Failing drug policy in the Netherlands; major shortage of pediatric antibiotics
'Minister calls attention to shortage of children's antibiotics,' Dutch newspapers wrote a week ago. Outgoing Minister Pia Dijkstra (Medical Care) recently called on producers of antibiotics to come forward. Why? There is a major shortage of children's antibiotics and rapid approval of new antibiotics could alleviate the need. You may have experienced it firsthand as a parent. And in pharmacy, we can certainly talk about it!
Not available
And not only the Parool wrote about it. Amoxicillin in drink form is currently not available. And what's the problem here? Unlike other drugs, it is difficult to find an alternative for antibiotics. At the pharmacy, we do everything we can to find a good alternative for your child in consultation with your doctor.
Is there really no other remedy to consider?
This is a question we often hear. In the case of pediatric antibiotics, the alternative is a drug that is not first or second choice, has more side effects and a different dosage. As healthcare providers, we are extremely careful and certainly don't want to "over-treat. So that's a complicated one.
Letting kids take pills?
The solution may be to try to give the right dose with dissolving tablets. But for children, in pharmacy we calculate with milligrams and millimeters. And really making a solvent from a tablet is not desirable.
Who is going to solve this problem?
The ministry, the NZa and health insurers must ensure that every Dutch person has access to good care. Insurers have a directing role in this and, in addition to the availability of care, they are also responsible for limiting costs as much as possible where they can. In the case of medicines, they purchase most of the unbranded medicines themselves and only the cheapest medicines are in principle eligible for reimbursement. This is also the case with antibiotics. As a result, other providers that are slightly more expensive get "is not reimbursed" status with the insurer. Manufacturers then reduce production volumes or withdraw the drug from the market altogether. This makes sense because, after all, the patient will not be reimbursed for these drugs. As soon as the 'cheapest' manufacturer itself has a supply problem, the other suppliers can no longer meet the demand. This is one of the causes of drug shortages.
Apothecaries have already presented plans that largely solve the problem. So far, these have not been embraced.
The drug policy in the Netherlands leads to these kinds of highly undesirable side effects when it comes to drug deliverability. We hope that the policy maker and health insurers will act quickly now!