Do Medicine Shortages Reduce Access and Increase Pharmaceutical Expenditure? A Retrospective Analysis of Switzerland 2015-2020

Jul 1, 2022, 00:00 AM
10.1016/j.jval.2021.12.017
https://www.valueinhealthjournal.com/article/S1098-3015(22)00053-5/fulltext
Section Title : HEALTH POLICY ANALYSIS
Section Order : 1124
First Page : 1124

Objectives

We analyze how shortages led to changes in access to and expenditure for pharmaceutical care in the Swiss health system between 2015 and 2020.

Methods

We combined cross-sectional and longitudinal data to study medicine shortages by incidence, duration, intensity, and pharmaceutical expenditure. We assessed 4119 markets defined by active ingredient, dosage form, and strength. We classified markets by essential medicine status and other characteristics. We differentiated shortages by the degree to which alternative options are still available. We investigated the first lockdown period of the pandemic, considering also the shortage of COVID-19–specific medicines.

Results

A total of 1964 markets never reported shortages, and 1336 markets reported some shortages; 819 markets reported shortages lasting at least 14 days. Markets with a higher number of manufacturers, a lower co-payment share, and lower prices more frequently reported shortages. We did not find differences by essential medicine status. In 50% of instances, the average price of substitutes available was lower than the price of the product on shortage. The total pharmaceutical expenditure attributed to shortages increased by CHF 17.00 million (€15.63 million) in 2018.

Conclusions

Medicine shortages have substantially reduced access to pharmaceuticals. Switzerland has experienced shortages on a scale similar to that in other countries. Prices of substitutes available at the time of shortages can be higher or lower, indicating an unelastic demand for medicines.

https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(22)00053-5&doi=10.1016/j.jval.2021.12.017
HEOR Topics :
  • Cost/Cost of Illness/Resource Use Studies
  • Economic Evaluation
  • Health Policy & Regulatory
  • Public Spending & National Health Expenditures
  • Retrospective Databases: Electronic Medical and Health Records, Admin Claims
  • Study Approaches
Tags :
  • essential medicines
  • market characteristics
  • supply chain
Regions :
  • Western Europe