Pharmacists ‘on the front lines’ of Europe’s medicine shortages

When Europe’s medicines supply chain comes under strain, community pharmacists are often the first to feel the impact. At a Pharmaceutical Group of the European Union (PGEU) event in the European Parliament, speakers agreed on a single message: tackling shortages requires structural fixes, not just crisis management.

Pharmacists described the daily reality of supply gaps, saying they are “on the front lines,” ensuring patients can continue treatment even when usual medicines are unavailable. Shortages demand complex, case-by-case interventions, with pharmacists spending significantly more time managing disruptions.

Patients bear the greatest burden. Ancel·la Santos, Head of Health at BEUC, warned that shortages cause “anxiety [and] distress,” treatment interruptions, switches to less suitable therapies, medication errors, and higher costs — impacts that ripple across the entire health system.

So how can Europe strengthen its supply chain?

Agnes Mathieu-Mendes, Head of Unit for Medical Products at the European Commission, highlighted a shift toward a “culture of prevention,” including mandatory shortage-prevention plans and earlier notification of market withdrawals, giving authorities and supply chains more time to react.

Matthias Blaas of the European Court of Auditors argued that under the current system, if there is a shortage, “there is no financial consequence” for industry - and “no reward for resilience either.” He said price-only tendering and single-winner contracts have driven an ultra-lean supply chain and manufacturing concentration that is fragile and prone to disruption.

Speakers called for moving “beyond price-only” criteria for critical medicines, building contingency stocks, and improving EU-level coordination to cushion shocks, while avoiding national measures that simply shift shortages across borders.

MEP Tomislav Sokol, Parliament’s rapporteur on the Critical Medicines Act, identified two major challenges the EU must address. The first is global dependency. He warned of “increased dependency on imports of medicines from third countries,” particularly generic medicines reliant on sole suppliers in countries such as India and China. This, he argued, is “definitely intolerable,” not only for geopolitical reasons but also for the fundamental “security of supply itself.” Global instability, from trade tensions with the US to disruptions in the Red Sea, underscored that Europe “does not want to be dependent on such a strategic asset as medicines”.

The second issue is equality of access. Sokol called it “entirely unacceptable” that innovative oncology medicines reach smaller or Eastern European markets “two to three years later” than larger member states. Solidarity and equal access, he stressed, must be central to EU health policy.

Within the proposed Critical Medicines Act, Sokol backed moving beyond the traditional “lowest price” tender model and single-winner contracts. He supported a strong “European preference,” proposing a benchmark of 50% of production in Europe for either final products or active ingredients. With over 500 votes in Parliament supporting this approach, he said there is an “obligation to push for that strongly.”

He also emphasised voluntary joint procurement to strengthen smaller states’ bargaining power and new safeguards on stockpiling. Excessive national stockpiles, he noted, “result in shortages in others.” Parliament proposes prohibiting stockpiling that harms other countries and, as a last resort, enabling EU-level redistribution approved by a two-thirds majority of member state representatives.

The final message was clear: Europe cannot rely on emergency improvisation, particularly amid growing geopolitical uncertainty. Participants recognised that medicine shortages have multiple causes — and that solutions must be equally multi-faceted, addressing regulation, procurement, industrial capacity and pharmacy practice to ensure patients are no longer left behind by commercial exits or fragile supply chains.