EU must address shortages of anti-cancer medicines

EU must address shortages of essential anti-cancer medicines, argues Josep Tabernero.

Josep Tabernero | Photo credit: ESMO

By Josep Tabernero

30 May 2017


Shortages of essential, low-cost generic medicines are a growing and painful issue across the European Union. Doctors, such as myself, pharmacists and patients are increasingly being affected by not having medicines in stock, the results of which are directly borne by patients. 

In an era where much of the debate is focused on delivering access to expensive medicines, I believe we are forgetting a problem which, in principle, shouldn't exist within the EU.

The European Society for Medical Oncology (ESMO) is increasingly concerned with this issue, which we believe has deteriorated over the last decade. With over 15,000 members from over 130 countries, the majority from Europe, we see at first hand the problems associated with shortages of essential, low-cost medicines.


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Cancer medicines are one of the most affected areas experiencing acute shortages in the EU, alongside antimicrobial agents. These shortages are happening on a daily and weekly basis and are generally managed by pharmacists on their own.

Unfortunately, these shortages are not being reported in a timely manner, as there is no effective system in place to track the supply of these medicines, nor is there a system that ensures their availability.

In addition, there are problems related to production and distribution, a lack of incentives for manufacturers to produce these medicines and with parallel exports.

The European Parliament's recently adopted resolution on EU options for improving access to medicines echoes our concerns regarding shortages. The World Health Organisation (WHO) has been addressing the issue of shortages for a number of years. 

It created the essential medicines list (EML) to ensure that a minimum number of crucial medicines are advised to be in stock at all times. The list was created with low and middle income countries in mind. 

However, even in Germany, one of the world's most developed countries, seven medicines from the WHO EML are currently in short supply, representing a quarter of all shortages reported in Germany. In Spain - my home country, 10 per cent of medicines from the WHO EML for cancer are frequently unavailable.

Given that these shortages exist and that we are a part of the EU, we need to ensure that a solution exists and involves the supranational level as well as national level. With this in mind, the Economist Intelligence Unit and ESMO launched a report on Cancer Medicines Shortages, on 17 May 2017 in Strasbourg. 

When the demand for these essential medicines exists and there is no way to manage the supply, the people who suffer most from these shortages are patients. 

We hope that through this report, we will be able to move a step closer to decreasing and eventually eradicating the shortage of essential, low-cost, generic cancer medicines.