The shelves in a Belgian drugstore warehouse are emptier than they used to be, and the country, like others in the European Union, is increasingly facing shortages of medicines, frustrating pharmacists and patients and putting pressure on public health services. N1.
"Often there is simultaneously shortage of several dozen medicines", which makes our lives much more difficult," he said Didier Ronsyn, a pharmacist from Brussels.
An EU audit last month found that shortages are a “chronic headache” across the Union.
Its 27 countries reported critical shortages of 136 medicines between 2022 and 2024, including antibiotics and drugs used to treat heart attacks, the European Court of Auditors (ECA) said.
A critical shortage means that there is no alternative available on the market.
Belgium reported the most cases to the European Medicines Agency (EMA) in 2024, with more than a dozen critical cases.
The cause lies partly in supply chain problems and Europe's overreliance on Asia for key drug components, the ECA said.
Lower drug prices are a result of sourcing from Asia, meaning Asian manufacturers now supply the EU with 70 percent of the active pharmaceutical ingredients it needs, according to a study cited in the ECA report.
Addiction is particularly pronounced in the case of painkillers, such as paracetamol or ibuprofen, and medicines that have been critically scarce in recent years, including some antibiotics and salbutamol, an asthma medication sold under the brand name Ventolin.
However, the inefficiency of the EU internal market is also to blame.
"Most calls due to shortages"
Drug prices vary within the bloc because national authorities negotiate individually with manufacturers, he explained Olivier Delaere, CEO of Febelec, a wholesale distributor that supplies about 40 percent of Belgian pharmacies.
As a result, manufacturers tend to ship more to countries that pay more, and only marginally to those that have negotiated lower prices, to avoid those drugs being resold for profit, he said.
In addition, the ECA said that most medicines have national approvals so packaging varies significantly between countries, making intra-EU trade "more expensive and complex".
This causes so-called "local shortages", when a product is not available in one EU country, but can be found just across the border in another member state, Delaere of Febelco said.
"It's a growing problem," he said.
About 70 percent of the approximately one million customer calls the company receives annually "are focused solely on drug shortages," Delaere said. "It's an absolutely colossal burden and drain on energy."
A complicated path to solving the problem
In 2024, pharmacists in the EU spent an average of 11 hours a week managing shortages, according to PGEU, a pharmaceutical trade group.
Ronsyn said he often spends an hour a day "making phone calls, checking information, sending patients or calling them back to tell them their medications have arrived or in certain cases that they haven't" - something that didn't happen in the past.
"It's also difficult for the patient, who might be a little fearful when they don't get their medication on time," he said.
Brussels is struggling to find solutions.
In March, the European Commission proposed a "critical medicines law" aimed at boosting production in the EU by providing incentives to manufacturers and encouraging member states to move away from price as a key criterion for awarding procurement contracts.
A "stock strategy" followed in July to coordinate supplies and ensure availability of medicines and other goods in case of crisis.
A commission spokeswoman said Brussels was confident that these and other recently presented proposals would "make a significant difference" and "significantly help solve the problem."
The laws are currently being negotiated with the European Parliament and the member states, which is sometimes a lengthy process.
"They're trying to find solutions, but it's always very slow," said Ronsyn, whose pharmacy overlooks the commission's offices.
"We'll probably get there one day, but for now it's complicated."
Source: N1
Photo: EPA/ALLISON DINNER
