Why is the production of medicines not in fact proportionate to the demands of the overall market?
Thursday, 25 September 2014 – Pharmacist33
«The problem to focus on is the drug quota, not so much the shortage: what we need to ask ourselves is rather why the production of medicines is not in fact proportionate to the demands of the overall market - made up of Italian and foreign demand - but apparently it is undersized. Is it possible that part of the requirement is deliberately left unsatisfied?»
The provocation was launched by Domenico Di Tolla, Fofi regional delegate for Puglia: «My Region was one of the first to take action on the issue of drug shortages, with the activation, through pharmaceutical services, of commissions for controls to wholesalers and, through the Nas, principals. With us there are few pharmacies that do exports, perhaps also for a logistical and positional reason.
There are about ten warehouses throughout the Region and of these the ones that export are known. If you tackle the problem by looking for a structural problem, on the supply chain, from production to distribution, you go close: we are full of data, from those that produce industries, to pharmacies, to those that arrive from intermediate distribution.
We know what the demand is, where the medicines come from, we know who exports. So what can controls like these reveal? The question should be shifted in another direction: if the Italian territory has a certain demand which includes both an internal request and a foreign one, and if equally abroad there is a certain need, because the production of certain drugs is unable to be proportionate but is undersized?».
As if to imply that there is a question (and an answer) that escapes and "therefore perhaps checks and investigations should be directed outside a circuit that is already traced in itself, going to understand where there may be anomalies".
But there are also other open issues: "I have in mind the last parliamentary question on the shortage of drugs which concerned an anticancer drug supplied above all by hospital pharmacies: because the phenomenon is not included even there, where drugs that are actually more expensive are actually dispensed ?”.
And then there are the 48 hours: «It is a mistake to ask pharmacies to report shortages after a lack of 48 hours: the logistical reasons are not considered. For example, a pharmacy can use two warehouses, which may not have the drug available in other warehouses. With this timing, you don't really realize when the drug is missing in the regional circuit".
As well as the classification: "I think it would be more appropriate to talk about deficiencies within a certain therapeutic area rather than on the AIC: patients often have different therapeutic responses available to the problem and it would be a matter of bringing, also through doctors, patients to accept them so that they are not discovered by the therapy».
Frances Giani
