There is a rush to the pharmacy to buy treatment for Covid and the flu in these peak months for the two viruses. But the raw materials that are increasingly difficult to find, starting with the active ingredients that arrive above all from China, are also struggling with a boom in infections. Without forgetting the effects of the war on transport and expensive energy. Here is the deadly mix of causes underlying the growing alarm over the shortage of medicines on which the Minister of Health Orazio Schillaci has decided to shed light by opening an urgent table. With the risk, however, that now the shortage of medicines could worsen due to the dangerous phenomenon of hoarding: people worried about not finding medicines could run to the pharmacy to hoard them, thus self-reinforcing the shortage.
Pharmacists were the first to sound the shortage alarm
Pharmacists have repeatedly raised the alarm in recent months and have repeatedly spoken of a «perfect storm»: «With the war in Ukraine still ongoing and the consequent production problems linked to the energy crisis and the shortage of packaging materials, such as glass and aluminum, the peak of the flu season and the long wave of Covid which is also affecting Asian countries producing active ingredients such as China and India – explained the president of the Federation of Italian Pharmacists’ Orders, Andrea Mandelli – the situation is struggling to return to normal. However, I would like to underline that citizens are never left alone: pharmacists remain an irreplaceable point of reference for informing and guiding patients, also suggesting the use of equivalent medicines and alternatives of the same therapeutic class and, where possible, setting up medicines in the galenic laboratories with which many pharmacies are equipped». To confirm the alarm is Antonello Mirone, the president of Federfarma Servizi, which represents the intermediate distribution of the drug: «The situation has now become unsustainable. We would like to know the real reason for the problem, to give citizens homogeneous answers. Because we have not seen the phenomena of drug shortages that we see now even in the midst of the Covid emergency ».
The list of 3200 deficient drugs published by AIFA
Currently, according to the latest monitoring by the Italian Medicines Agency updated to 10 January, there are 3,200 medicines in short supply in pharmacies throughout Italy, including anti-inflammatories, antipyretics, some types of antibiotics, cortisone for aerosols, cough products , but also antihypertensive and antiepileptic drugs. Scrolling through the list published by AIFA which also indicates the reasons for the shortage, in addition to the “temporary” and “definitive” cessation of marketing, two other very frequent reasons also emerge, namely “the high demand” and the “problems productive”. In particular, the high demand concerns some drugs most used this season precisely for the treatment of Covid and the flu, while production problems could hide the difficulty in finding raw materials such as active ingredients, but also those necessary for packaging such as boxes and blisters. However, as the president of Farmindustria also recalls Marcello Cattani «50% of the 3,200 deficiencies are drugs that can be replaced by other drugs. So, in fact it is a theoretical deficiency ».
Among the anti-inflammatory deficiencies, tachyprine and antibiotics
What is worrying is the fact that “among the drugs that patients have the most difficulty finding are common anti-inflammatories such as Brufen, Nurofen and Moment, mucolytics such as Fluimucil, anti-pyretic drugs such as Tachipirina”, he explains Sylvester Scotti, secretary of the Italian Federation of general practitioners (Fimmg), who recalls how in this period there is “a macro use of some drugs, due to the simultaneity of viral forms to be tackled with anti-inflammatories for muscle pain, considering that we have a flu which this year had 20% more infections than last year and which runs at the same time as Covid, for which the same symptomatic drugs are used ». Then due to the shortage of some antibiotics, “such as those based on cephalosporins such as Cefixoral – adds Scotti – there is a problem with the supply of active ingredients from China, a country now in great difficulty due to Covid”. «There is a trend that has increased compared to a year ago, with about 500 more stable overall shortages – adds Cattani, president of Farmindustria -, but they are concentrated in a few categories: antidepressants, antihypertensives, antibiotics, anti-inflammatories, diuretics and neuroleptics. These are mainly the categories of medicines affected by shortage states.
Risk of hoarding with the rush to stock up
But behind the phenomenon of shortage there could also be a problem that is perhaps even more insidious: that of hoarding and forms of speculation. “Covid and the flu provide for the same therapy and this causes concern on the part of citizens who want to be ready: a therapeutic anxiety that leads to wanting to fill the locker at home”, he warns Robert Tobias, National Secretary of Federfarma. «It is important that citizens do not rush to hoard supplies», adds Mandelli who underlines how it should be explained «to Italians that the pharmacist must be trusted, who will be able to give suitable alternatives for the missing drug. And above all, we must avoid stockpiling by hoarding medicines to keep at home, thus taking them away from those who need them at the moment. We need a virtuous collaboration ». Scotti of Fimmg also evokes «forms of speculation, similar to those seen on fuels. In fact, many of the drugs that are lacking can be prescribed and have a price agreed with the National Health Service but have the same active ingredients as over-the-counter drugs, sold without a prescription and with prices determined by supply and demand. This gives rise to possible speculative phenomena».