In Italy there are 237 medicines that cannot be found. Aifa, the Italian Medicines Agency, constantly monitors the so-called temporary shortages. The list published at the moment is very long: contains 2,253 medicines (inside there are also different formulations of the same active ingredients). Often, Repubblica explains today in an article by Michele Bocci, they are old molecules, which no one uses anymore, or duplicates, drugs that are easy to replace and which have remained in the handbook, notoriously too extensive with its 
16 thousand preparations.
So it is more interesting to go and see how many medicines Aifa has authorized local health authorities and pharmacies to buy abroad, because that is the signal that there are patients who have materially lacked therapy. This second list today contains 237 names (for about 170 active ingredients): those of the unobtainable. There are painkillers, vaccines, antibiotics, hormones, sedatives.
In its recent alarm, France disclosed data from the EMA, the European drug agency, which shows that almost 80% of active ingredients is now produced in India and China. Just thirty years ago this was the percentage of European producers. Cheaper medicines or those used by few patients, and therefore less profitable for the industries, are most at risk. But the shortage also affects the other extreme, i.e. more expensive drugs. In this case the danger is theft, which this year in Italy has resumed in an important way.
A further problem is parallel exports, permitted by law for wholesalers and pharmacists as well. Are there medicines that cost more abroad? Those who distribute them decide to remove them from the Italian market to earn more elsewhere. There would be precisely this phenomenon behind the recent shortage of six products, for which there have also been cases of counterfeiting.
Namely Neupro, against Parkinson's, Clexane, a heparin, Vimpat and Keppra, antiepileptics and Spiriva, for respiratory problems. The case of Sinemet is a bit different, an inexpensive anti-Parkinson's drug which this year has caused enormous problems. It was missing due to production difficulties, but Aifa decided to counter the shortage by applying the block on exports for the first time, a rule inserted by the minister Giulia Grillo in the Calabria decree.
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