When I tried to receive the medicine I was accustomed to taking at the usual pharmacy, "I'm running out of that medicine now ..." In



fact, the supply of medicines is on an unprecedented scale all over the country.



Which medicine?

why?

How long will it last?


I have summarized what I know and what I should be aware of.


(* Scheduled to be broadcast on NHK News "Good Morning Japan" at 7 am on 21st (Friday))

Which medicine is missing?

The Ministry of Health, Labor and Welfare believes that there are at least 3,000 items of drugs that have been delayed or restricted from being shipped to pharmacies and medical institutions.

This is about 20% of all medical drugs.



The main illnesses for which these drugs are used are:


(* Confirmed on the website of a pharmaceutical company as of January 20, 2022)


▼ Allergies (asthma, urticaria, atopy, pollinosis, rhinitis ...)


▼ Hypertension, angina, arrhythmia


▼ Epilepsy


▼ Bronchitis


▼ Pneumonia


▼ Rheumatoid arthritis


▼ Rhinitis, gastric ulcer


▼ osteoporosis


▼ heart failure, angina


▼ stroke


▼ viral infection ...



In addition,


▼ antihypertensive and analgesic agents


▼ antibacterial agents are also included.

What do you do when you don't have medicine?

When "the medicines you take all the time" aren't enough, pharmacies often interact with the prescribing doctor and give you "drugs of the same ingredients" made by another manufacturer instead.



When the NHK interview team interviewed at a pharmacy in Nishitokyo City, Tokyo in December, "due to lack of medicine, we had to switch to another medicine at a rate of" 1 in 4 or 5 ". There were pharmacists who spoke at the same rate at other pharmacies.



In addition, a pharmacist at another pharmacy in Tokyo, who was interviewed on the 13th of this month, said, "I have the impression that the situation is getting worse day by day," and this situation is still continuing at pharmacies and medical institutions around the world. increase.

Why did you get up?

The trigger was the scandal of Kobayashi Kako, a generic drug manufacturer in Fukui Prefecture, which was discovered in December 2020, about a year ago.

The ingredients of sleep-inducing agents have been mixed into the treatment of fungal diseases such as athlete's foot, causing health hazards to more than 240 people all over the country, and systematic fraud such as manufacturing in processes not approved by the government for many years. The malicious facts such as the fact that it kept hiding in the air became clear.



In response to the situation that undermines trust in such drugs, prefectures nationwide conducted on-site inspections without prior notice, and inspections were strengthened, and self-inspections by manufacturers were also conducted.



As a result, problems in the manufacturing process were found at multiple manufacturers, including one of the three major generic companies, Nichi-Iko (Toyama), and orders to suspend operations were issued one after another, and a wide variety of pharmaceutical products were shipped one after another. It was stopped.



"Kobayashi Kako", which was the beginning, did not resume even after the period of the business suspension order, and it was decided to transfer the factory etc. to another major generic company, and "Nichi-Iko" will be fully resumed. Not reached.

Professor Hiroyuki Sakamaki of Kanagawa University of Health and Welfare, who is familiar with pharmaceutical issues, says, "There is an unprecedented supply shortage."

On top of that, he talks about the fact that the supply shortage continues even after a year or so from the beginning.



"When one company stops shipping, orders are concentrated on another company that makes drugs with the same ingredients. Even the company that received the order has to exceed its own supply and limit shipping, and more. Shipment adjustments will spread to other companies as if they were playing billiards. I think that the situation of supply shortages that became large due to this peaked around last summer and has not recovered since then. "

The medicine has changed ... what should I do?

What should I do if a pharmacy gives me a different medicine than usual?

Based on the advice of a pharmacist interviewed at a pharmacy in Nishitokyo City, I would like to introduce two points to note.

[Caution 1] Listen carefully to the pharmacist's explanation

It may seem obvious, but first of all, it is important to listen carefully to the explanation when you get the medicine prescribed at the hospital at the pharmacy.

This is because even if the original medicine and the ingredients of the medicine are the same, the "color", "shape", "number of times of drinking" and "timing" may change depending on the manufacturer.

If you forget to take the medicine and the symptoms recur, or if you have the "usual medicine" on hand, you may take it twice and have side effects.



When you are worried, it is recommended that you divide the amount you drink the next day into bags the day before.

However, some medicines are sensitive to humidity, so I would like you to leave them out of the sheet for only one day.

[Caution 2] If you feel something is wrong, consult immediately

Basically, the same effect can be expected even if the drug is made by another manufacturer if it has the same ingredients.

However, there are rare people who do not fit their constitution because the additives are different depending on the manufacturer.



If you feel that your medicine is less effective than your usual medicine, or if you feel unwell, do not hesitate to consult your pharmacy immediately.

"Original medicine" When will you return?

How long will this shortage of medicines continue?



Unfortunately, it seems unlikely that it will be resolved next month or next month, and the current situation is expected to continue for the time being.



Looking at the production of medicines, first of all, it is necessary to increase the production by the amount that the shipment has stopped and the supply has decreased, but in the case of medicines where safety is strictly required, it will take one year to expand the production equipment.



Some manufacturers are taking measures to extend the operating hours of their factories, but the current situation is that the addition of about 10% to 20% is full and it is far from making up for the shortfall.

Under these circumstances, one of the guidelines for when large-scale production increases are possible is the large-scale announcements made by two major generic companies, Sawai Pharmaceutical and Towa Pharmaceutical, one after another in the fall of last year. We are planning to increase production.



Two years later, by the end of 2024, the production capacity of billions of tablets will be increased, and it is expected that the current drug shortage will be gradually resolved.



On the other hand, the Ministry of Health, Labor and Welfare is calling on pharmacies and medical institutions to request manufacturers to increase production and refrain from placing more orders than necessary, but the situation is not sufficient.



Professor Hiroyuki Sakamaki of Kanagawa University of Health Services graduate school said, "In the United States, government agencies collect information from manufacturers about which medicines are likely to be in short supply and when, and the government should implement such a mechanism to control the confusion. We need to hurry up and get it in order. "