Drugs shortages are becoming more acute across Europe and in America. Why?
people, a good belly laugh is a wonderful thing. For Rachel Rothwell, it can literally cause her to crumple to the floor. She suffers from cataplexy, a condition whereby strong emotions, such as joy or anger, paralyse the muscles, prompting complete physical collapse. For the past nine years, a medication called clomipramine has alleviated her symptoms. So effective was the medication she almost forgot she suffered from the disease at all.
America is not alone. In France shortages in medications increased 20-fold between 2008 and 2018, according to the country’s drug regulator. Local pharmacists in Europe spend five to six hours a week trying to track down medicines for their customers in other dispensaries because they themselves have run out, or trying to identify suitable alternatives.
Medications most commonly vanish from pharmacies as a result of manufacturing problems in the factory that makes the drug or its active ingredient. Roughly 40% of generic drugs sold in America have just one manufacturer each. That means that a snag on a single production line can trigger a worldwide shortage.
The active chemicals for many medicines also have just a handful of manufacturers. These are increasingly based in India or China, where recalls of poor-quality products are common. The recent discovery of contamination in a Chinese factory making valsartan, the active compound in a widely used blood-pressure medication, has led to the withdrawal of dozens of drugs in at least 22 countries, mostly in Europe. That particular factory, it transpired, made half of the world’s supply of valsartan.
If long supply chains bring one kind of risk, the clustering of factories in a single place brings another. Puerto Rico, an American territory in the Caribbean, is home to one such cluster. When two hurricanes blasted the archipelago in 2017, half of the world’s ten biggest drugmakers were affected. Storm damage to Puerto Rican factories limited the supply of 11 of the world’s 20 most popular drugs. Nobody knows how many other vulnerable clusters now exist.
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