Latvia looks for ways to fight medicine shortages: LTV's De Facto

The solidarity mechanism announced by the European Union to share medicines in the event of shortages will not solve the ongoing lack of medicinal products, as acknowledged by the Latvian medical authorities, since the problem is more deeply rooted, Latvian Television's De Facto reported December 3.

As De Facto found out, though medicine deficit is not as prominent as last winter, there are medicines that pharmacies struggle to stock.

"The first time was earlier this year when I went to the pharmacy I usually shop at and there I was told there was no medication and there would be no medication. Well, I was shocked," Daiga Kampane, who is diabetic, said in a conversation with LTV.

Also at the end of November there were red X marks again in the National Register of Medicines database, meaning there are none in wholesale and, accordingly, pharmacies.

Daiga has managed to adapt to this situation in time, because the local pharmacy is forthcoming. "I do not know whether it is an initiative from the pharmacy itself [..] but they form a queue, issue a number. You line up for those drugs when you apply, and when those drugs come into the pharmacy, they call you and you can come get them," she says, adding that the first time she had to wait four weeks.

Alice Nīcmane-Aišpure, head of the Latvian Association of General Practitioners, said that other medicines were also lacking. The issue of how to deal with it has been on the table for years, but it was brought up louder last year when the problems were particularly rampant. Now the European Union has decided to build a national solidarity mechanism. It provides for the voluntary sharing of medicinal products if one country has a surplus them and another lacks them.

Deputy Director of the State Agency of Medicines Sergejs Akuličs said: "It is also clear that all these mechanisms, which are already in operation and are still being developed, are like Swiss cheese - there are holes somewhere and it is only by using different mechanisms at the same time that we eliminate some kind of risks. Because there is no silver bullet that helps solve the situation once and for all."

How exactly European countries will share medicines, if necessary, is not yet clear. It wouldn't be something entirely new and buildable from scratch. Moreover, Latvia already has a similar experience, says the Ministry of Health.

Inese Kaupere, head of the pharmaceutical department of the Ministry, said similar exchanges are already taking place between the Baltic States. However, she acknowledged that joint and several sharing of medicinal products can also be carried out only if someone has something to give.

The problems of drug shortages are much deeper and start already in the manufacturing process, the association representing drug wholesalers says.

Janis Lībķens, board Member of the Latvian National Association for Medicine Supply, says the main problem is the shortage of raw materials.

“Because raw materials from Asia were delivered in the free market so far, and if for whatever reason these logistics chains are cut, we are experiencing a shortage,” he said.

The industry is encouraged to build stockpiles of medicines through state involvement at times of crisis, where wholesalers see themselves as custodians of such stockpiles. But the Ministry of Health says hospitals must provide at least three months ahead already, and for now, no other changes are planned.

European countries are expected to draw up a list of critical medicines next year. Their availability, in cooperation with producers, would be taken care of in particular. In cases where there would not be enough for everyone, the medicines would be shared centrally by the European Union, as was the case with Covid vaccines at first.

There has also recently been a national survey on the possibility of joint purchases of antibiotics. Kaupere said:"We have expressed an interest in participating in such joint procurement. At present, no antibiotics have been purchased, but it is proposed that Member States assess the possibility. We have responded. Well, we're hoping for this kind of joint procurement. They could perhaps be its rarest and most expensive [medicines]."

However, this too will not be a solution for everyone, for example in the case of diabetes medicines. The production capacity of antibiotics could still be raised by producers, but not that of diabetes medications. Latvia has also verified this.

"'One of the manufacturers said they had increased production capacity. Even now they are working 24/7, one promised they could get better delivery. The others were not so promising,” Kaupere said. In such cases, the only option is to seek alternative medicines.

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