Drug Shortages
Abstract
Adequate supply of medicines is fundamental to the achievement of key aspects of universal health coverage. The COVID-19 pandemic however, has jeopardized access to care by interrupting the supply of essential medicines. In Germany, between March and June 2020, 116 drug presentations were newly reported to be on short supply. Among them were medicines to treat patients suffering from severe symptoms of COVID-19 such as probofol used to sedate patients in critical care needs and in patients requiring ventilation.Drug shortages reflect the lack of sufficient access to (essential) medicines, at least for a limited amount of time where supply cannot meet demand at a national level. Before the COVID-19 pandemic, drug shortages were present in many fields of therapy from complex injectable cancer drugs, inexpensive products such as saline, to high volume drugs such as valsartan to treat common high blood pressure.This project analyzes the causes and consequences of drug shortages. We aim to develop a framework that aids in identifying causes of drug shortages across economics, management, and medical disciplines. Unlike the vast majority of the existing evidence that describes the situtation in the United States, we will focus on health care provided by European health care systems and particularly shortages reported in Germany, Austria and Switzerland. Moreover, we will make accessible new data sources to characterize the scope of drug shortages reported in Europe, classify the causes of drug shortages and perform causal analysis of the drivers of drug shortages at national level. Specifically, we aim to describe the pharmaceutical supply chain and identify bottlenecks within the supply chain framework, due to the interruptions caused by the COVID-19 pandemic. We will map all global and regional policy and industry measures taken by governments and health care systems to overcome such interruptions. We will then empirically identify causal effects of supply-chain, regulatory and governance related aspects that lead to drug shortages in a particular health system. The objective is to combine product level data on drug shortages from national reporting systems of drug shortages, trade-flows, prices, regulatory and governance systems, and perform econometrics analysis. We will then turn to analyzing the consequences of drug shortages on health and health care cost in one particular health care system (Switzerland), using health insurance claims data in one health insurance system. The focus of our work will center on the situation arising from the COVID-19 pandemic and the resulting changes in supply and demand of medicines.