Imagine there is a life-saving medicine for you, but ‘the system’ stands in your way

Lege strips waar medicatie in zat

The medicine shortage in the Netherlands seems to be reaching a new record, with potentially life-threatening consequences. This is evident from the story shared by two parents of a sick baby with de Volkskrant. In their case, the pharmacy, health insurer, and the hospital could not provide the medicine that was needed to save their baby's life. As a result, the parents had to take responsibility for obtaining the life-saving drug. According to Martin Buijsen, professor of Health Law at Erasmus School of Law, this case illustrates the urgency and dire consequences of the medicine shortage in the Netherlands: “This is what happens when you build a system that is far too complicated.”

The concerned baby experienced an epileptic seizure after three months, prompting its parents to embark on a desperate race for treatment. However, the necessary medication – vigabatrine – was unavailable in the Netherlands. Despite the doctor's urgent recommendation to start the medication immediately, the parents had to take matters into their own hands and seek the medicine abroad.

The causes of the shortage

Several factors contribute to the medicine shortage that the Netherlands is currently facing. Issues such as a production error in a factory or a global event like the COVID-19 pandemic can lead to a worldwide shortage of medicines. Additionally, the dependence on raw materials from low-wage countries such as China and India creates instability in the supply chain. These factors, among others, have resulted in an alarming number of medicine shortages in the Netherlands, with more than 1500 reported cases in 2022.

Legally, the responsibility to supply medicines lies with the pharmacist. “But in cases of force majeure, the health insurer should mediate”, Buijsen explains. “They should ensure that their customers can access medicines covered by the basic insurance package. If the Inspectorate has permitted pharmacists to obtain such medication from abroad – as was the case in the scenario described – then the pharmacist should also arrange it”, the professor of Health Law adds. However, in challenging cases, such mediation often leads to delays and uncertainties, leaving individuals to find a timely solution.

Liberalisation of the medicine market

According to Buijsen, the Dutch healthcare system – emphasising market forces and limited government regulation – has paved the way for complicated situations like that of the baby in question. “This is what happens when you create a far too complicate system”, the professor states. “We handed over control of healthcare to private, profit-driven health insurers. First, regulated market forces were introduced, and then everything had to be lean and mean. The government relinquished control can no longer steer a course that takes long-term considerations into account.”

Since the European Parliament approved a resolution in 2020 calling for the EU to become more self-sufficient in medicines, various plans have been made. These include the establishment of new medicine factories in Europe, a European emergency pharmacy, and an easing of medicine transportation to address the issue. However, these plans have yet to materialise. According to experts, it is now up to the Ministry of Health, Welfare, and Sport (VWS) to cooperate with Europe to find structural solutions."

More information

Click here to read the entire article in de Volkskrant.

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