The most proven broad spectrum antibiotic juices for children have not been available in Austria for weeks. They will no longer be delivered in March either, reported the President of the Chamber of Pharmacists, Ulrike Mursch-Edlmayr, in an APA interview. She called on the republic to buy raw materials abroad so that pharmacies can produce the funds themselves. The responsible Ministry of Health promptly rejected it, and Pharmig also expressed doubts about the plans.
“Unfortunately, from the point of view of the Ministry of Health, the proposal of the Chamber of Pharmacists cannot be implemented in the short term. There is no legal basis for the federal government to buy active ingredients. In addition, drug manufacturers usually secure the active ingredients available on the market for their own production Quality assurance, i.e. testing the purity of the active ingredients so that medicines can then be manufactured. A short-term change to this system overnight is therefore not possible or expedient,” said the ministry in a statement.
In Austria, the possibility of prescribing active ingredients is missing. “Austria is currently the only European country in which there is neither a legally regulated prescription of active substances nor a drug substitution. The Ministry of Health has been concerned with implementing this in Austria since 2019,” says the statement on Wednesday and thus four years later the project was started. The ministry has assured that solutions will be developed together with all stakeholders in order to counteract such supply bottlenecks in the future. In particular, drug reserves are to be increased.
According to Mursch-Edlmayr, neither wholesalers nor pharmacies currently have stocks, and there are waiting lists for children and adults with more than 23,000 packs. As a result, the supply bottleneck for certain medicines, which has been particularly acute since autumn, has worsened again for antibiotics for children. In 2019, around 130,000 packs of children’s antibiotic juices were consumed in Austria, and around 80,000 packs were sold in 2022, and more were not available. “We didn’t even manage to cover the annual requirement before the pandemic,” said Mursch-Edlmayr.
“We know that there are raw materials on the market at the moment and we know exactly how much raw material we need for these products,” emphasized the President of the Chamber of Pharmacists. The chamber offered the Ministry of Health to freshly prepare these products in the pharmacies – in a so-called magistral recipe. For the procurement of raw materials abroad, the republic must give a purchase guarantee and secure the financing, explained Mursch-Edlmayr. The domestic wholesale trade could then take care of the distribution to pharmacies throughout Austria. For the patients or, in this case, the parents, only the prescription fee is charged for the drugs produced in pharmacies.
“Doubts about the practical feasibility”, i.e. the production of antibiotics in pharmacies, were also expressed by Alexander Herzog, Secretary General of the Association of the Pharmaceutical Industry (Pharmig) in the “Ö1” lunchtime journal. Although the pharmacies have a “proven system of magistral preparation”, this applies to a small number of items. “In some cases, highly explosive additives are needed for antibiotics, and these can only “reasonably be produced in large quantities,” said the Pharmig Secretary-General. If pharmacists are able to do this at all, they will certainly not be able to do so on a large scale, stressed Herzog.
He assured that the pharmaceutical industry is traveling “around the globe” and all available raw materials are safer. “We’re doing everything we can”. The order stocks have also been “dramatically increased”. The triple crisis with corona, influenza and RSV was not foreseeable. The situation will get better when the flu flattens out. He also appealed to the population to only buy those products in pharmacies that are actually needed. In any case, Pharmig is in intensive contact with the Ministry of Health. A European solution is needed for large storage facilities for medicines, said Herzog.
“Of course, we fully support that, that you buy the raw substances,” said Reinhold Kerbl, Secretary General of the Society for Pediatrics and Adolescent Medicine (ÖGKJ). Then the funds could be safely manufactured in all pharmacies in Austria with the same recipe. There are still certain antibiotics, but the ones that have been tried and tested for many decades and that cause the least resistance, “they haven’t been around for weeks,” said the pediatrician who works at the LKH Leoben, especially in the child-friendly dosages. This is “threatening and a danger for those affected”. There are also examples where children are sent long distances to hospitals for infusions because the oral antibiotic is not available.
It is “actually all diseases that can be treated with antibiotics,” such as ear and pneumonia and currently “a real wave of streptococcal infections,” reported Kerbl. Penicillin drugs are not available and others have to be used that cause resistance and are “of course becoming scarce”. “So far as I can remember, there has never been anything like this,” said the specialist. In the past two years, fewer of these infections had occurred due to the corona measures and now the situation is “not entirely unexpectedly back to normal” or there is even an additional catch-up effect.
“We clearly demand raw material storage in Austria,” said Mursch-Edlmayr. Then, on the one hand, children’s antibiotic juices could be produced, but also medicines for adults, if there is a need. The problem of delivery bottlenecks will continue to accompany us and the raw materials have a long shelf life, emphasized the President in the discussion on the sidelines of the advanced training conference of the Austrian Chamber of Pharmacists in Schladming. This also dealt with the magistral preparation of eye drops. “We produce them as standard, but also when there is a shortage,” explained Mursch-Edlmayr. The latest guidelines were presented at the congress, which were developed jointly by the Ophthalmological Society (ÖOG, association of ophthalmologists) and the Chamber of Pharmacists.
