It was the third time in a short time that Dijkstra had to answer for the medicine shortages that the Netherlands is increasingly experiencing. In February she had to consider the shortage of essential antibiotics, which has still not been resolved. It did not stand alone; it previously emerged that last year 5 million Dutch people were unable to obtain a prescribed medicine due to a shortage.
On Tuesday, the House discussed an acute shortage of the asthma medicine salbutamol aerosol, the most commonly used ‘puff’ against the disease and essential for children under the age of 6. They are dependent on it because they cannot inhale other powdered substances properly. In total, half a million Dutch people use the drug. Last week it turned out that there is only a two-week supply left at most pharmacies.
NSC MP Daniëlle Jansen (NSC) wanted to know from Dijkstra how she will solve this problem in the short term, because ’87 thousand children literally have difficulty breathing’. According to Jansen, they cannot wait until ‘the government has a proper solution’.
Dijkstra pointed out to Jansen that measures have been taken to prevent worse. For example, last week the Youth and Health Inspectorate (IGJ) gave permission to pharmacists to import the drug from other countries. Scarce resources should also be reserved for children and adults should be provided with alternative resources.
But these emergency measures are not enough to solve the shortage, Dijkstra also acknowledged. For example, imports will not make up for the shortage, because almost all European countries are struggling with it, she emphasized. ‘There is only some left in Italy and Romania, but that is not enough.’ She could therefore only give the ‘disappointing answer’ that there is little that can be done in the short term except to wait and see whether production gets going again. “We can’t get it anywhere.”
That was met with little understanding. NSC member Jansen accused Dijkstra of being too ‘relaxed’ about the dire shortage. According to Dijkstra, the urgency is ‘very great’ for her, but the reality is unruly.
Depending on China and India
Dijkstra and her predecessor Kuipers often pointed out the complexity of the problem in Parliament. Some of the causes lie abroad. Many countries are dependent on production in China and India. If there is a hitch somewhere there, the consequences can be felt everywhere. A scarcity of raw materials and rising demand also play a role.
At the same time, the Netherlands seems to be suffering from global shortages remarkably quickly. According to pharmacists, the cause of this lies in the so-called preference policy of health insurers. To reduce the price of resources, they make agreements with one supplier. This means costs are lower, but it also pushes out other suppliers. If there are shortages, they will more quickly choose a sales market where they can charge more for their scarce resources. The Netherlands is therefore vulnerable.
In February, Dijkstra wrote in a letter to the House that she is looking at adjusting the preference policy and has made the first agreements about this. The KNMP pharmacy association called it ‘a first step’, but they also wrote that an effect is still pending.
As long as a structural solution is not found, only emergency measures remain. The only thing the minister seems to be able to do now is ask suppliers to report shortages earlier. In this case, according to Dijkstra, they had not done so in a timely manner, which meant that no measures were taken. In the Chamber she appealed to the companies.
Furthermore, Dijkstra seems to see little perspective in the short term. ‘If I am called back to Parliament next week because a remedy is not available, I will give the same answers again. This cannot be resolved quickly.’
