At a drug wholesaler warehouse in Belgium, the shelves are noticeably emptier, reflecting a troubling trend across the European Union. Chronic drug shortages have become a significant issue that frustrates pharmacists and patients alike while placing additional strain on public health services. According to Didier Ronsyn, a pharmacist based in Brussels, “There are often several dozen medications that are in short supply simultaneously, which makes our lives very difficult.”
An audit conducted by the European Court of Auditors (ECA) last month highlighted the widespread nature of this problem, describing shortages as a “chronic headache” for the EU. Between 2022 and 2024, all 27 member states reported critical shortages of 136 drugs, including essential treatments such as antibiotics and medications for heart attacks. Belgium reported the highest number of cases, with more than a dozen critical instances—where no alternatives are available—reported to the European Medicines Agency (EMA) in 2024 alone.
The ECA pointed to supply chain disruptions and an increasing dependency on Asian manufacturers for key pharmaceutical components as contributing factors to the crisis. As a result, around 70 percent of the active pharmaceutical ingredients used in the EU are sourced from Asia. This reliance is particularly acute for common painkillers like paracetamol and ibuprofen, as well as critical medications like salbutamol, known commercially as Ventolin.
In addition to these supply issues, inefficiencies within the EU’s internal market exacerbate the situation. Drug pricing varies significantly across member states because national authorities negotiate independently with pharmaceutical producers. Olivier Delaere, CEO of Febelco, a wholesale distributor that services about 40 percent of Belgian pharmacies, explained that manufacturers often prioritize deliveries to countries that offer higher prices, leaving those who negotiate tougher deals with insufficient supplies.
The ECA noted that most medicines remain authorized at the national level, resulting in packaging variations that complicate trade between EU nations. This leads to “local shortages,” where a product is unavailable in one country but accessible just over the border, highlighting the complexity of the situation. Delaere stated, “It’s a growing problem,” as automated dispensers in his warehouse prepare orders for pharmacies, reflecting the increasing demand for limited stock.
The impact on pharmacists is significant. In 2024, they reported spending an average of 11 hours per week managing these shortages, according to the Pharmaceutical Group of the European Union (PGEU). Ronsyn mentioned that he often dedicates an hour each day to making phone calls, checking stock, and informing patients about their medication status—a situation that was not commonplace in the past. “It’s also tough for the patient, who might panic a little when they don’t get their medication on time,” he added.
In response to this escalating crisis, the European Commission has proposed a “critical medicines act” to enhance manufacturing within the EU. This initiative aims to provide incentives for production and encourages member states to prioritize factors beyond price when awarding procurement contracts. This proposal was followed by a “stockpiling strategy” introduced in July 2024, aimed at coordinating stocks and ensuring availability of medicines and other crucial goods in times of crisis.
A spokesperson for the European Commission expressed optimism about these proposals, stating that they “will make a substantial difference” in addressing the ongoing shortages. Currently, these legislative measures are under negotiation with the European Parliament and member states, a process that often takes considerable time.
Despite efforts to find solutions, Ronsyn remains skeptical about the speed of progress. “They are trying to find solutions, but it is always very slow,” he noted, while overlooking the commission offices from his pharmacy. “We will probably get there someday, but for now it’s complicated.” As the situation continues to develop, the EU faces increased pressure to find effective strategies to mitigate the impact of these chronic drug shortages on its healthcare system and the patients who rely on it.