrating how the state sometimes has to compensate for weaknesses in the commercial supply chain.
The political response is now moving through parliament. The popular initiative, “Yes to the Security of Medical Care”, seeks to strengthen the security of supply. The National Council has recommended that voters reject it, while supporting a direct counter-proposal from the Federal Council.
Five of the six parliamentary groups in the National Council agreed that the initiative addresses a genuine problem. Most nevertheless preferred the government’s counter-proposal, arguing that it is more targeted. The Swiss People’s Party opposed both the initiative and the counter-proposal. The two measures will now move to the Council of States.
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