AIMS AND OBJECTIVES: The aim of the 2019 EAHP Medicines Shortages Survey was to collect information on reasons and management strategies for medicines shortages as well as details on their impact on patients. The survey targeted hospital pharmacists (HPs), physicians (PHYs), nurses (NRS) and other healthcare professionals (OHCPs). A separate set of questions addressed patients (PTNs). METHODS: A 28-question survey was conducted by EAHP, collecting information from European HPs, PTNs, NRS, PHYs and OHCPs on the shortage situation in their respective countries. The survey ran from 7 November 2019 to 13 January 2020. The results were analysed by EAHP. RESULTS: There were 2136 HP responses to the 2019 survey compared with 1666 in 2018. While 95% of HPs and 89% of OHCPs consider medicine shortages a current problem, only 71% of PHYs and 62% of NRS state the same. Shortages of active pharmaceutical ingredients (72%), manufacturing (72%) and supply chain problems (49%) are leading causes of shortages according to HPs, while PHYs (40%) and NRS (37%) consider the pricing to be their driver. Antimicrobials and oncology medicines were most affected by shortages in 2019. Compared to 2018, the percentage of respondents who reported shortages of oncology medicines increased from 39% to 47% in 2019. HPs (42%), PHYs (36%) and OHCPs (38%) consider delays in care as the main consequence of medication shortages. The satisfaction with reporting systems for medicine shortages decreased from 56% in 2018 to 48% in 2019 for HPs, while they remain low for PHYs (36%). CONCLUSIONS: Medicines shortages affect patient care and healthcare professionals' everyday tasks. Better enforcing of the mandatory early notification of shortages and structured mitigation response is recognised by all respondents as best strategy to tackle shortages.

Hospital Pharmacy Institute of Orthopaedic Surgery 'Banjica' Belgrade Serbia

Hospital Pharmacy Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione Palermo Italy

Hospital Pharmacy Motol University Hospital Praha Czech Republic

Pharmacy Centro Hospitalar Vila Nova de Gaia Espinho EPE Vila Nova de Gaia Portugal

Policy and Advocacy European Association of Hospital Pharmacists Brussels Belgium

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Fox ER, Sweet BV, Jensen V. Drug shortages: a complex health care crisis. Mayo Clin Proc 2014;89:361–73. 10.1016/j.mayocp.2013.11.014 PubMed DOI

The Economist Intelligence Unit Addressing medicine shortages in Europe taking a concerted approach to drive action on economic, manufacturing and regulatory factors, 2017. Available: http://graphics.eiu.com/upload/topic-pages/medicine-shortages/Addressing-medicine-shortages-in-Europe-EIU.pdf [Accessed 24 Apr 2020].

World Health Organization Medication without Harm – WHO global patient safety challenge, 2017. Available: https://www.who.int/PTNafety/medication-safety/medication-without-harm-brochure/en/ [Accessed 24 Apr 2020].

Bochenek T, Abilova V, Alkan A, et al. . Systemic measures and legislative and organizational frameworks aimed at preventing or mitigating drug shortages in 28 European and Western Asian countries. Front Pharmacol 2017;8:942. 10.3389/fphar.2017.00942 PubMed DOI PMC

Miljković N, Gibbons N, Batista A, et al. . Results of EAHP’s 2018 Survey on Medicines Shortages. Eur J Hosp Pharm 2019;26:60–5. 10.1136/ejhpharm-2018-001835 PubMed DOI PMC

Institute for Safe Medication Practices Drug shortages threaten patient safety, 2010. Available: www.ismp.org/resources/drug-shortagesthreaten-patient-safety [Accessed 24 Apr 2020].

The Society of Hospital Pharmacists of Australia Medicine shortages in Australia a snapshot of shortages in Australian hospitals, 2017. Available: https://www.shpa.org.au/sites/default/files/uploaded-content/website-content/shpa_medicines_shortages_in_australia_report_june_2017.pdf [Accessed 24 Apr 2020].

US Food and Drug Administration Drug shortages: root causes and potential solutions, 2019. Available: https://www.fda.gov/media/131130/download [Accessed 24 Apr 2020].

Pharmaceutical Group of the European Union PGEU survey on medicine shortages 2019, 2020. Available: https://www.pgeu.eu/wp-content/uploads/2019/03/PGEU-Medicine-Shortages-Survey-Results-2019.pdf [Accessed 24 Apr 2020].

European Association of Hospital Pharmacists EAHP's 2014 medicines shortages report, 2014. Available: https://www.eahp.eu/sites/default/files/shortages_report05online.pdf [Accessed 24 Apr 2020].

Fox ER, McLaughlin MM. ASHP guidelines on managing drug product shortages. Am J Health Syst Pharm 2018;75:1742–50. 10.2146/ajhp180441 PubMed DOI

Griffith MM, Patel JA, Sutton SH, et al. . Prospective approach to managing antimicrobial drug shortages. Infect Control Hosp Epidemiol 2012;33:745–52. 10.1086/666332 PubMed DOI

France Assos Santé Pénuries de médicaments et de vaccins, 2018. Available: https://www.france-assos-sante.org/communique_presse/penurie-de-vaccins-et-medicaments-inquietudes-de-france-assos/ [Accessed 24 Apr 2020].

De Weerdt E, De Rijdt T, Simoens S, et al. . Time spent by Belgian hospital pharmacists on supply disruptions and drug shortages: an exploratory study. PLoS One 2017;12:e0174556. 10.1371/journal.pone.0174556 PubMed DOI PMC

Griffith MM, Pentoney Z, Scheetz MH. Antimicrobial drug shortages: a crisis amidst the epidemic and the need for antimicrobial stewardship efforts to lessen the effects. Pharmacotherapy 2012;32:665–7. 10.1002/j.1875-9114.2012.01158.x PubMed DOI

Gross AE, Johannes RS, Gupta V, et al. . The effect of a piperacillin/tazobactam shortage on antimicrobial prescribing and clostridium difficile risk in 88 US medical centers. Clin Infect Dis 2017;65:613–8. 10.1093/cid/cix379 PubMed DOI PMC

Gundlapalli AV, Beekmann SE, Graham DR, et al. . Antimicrobial agent shortages: the new norm for infectious diseases physicians. Open Forum Infect Dis 2018;5:ofy068–ofy. 10.1093/ofid/ofy068 PubMed DOI PMC

European Medicines Agency Good practice guidance for communication to the public on medicines’ availability issues. Recommendations for EU national competent authorities and EMA to ensure adequate public information, 2019. Available: https://www.ema.europa.eu/en/documents/regulatory-procedural-guideline/good-practice-guidance-communication-public-medicines-availability-issues_en.pdf [Accessed 24 Apr 2020].

Australian Government Department of Health, Therapeutic Goods Administration . Management and communication of medicine shortages and discontinuations in Australia – Steps: report, manage and communicate, 2020. Available: https://www.tga.gov.au/book-page/steps-report-manage-and-communicate [Accessed 24 Apr 2020].

Australian Government Department of Health, Therapeutic Goods Administration . Medicine shortages information initiative, critical medicine shortages and other information, 2020. Available: https://apps.tga.gov.au/prod/MSI/search [Accessed 24 Apr 2020].

Institute for Safe Medication Practices Drug shortages: national survey reveals high level of frustration, low level of safety. 15 Horsham: ISMP Medication Safety Alert, 2010: 1–4. https://www.ismp.org/resources/special-issue-drug-shortages-national-survey-reveals-high-level-frustration-low-level

Institute for Safe Medication Practices ISMP survey on drug shortages for hospital pharmacy directors or their designees only. 22 Horsham: ISMP Medication Safety Alert, 2017: 5–6. https://www.ismp.org/resources/drug-shortages-continue-compromise-patient-care

Phuong JM, Penm J, Chaar B, et al. . The impacts of medication shortages on patient outcomes: a scoping review. PLoS One 2019;14:e0215837. 10.1371/journal.pone.0215837 PubMed DOI PMC

Miljković N, Godman B, Kovačević M, et al. . Prospective risk assessment of medicine shortages in Europe and Israel: findings and implications. Front Pharmacol 2020;11:357. 10.3389/fphar.2020.00357 PubMed DOI PMC

Acosta A, Vanegas EP, Rovira J, et al. . Medicine shortages: gaps between countries and global perspectives. Front Pharmacol 2019;10:763. 10.3389/fphar.2019.00763 PubMed DOI PMC

Kaakeh R, Sweet BV, Reilly C, et al. . Impact of drug shortages on U.S. health systems. Am J Health Syst Pharm 2011;68:1811–9. 10.2146/ajhp110210 PubMed DOI

Caulder CR, Mehta B, Bookstaver PB, et al. . Impact of drug shortages on health system pharmacies in the southeastern United States. Hosp Pharm 2015;50:279–86. 10.1310/hpj5004-279 PubMed DOI PMC