An EU of ideas can tackle medicine shortages

The EU’s health mandate should allow for greater collaboration on shortages of inexpensive essential medicines, writes José Inácio Faria.

 José Inácio Faria | Photo credit: European Parliament Audiovisual

By José Inácio Faria

05 Apr 2019

It has been five years since I began my mandate as a Member of the European Parliament. Since then, I have witnessed, and been honoured to take part in, the remarkable work of my esteemed colleagues working in the European institutions.

Nowhere is this more apparent than in the field of healthcare, where the European Parliament has taken a proactive stance to tackling Europe’s major challenges. In recent years, we have seen the true value of an coordinated EU approach in this field.

Although not a core European competence, the positive impacts on the health of our citizens brought about by my fellow colleagues has been remarkable. The adoption of legislation on Clinical Trials, on Falsified Medicines and on Cross border Healthcare illustrates this added value.


These emphasise the value of a centralised and coordinated approach in concretely helping patients throughout Europe. Currently, we are working on implementing legislation on Health Technology Assessments and Supplementary Protection Certificates.

I am certain that the time is now ripe for the EU to take another ambitious step on behalf of European patients. For this reason, I have been working with stakeholders to tackle the issue of medicine shortages.

I am convinced this area can benefit from the pioneering types of EU legislation we have seen previously. Shortages of inexpensive essential medicines is an under-addressed issue, despite its grave impact on patients.

Efforts by many Member States in recent years have shown the difficulties in tackling this problem alone. This is why it is crucial for the EU to take a coordinated and centralised approach.

We must not underestimate the scale of this problem. The European Association for Hospital Pharmacists (EAHP) reported in 2018 that 75 percent of European pharmacies surveyed experienced weekly shortages.

This represents a growing public health crisis that hits the most vulnerable of our citizens. Not only do patients depend on regular supplies of their medicines, shortages can also severely limit a physician’s ability to provide appropriate treatment.

"It is clear that shortages of inexpensive essential medicines are a European problem requiring a European solution"

Oncology patients are particularly vulnerable to these shortages, as there are often no alternative treatments and where there are, they may be less suitable or more expensive. The European Parliament’s work on cancer has been nothing short of relentless, but we must now turn our attention to a systematic problem that is endangering patients across the continent.

The European Society for Medical Oncology (ESMO), with whom I have been collaborating for the past few years, published a study in 2016 on the availability of anti-neoplastic medicines, which revealed a large shortage of anti-cancer medicines in Europe.

We cannot hope to truly support cancer patients in Europe without a coordinated approach on shortages. My own country of Portugal has also been affected by shortages. Despite positive efforts to predict and prevent medicines shortages, the problem remains.

The EAHP study revealed that nearly 70 percent of surveyed hospitals in Portugal dealt with shortages on a weekly basis. Disparities between Portugal and other European Member States exacerbate the issue. The lower prices of medicines in Portugal compared to other European markets may encourage parallel trade.

This, combined with the lack of stricter regulatory measures to penalise the shortfall in market supply by manufacturers, this can aggravate medicine shortages. It is clear that shortages of inexpensive essential medicines are a European problem requiring a European solution.

Therefore, I am pleased to note that the EU has not been slow to take a stance on this problem. The establishment of a joint task force, including the European Medicines Agency (EMA) and the Heads of Medicines Agency (HMA), to study the availability of authorised medicines for human and veterinary use was a landmark development and I have followed their work closely - particularly their efforts to draft a Europe-wide definition of medicines shortages.

"Oncology patients are particularly vulnerable to these shortages, as there are often no alternative treatments and where there are, they may be less suitable or more expensive"

The task force is well positioned to provide strategic advice to EU policymakers and demonstrates how the EU provides added value to its citizens. Considering the vulnerability of oncology patients, I also welcomed the 2017 policy recommendations on managing and preventing shortages drafted by ESMO and the Economist’s Intelligence Unit (EIU).

This revealed the dire levels of cancer medicines shortages in Europe and outlined key recommendations for the EU to move forward in the next few years.

Given our proximity to the European elections, and a fresh set of priorities for the next mandate, it has become my personal mission to highlight these problems at the highest level. This way, we can position inexpensive essential medicines shortages as a key political priority for the EU’s 2019-2024 legislature.

It is my duty as an MEP to raise awareness of this issue and I look forward to discussing solutions with my fellow policymakers from every political party during an event in April that aims to make inexpensive essential medicines shortages a problem of the past.

We need to ensure equal access to inexpensive essential medicines across all Member States; we need to be able to predict and prevent medicines shortages and we need to make the best use of the EU and ensure it accomplishes what it does best: helping its citizens.


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