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Cited by 154Pharmaceutical Economics and PolicyPharmaceutical Quality and CounterfeitingGlobal Health Workforce Issues

Medicine Shortages: Gaps Between Countries and Global Perspectives

Open access
Acosta, Angela, Vanegas, Egdda Patricia, Rovira, Joan, Godman, Brian, Bochenek, Tomasz·2019·Frontiers in Pharmacology
DOI 10.3389/fphar.2019.00763PMC PMC6658884
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Abstract

Over the last decade, global health policies and different research areas have focused on the relevance of medicine shortages. Published studies suggest there have been difficulties with access to medicines since the beginning of the twentieth century. Some suggested approaches have enabled advances in our understanding and management of the problem. However, in view of global and regional health care concerns, the phenomena needs to be characterized and described more fully in order to provide evidence about the current types of affected medicines, identified causes, and potential strategies to address this. This study aims to compare the situation regarding shortages between countries in three different regions, analyzing adopted definitions, main causes reported for the shortage’s events, global context and national approaches Methodology: An observational study presented as a narrative review of the situation and findings. Results: Based on the reported cases in the literature, a typology of medicines shortage and supply interruption episodes and its causes were proposed; national approaches to notify and manage the medicines shortages cases were described and classified by update frequency; main differences between market and supply chain manage perspective of the situation were identified global and countries perspectives also were described with emphasis on available definitions. Conclusion: Policy makers require solutions that prevent those cases in which the population's health is affected by episodes of medicine shortages and/or interruption in the supply chain. In addition, to generate a glossary related to logistics management and the availability of medicines will be useful to understand and overcome the phenomena; and to recognize that potential solutions are not only related with actions linked to research, development and innovation as some global perspectives are proposing, but much wider.

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Crossref · 10.3389/fphar.2019.00763

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  • Shortage of APIs affects many manufacturers worldwide, causing medicine shortages and leading to concerns with patient management.

    “Shortage of APIs affects many manufacturers worldwide, causing medicine shortages and leading to concerns with patient management [5, 43, 44].”

    From Medicine shortages and challenges with the procurement process among public sector hospitals in South Africa; findings and implications (2020) · cites this paper as [5]

    In Results > Contexts and Reasons of Medicines Shortage (page unavailable), the review lists supply of raw materials among causes of medicine shortages and discusses their health consequences. Results > Medicines Involved (page unavailable) says shortages involving active ingredients are a concern across several world regions. It does not establish that API shortages affect many manufacturers worldwide, so that part of the claim is unsupported. (LLM, conf=0.84)

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  • Multiple factors contribute to medicine shortages, including manufacturing and quality problems, production delays, lack of manufacturing capacity, shortage of raw materials, political instability, profitability issues, long lead times, delays in awarding tenders, absence of national contracts on regional code lists, failure of suppliers to meet demand, and failure to pay suppliers.

    “Some of the contributing factors to the shortage of medicines include manufacturing and quality problems, production delays, lack of manufacturing capacity, shortage of raw materials, political instability, and profitability issues [5, 6, 8, 9, 18].”

    From Medicine shortages and challenges with the procurement process among public sector hospitals in South Africa; findings and implications (2020) · cites this paper as [5]

    Table 2 in Results > Contexts and Reasons of Medicines Shortage lists quality concerns, industrial capacity, production problems, raw-material supply, and political and social issues as causes; the same section discusses low profitability. It does not specifically identify production delays or political instability, the more precise causes named in the citing sentence. (LLM, conf=0.82)

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  • Such properties of banana peel seem useful in Tanzania, where some medicine is counterfeited and access to drugs is limited, especially in remote areas, or in China, Brazil, Venezuela, Iran, Iraq, and Jordan, where medicine shortages have been reported.

    “Such properties of banana peel seem useful in, e.g., Tanzania, where some medicine is counterfeited and access to drugs is limited, especially in remote areas [93], or in China, Brazil, Venezuela, Iran, Iraq, and Jordan, where medicine shortages have been reported [94].”

    From Potential Valorization of Banana Production Waste in Developing Countries: Bio-Engineering Aspects (2024) · cites this paper as [94]

  • The origins of medicine shortages are complicated, can differ among regions and countries, and consequently potentially require different strategies to address them.

    “The origins of medicine shortages are complicated, can differ among regions and countries, and consequently potentially require different strategies to address them [5, 6, 15].”

    From Medicine shortages and challenges with the procurement process among public sector hospitals in South Africa; findings and implications (2020) · cites this paper as [5]

  • Medicine shortages are a complex global challenge affecting all countries, including South Africa, with shortages of even essential medicines becoming a global problem irrespective of the economic status of countries.

    “Over the years, the shortage of medicines has been a challenge to the effective delivery of quality healthcare services worldwide including South Africa [1–10], with shortages of even essential medicines becoming a global problem irrespective of the economic status of countries [11–13].”

    From Medicine shortages and challenges with the procurement process among public sector hospitals in South Africa; findings and implications (2020) · cites this paper as [5]

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Research works printed but not linked: 1

  1. Servicio Vasco de Salud -Osakidetza (2016). Desabastecimiento De Medicamentos: Un Problema Sin Resolver [Internet]. Vol. 23, INFORMACIÓN FARMACOTERAPÉUTICA DE LA COMARCA. Vitoria - Gasteiz. Available from: http://www.osakidetza.euskadi.eus/contenidos/informacion/cevime_infac/es_cevime/adjuntos/INFAC_Vol_23_N_7_Desabastecimientos.pdf.

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Authors
Acosta, A., Vanegas, E. P., Rovira, J., Godman, B., & Bochenek, T.
Affiliations
  • Universidad Nacional de Colombia (CO)
  • Andalusian School of Public Health (ES)
  • Karolinska University Hospital (SE)
  • Jagiellonian University (PL)
ORCID
Venue
Frontiers in Pharmacology
Publisher
Frontiers Media SA
Published
2019-07-19
Volume
10
Pages
763-763
ISSN
1663-9812 (ISSN-L)
DOI
10.3389/fphar.2019.00763
PMC
PMC6658884
OpenAlex
W2952637388
Cited by
147
References
79
Citations by year
2026: 18 · 2025: 17 · 2024: 26 · 2023: 19 · 2022: 19 · 2021: 29 · 2020: 16 · 2019: 2
FWCI
20.60
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Pharmacology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Strathprints: The University of Strathclyde institutional repository (University of Strathclyde) (acceptedVersion, public-domain)
  • Homo Politicus (Academy of Humanities and Economics in Lodz) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Pharmaceutical Economics and Policy
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pharmaceutical Quality and Counterfeiting
  • Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
Keywords
drug shortages, access to medicines, global health policy, supply chain management, pharmaceutical logistics

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