Abstract
ObjectivesWe analyze how shortages led to changes in access to and expenditure for pharmaceutical care in the Swiss health system between 2015 and 2020. MethodsWe combined cross-sectional and longitudinal data to study medicine shortages by incidence, duration, intensity, and pharmaceutical expenditure. We assessed 4119 markets defined by active ingredient, dosage form, and strength. We classified markets by essential medicine status and other characteristics. We differentiated shortages by the degree to which alternative options are still available. We investigated the first lockdown period of the pandemic, considering also the shortage of COVID-19–specific medicines. ResultsA total of 1964 markets never reported shortages, and 1336 markets reported some shortages; 819 markets reported shortages lasting at least 14 days. Markets with a higher number of manufacturers, a lower co-payment share, and lower prices more frequently reported shortages. We did not find differences by essential medicine status. In 50% of instances, the average price of substitutes available was lower than the price of the product on shortage. The total pharmaceutical expenditure attributed to shortages increased by CHF 17.00 million (€15.63 million) in 2018. ConclusionsMedicine shortages have substantially reduced access to pharmaceuticals. Switzerland has experienced shortages on a scale similar to that in other countries. Prices of substitutes available at the time of shortages can be higher or lower, indicating an unelastic demand for medicines.
Highlights
A shortage of medicines refers to a situation in which the supply becomes so limited or the demand increases such that excess demand exists for a certain period.[1]
The objective of this study is to describe the extent to which medicine shortages available in the Swiss health system led to reduced access to pharmaceutical care
Using the Swiss BWL classification, per active ingredient defined by Anatomical Therapeutic Chemical (ATC) level 5, we identified whether a medicine was defined as essential
Summary
A shortage of medicines refers to a situation in which the supply becomes so limited or the demand increases such that excess demand exists for a certain period.[1]. The COVID-19 pandemic has led to short-term spikes in demand for medicines, and trade interruptions have increased public awareness of the need to maintain an overview of the availability of essential medicines.[9]
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