Chronic drug shortages across the European Union are causing significant challenges for pharmacists and patients, particularly in Belgium, where reports indicate an alarming scarcity of essential medications. According to a recent audit by the European Court of Auditors (ECA), the EU’s 27 member states reported critical shortages of 136 drugs between 2022 and 2024, including vital antibiotics and medications used during heart emergencies.
Belgium has experienced the highest number of reported cases, with over a dozen critical shortages notified to the European Medicines Agency (EMA) in 2024 alone. Didier Ronsyn, a pharmacist based in Brussels, expressed frustration over the situation, stating, “There are often several dozen medications that are in short supply simultaneously, which makes our lives very difficult.”
Supply Chain Issues and Market Inefficiencies
The ECA identified several factors contributing to these shortages. A significant issue is the EU’s reliance on Asian manufacturers for active pharmaceutical ingredients, which account for approximately 70 percent of the region’s needs. This dependency poses risks, particularly for widely used painkillers such as paracetamol and ibuprofen, as well as for important drugs like salbutamol, marketed under the brand name Ventolin.
Olivier Delaere, CEO of Febelco, a major wholesale distributor serving around 40 percent of Belgian pharmacies, highlighted market inefficiencies as another critical factor. Drug prices vary significantly across the EU, as each national authority negotiates separately with manufacturers. As a result, producers tend to allocate more resources to countries offering higher prices, leaving others at risk of shortages.
Additionally, the ECA pointed out that most medicines are still authorized at the national level, leading to packaging differences that complicate internal EU trade. Delaere noted that this creates “local shortages” where a product may be unavailable in one member state but readily accessible just across the border.
Impact on Pharmacists and Patients
The ramifications of these shortages are profound, affecting both healthcare providers and patients. Delaere reported that approximately 70 percent of the one million client calls his firm receives annually are related to medication shortages. In 2024, pharmacists in the EU spent an average of 11 hours per week managing these shortages, according to the Pharmaceutical Group of the European Union (PGEU).
Ronsyn detailed his daily struggles, spending up to an hour communicating with patients about their prescriptions, often having to inform them of delays or unavailability. “It’s also tough for the patient, who might panic a little when they don’t get their medication on time,” he explained.
In response to the escalating crisis, the European Commission has proposed several initiatives aimed at addressing the issue. In March, the Commission introduced a “critical medicines act” designed to enhance manufacturing within the EU by providing financial incentives and encouraging member states to prioritize factors other than price in procurement contracts. This was followed by a “stockpiling strategy” in July, which aims to coordinate medicine stocks across the bloc to ensure availability during crises.
A spokesperson for the Commission expressed confidence that these measures will “make a substantial difference” in tackling the ongoing drug shortages. However, the legislative process to finalize these proposals is expected to be lengthy, requiring negotiations with the European Parliament and member states.
Ronsyn remains cautious but hopeful, observing, “They are trying to find solutions, but it is always very slow. We will probably get there someday, but for now, it’s complicated.” As the EU grapples with these persistent challenges, the urgency to resolve medication shortages remains a pressing priority for both healthcare providers and patients alike.
