Medicine shortages could last up to six months, ‘but no cause for alarm’

A chronic global medicine shortage is estimated to last another six months in Malta but there is no cause for alarm, according to the head of the Central Procurement and Supplies Unit (CPSU).

Karl Farrugia said stock is trickling in and the authorities are stockpiling in a bid to cope with the demand for medicines, especially over the winter season.

Insisting that “less than one per cent” of the total number of medicines are out of stock, Farrugia explained that stock levels are improving and expected to return to normal levels by around June.

“I would expect us to reach normal supply levels by midway through this year but we will have improvements by the end of the first quarter,” he said, describing the situation as “challenging but not alarming”.

Shortages have been blamed on global supply chain problems, with a lack of available Active Pharmaceutical Ingredients (APIs) from China and India seen as a key issue.

The UK has also banned exports of certain antibiotics while medications were restricted for export due to fears of a shortage.

“China and India have restarted their production lines, so we expect this to be resolved in the couple of months to come,” he told Times of Malta on Tuesday.

“There will be on-and-off problems but we don’t expect these to last months.

“Patients can expect to wait a couple of weeks before finding an alternative product [for missing prescriptions].”

Patients are known to be hoarding medications because of the low levels of stock, with Farrugia stating that more education was needed to avoid the problem.

He also confirmed that certain doctors continue over-prescribing broad-spectrum antibiotics in some instances.

Shortages are currently impacting most classes of pharmaceuticals.

“It is affecting different classes of medication but mainly antibiotics, antivirals and anti-inflammatories,” Farrugia said, speaking at the CPSU headquarters in San Ġwann, a centre home to 2,000 pharmaceutical products and 5,000 medical devices.

CPSU: 'not possible' to calculate shortages

Despite assurances, when asked for the total number of missing products, Farrugia explained it was “not possible” to estimate shortages by the number of physical items in the CPSU warehouse.

“For example, if a patient is taking 375mg of Augmentin and I only have one gram, that is useless to that patient,” he said.

While much attention has been focused on the shortage of antibiotics, medicines used to treat mental health conditions have also been reported as approaching low levels.

Farrugia dismissed any major concerns over a shortage of pharmaceuticals used to treat Attention Deficit Hyperactivity Disorder (ADHD), adding that he is not forecasting problems maintaining drugs for mental health treatment.

ADHD is a common disorder associated with hyperactivity, impulsivity and reduced attention. In October, shortages of Methylphenidate – a drug commonly used to treat the condition – led parents having to pay hundreds of euros to source supplies from overseas.

What is being done to mitigate shortages?

Asked if the government has a contingency plan in the event of shortages continuing indefinitely, Farrugia replied: “We are taking certain measures not to arrive to that stage, including placing multiple orders with different suppliers. We are pre-empting that the situation will never occur. If it does, we will have to go back to the drawing board.”

While confirming that plans were being drawn up at an EU level, these are aimed at tackling shortages generally and not specifically the current situation.

The government on Tuesday rejected a request by the opposition for an urgent parliamentary health committee meeting to discuss the shortages.

Last week, the Nationalist Party accused the government of keeping the full extent of the shortages hidden from the public, highlighting various missing medicines including a replacement insulin treatment used by diabetics, as well as those used to treat stomach-related issues and cystic fibrosis.

The CPSU supplies the Pharmacy of Your Choice (POYC) scheme, hospitals and primary healthcare centres.

Why no updates on the CPSU website?

Last week, Times of Malta reported eight out-of-stock medicine reports were missing from the CPSU website. The reports are supposed to be updated weekly.

When questioned about the issue, Farrugia explained that the website had not been updated due to difficulties keeping up with the rapidly changing levels of stock.

“You can’t do it manually because it gives the wrong perception. People will start panicking. Giving the wrong information is even worse than not giving the information,” he said.

But a new automated system to monitor stock levels in real time will be online within the next couple of weeks.

“We apologise to the public for not informing them that it was a work in progress to get it into a different system,” he said.