Two new position papers focusing on medicine and medical device shortages and on procurement, including the role that hospital pharmacists play in mitigating and managing these issues, have been adopted by the European Association of Hospital Pharmacists’ (EAHP) General Assembly.
With shortages becoming an increasingly pressing issue across Europe, EAHP’s new Position Paper on Shortages of Medicines and Medical Devices outlines the importance of multi-stakeholder collaboration and information exchange to reduce the risk of serious harm to patients and health systems.
EAHP advocates for a patient-centred, holistic approach in mitigating shortages and outlines several recommendations for hospital pharmacists, regulators, those involved in the supply chain and other stakeholders to minimise the impact on patients.
Since the results of the EAHP 2023 Shortage Survey Report showed that only 51% of hospital pharmacists find national public shortages reporting systems to be fit for purpose, the position paper recommends that ‘efforts should be made to strengthen the robustness and functionality of these reporting systems’, with ‘harmonised communication, including collection, reporting, analysis and feedback of comprehensive data on medicine and medical device shortages’ at their centre.
The EAHP also urges the sharing of best practice and implementation support on shortage management strategies between all stakeholders to support patient safety.
Further efforts needed for medicines shortages
At a Europe-wide level, the position paper recommends that ‘further efforts should be invested in the development of a comprehensive communication strategy on shortages of medicines’, alongside ‘accelerating’ the introduction of a European Shortages Monitoring Platform – currently expected to be operational in 2025.
According to the EAHP, only ‘a comprehensive communication strategy on shortages across Europe will ensure that all supply chain actors, including hospital pharmacists, receive adequate information on all shortages in their countries’.
In addition, EAHP calls for ‘more rigorous rules’ on issuing timely alerts about shortage problems, with national early reporting systems that exist only for medicines in a few countries ‘complemented by a European-wide database that lists reasons and estimated durations of shortages including medical devices’. It also advocates for this system to include ‘advice on alternatives which includes the expertise provided by hospital pharmacists’.
The position paper also advises national governments to evaluate if their shortages measures and management systems, including shortages reporting mechanisms are fit for purpose and ‘to rectify shortcomings where and when needed’ – which, it says, ‘includes the removal of legal barriers that prevent compounding in hospital pharmacies in case of a medicine shortage’.
Commenting on the shortages position paper, EAHP’s new president, Dr Nenad Miljković, said: ‘Hospital pharmacists expend significant time and energy finding alternatives and solutions to alleviate medicine and medical device shortages, so patients and healthcare professionals will always get support from pharmacists in times of shortages.
‘However, if we want to find the best solutions that provide the best health outcomes, we need to work together and be better prepared for future challenges. EAHP advocates for a patient-centred, holistic approach in mitigating shortages, which is why we really worked hard to create this complete and focused position paper on shortages.’
Optimising procurement
The new EAHP Position Paper on Procurement concentrates on the pivotal role of hospital pharmacists in optimising the procurement of medicines and medical devices and on the relation between procurement and shortages.
This centres on the need to ensure ‘every patient within the hospital receives the necessary treatment getting the appropriate medical device and the right amount of the right medicine, of the right quality, at the right time and at the best possible price’, the position paper states.
It highlights the need for hospital pharmacists to be involved in leading all phases of procurement processes and practices within the multidisciplinary team. This includes using their knowledge effectively in relevant Health Technology Assessments and promoting the appropriate selection, procurement, logistics and use of biosimilar medicines and advanced therapy medicinal products.
Providing education about these products to both patients and other healthcare professionals is also a key role for pharmacists, according to the EAHP, which ‘could lead to support national healthcare efforts to reduce shortages’.
Avoiding ‘winner takes all’
Another key recommendation outlined in the procurement position paper is the implementation of models that are not solely based on a single ‘winner takes all’ concept, to minimise the impact of shortages on patients.
‘Most value is obtained in medicines and medical devices that are available from multiple sources or for which there are various comparable products,’ the position paper states.
The importance of implementing environmental sustainability criteria in the procurement of medicinal products is also noted.
‘Due to their knowledge and skills, hospital pharmacists are specialists in the field of all medicinal products’ procurement and should be part of the leading team in all phases of procurement processes and practices to ensure the continuity of supply of medicinal products that are safe, of best quality, efficient and cost-effective,’ said Dr Miljković.
‘The responsible use of healthcare products is directly linked to the availability, safety, quality and efficacy of medicines in the hospital, so public procurement of medicinal products should be carried out by a multidisciplinary approach involving hospital pharmacists and other healthcare professionals working in the hospitals.’
In December, the EAHP welcomed a raft of recently released measures from the European Commission and other bodies to better prevent and mitigate medicines shortages in the European Union.
