Drug Shortages as a Constant Public Healthcare Crisis - Causes, Consequences, Solutions


public healthcare crisis management drugs shortage supply chain


Publications on drug shortages have examined the extent, causes, nature and consequences of the triggers to public healthcare crises that have adverse effects on healthcare systems and patients. The shortage of medicines is investigated in different countries and is found to be due to a complex of reasons, putting to a serious test not only the drug supply chain but also the entire public healthcare systems, with high potential for serious impact on human health.  It is becoming a worldwide issue that has deepened in recent years, especially in the context of a global pandemic, affecting both developed and developing countries. Prior the pandemic the United States reports an increase in shortages of newly registered products from 70 to 267 drugs over the five-year period from 2006 to 2011. The European Commission alarms that between 2000 and 2018 the shortage of widely used drugs has increased. Covid – 19 pandemic led to unprecedented lack of medicines due to manufacturing problems, stockpiling and overconsumption. The shortage of medicines puts the branches and structures of public healthcare in a situation of inability to fulfill their legal and moral obligations and responsibilities to consumers - from patients to specialists, pharmacies, and medical facilities. Being not only market deficiency but also regulatory challenge. Being a global phenomenon it still lacks common knowledge and common regulatory actions of different countries obvious in the fact that there are 25 definitions in the world of what constitutes a "drug shortage".  This article is based on a study of the author of the consumer implications of drug shortages, conducted in Bulgaria in the period June 2018 - December 2021, covering 1460 signals for drugs in short supply before and during the pandemic. The article is also supported by a literature review on drug shortages. The author discusses the thesis that in-depth study of the causes and consequences of this ongoing crisis in public health would provide scientific and expert circles with tools to find sustainable solutions through which it can be foreseen, managed, and overcome with timely and effective measures.