Germany was once the pharmacy of the world.
Dax companies like Merck or Fresenius live off their founding myth of having started as a pharmacy a long time ago.
The German pharmaceutical industry is still an important player in the sector worldwide.
The rise of Biontech in the course of the corona pandemic proves what is possible in this country.
And yet the really big wheel – as in many other branches of industry – is turned further east.
China has established itself as a manufacturer of active ingredients without which little would work, India as a drug producer.
This has consequences that patients in this country feel again and again: Important medication is missing.
"Supply bottlenecks" is the term of the hour, which pharmacists are particularly outraged about.
"Bad" is the situation, says a head of the association.
I've never seen anything like it in my 30+ years of work.
The Federal Institute for Drugs and Medical Devices currently lists 299 such delivery bottlenecks for medicines.
This database contains everyday medicines such as the painkiller ibuprofen.
Children's fever juices, blood pressure and diabetes medication were also recently affected.
It's about the basics
With a view to around 100,000 drugs approved in Germany in total, that sounds like a manageable quota.
Especially since a delivery bottleneck is by no means a supply bottleneck.
What is meant by this is a delivery interruption of more than two weeks or a significantly increased demand that exceeds the supply.
Only when equivalent alternative medicines are not available do experts speak of a supply bottleneck.
This is comparatively rarely the case.
And yet every bottleneck gives cause for reflection.
It's about fundamentals and about the question that many managers and politicians ask themselves: Have we gone too far with globalization?
Shouldn't we produce more at home again?
A question that is more urgent in a field like pharmaceuticals than in consumer electronics.
You may be able to do without a new smartphone, but not vital medicines.
This number shows how great the dependency is today: 68 percent of the production sites for the active ingredients intended for Europe are now in Asia.
The train to Asia seems unbroken, as demonstrated by the innovative biopharmaceuticals division.
At present, the active ingredients are still mainly produced in Europe and North America.
But how long?
While not a single production site for biopharmaceutical active ingredients was reported in China or India before 2013, ten medicinal products manufactured in these countries have since been approved.
And so the pharmaceutical association VFA warns emphatically against "new dependencies".
China and India have long been more than the extended pharmaceutical workbench of the West.
They developed into serious competitors in the innovative field.
How much does society want to pay for health?
Which in turn leads back to domestic politics.
After all, few industries are as heavily regulated as pharmaceuticals – and in part for good reason.
Health care costs are rising and rising.
In Berlin, attempts are being made to counter this with price fixing and manufacturer discounts for tablets and the like.
The industry complains that this is intentional cost pressure and gets out when production in Europe is no longer worthwhile.
Manufacturers of generics, cheap copycat drugs, in particular, get to this point fairly quickly.
Especially in times of expensive energy and high inflation, which they cannot simply pass on.
Federal Minister of Health Lauterbach also took note of the seriousness of the situation.
The problem of supply bottlenecks is serious, he said in an interview last week.
In a new law, health insurance companies are to be obliged, if the worst comes to the worst, to also buy from manufacturers who produce with more expensive active ingredients.
It is questionable whether the deadlock can be resolved with a single new regulation.
It would be necessary to consider a fundamental reform of the healthcare system.
There remains one question for society as a whole: How much is it willing to pay for healthcare?
The delivery bottlenecks in the supply of medicines are only a small part of the overall problem.