Drug supply shortages in Spain up by 41% last year

Episodes of drug shortages in Spain's pharmacies are on the rise. Last year there were 41% more shortages of some products in pharmacies than in 2023. Throughout the year there were major problems in obtaining up to 4,983 different drug products, some of which are essential to maintain treatments for large groups of patients. There were almost 1,400 more products with supply problems than just one year earlier.

Incidents of out-of-stock situations in Spanish pharmacies have become a chronic problem, with an average of more than 700 products that are difficult to source at any time of the year, according to the annual report by Luda Partners, the technology company that has provided thousands of Spanish pharmacies with a digital system for the immediate procurement of medicines in short supply. The report places the most critical moment of 2024 as occurring in January when the shortage then broke all records as most pharmacies were unable to supply up to 947 drugs in that month.

Among the drug groups with the greatest supply problems over the last 12 months were antidiabetics with 13% of critical shortage episodes, psychostimulants used for attention deficit hyperactivity disorder (ADHD) at 11% and treatments for peptic ulcer and gastro-oesophageal reflux at 5%. With smaller but important percentages are antibacterials and those for the digestive system, especially Kreon, enzymes used to alleviate pancreatic insufficiency for which there is no alternative treatment for those patients.

Among anti-diabetes drugs, as was the case in 2023, one of the most difficult to buy was Ozempic (used in weight loss treatment plans), but also Trulicity, Fiasp, Novorapid and Victoza. The list of ADHD drugs in short supply in Spanish pharmacies was topped by Concerta, followed by Equasym, Elvanse, Medikinet and Atenza (the latter especially at the end of the year).

The group of peptic ulcer and gastro-oesophageal reflux agents consists of almost a single medicine, Pylera, which has serious supply problems. According to pharmacists this could be a shortage of the active ingredient, a situation that is similar to the problems experienced with Concerta, which is by far the drug that suffered the largest and longest supply shortages last year.

Concerta overtook Ozempic as the drug with the biggest supply problems in 2024. This drug, used to treat ADHD, has surpassed the large shortage figures recorded for the anti-diabetic, with 8% more shortages reported than Ozempic. In October 2024 reported incidences of product shortages in Spain for Concerta were 54% higher than the record high registered during the peak of the Ozempic crisis in 2023.

The shortage of medicines in Spain is due to a wide range of factors. Some are cyclical, such as the shortage of anti-influenza drugs in winter or antidepressants and antihistamines in autumn and spring due to seasonal increases in demand. There is also the lack of drugs when they go viral on social media, as happened with Ozempic. Another factor is the interruptions in the supply chain due to wars and other conflicts, as with Ukraine and Palestine. The final factor is simply due to reductions in distribution when the pharmaceutical companies face increased costs.

Other factors are permanent and this is where experts are calling for change. They are calling for the drug manufacturers to be able to quickly replace a drug in short supply with an alternative or equivalent and for these companies to be encouraged to produce their own-label medicines in cases of shortages. In addition they are calling for a review of the very low official prices that put Spain at the bottom of the priority list with the drugs firms when there are shortages. Lastly, they call for the domestic production of essential drugs, 80% of which are made in Asia, to reduce dependence on supplies from overseas.

One of the palliative measures already under way is the digitisation of pharmacies with tools for sourcing medicines in short supply quickly and nearby. The Digital Pharmacy Network, which already has 3,700 pharmacies in Spain on its books, has enabled more than 452,000 patients in recent months to find the medicines they need to continue their treatment without interruption.

These drug shortage data for Spain, said Luis Martín Lázaro as co-founder of Luda Partners, call for "the urgent implementation of effective strategies to guarantee access to essential medicines in order to prevent critical situations such as those that have occurred in other countries (like Colombia or the UK), where drug shortages have had fatal consequences, including loss of life."