Researchers at the Vienna Complexity Science Hub (CSH) and the newly founded ASCII supply chain research institute have compiled recommendations to avoid antibiotic shortages in the future. Thus, “investments in data infrastructure, planning and forecasting” are necessary, explain the complexity researchers Peter Klimek. Austria plays a central role in the current situation, as one of the few European antibiotic production sites is located in Kundl.
infrastructure construction
Klimek, a CSH researcher and head of ASCII (Austrian Institute of Supply Chain Intelligence), called for the development of infrastructure “to measure, know and be able to predict the need for antibiotics”. The second important measure is to place greater importance on security of supply and take appropriate measures, because a well-designed market must internalize the risk of a disruption, he said on Monday, when the analysis was published online.
In emergencies, additional production capacities could eliminate bottlenecks at an early stage, it was suggested as another starting point. Coordinated and more centralized EU stocks should also help reduce overall safety stocks and avoid inefficiencies.
closer cooperation
As a bargaining power pool, countries, regions or health agencies may consider closer cooperation to implement joint forecasting and procurement strategies, advises the team led by Klimek and ASCII Deputy Director Klaus Friesenbichler of the Institute for Economic Research (WIFO).
During most of the analysis period, the manufacturer Sandoz produced the active substance amoxicillin in Spain and gradually increased its penicillin production in Kundl in Tirol. At the same time, the list of antibiotics not available in Austria included several products made in Austria despite domestic production of penicillin, according to the analysis.
Austria and Spain
“Our data show that Austria and Spain are closely linked in terms of supply chains,” the researchers report. When it comes to active ingredients and bulk products, Austria is most dependent on Spain (followed by China). For packaged goods, Austria is most dependent on Germany and Italy, with significant indirect dependence on the US. Direct dependence on China has decreased over the last ten years, but this has not changed indirect dependence, as explained in relation to the situation in Germany.
“Not a new phenomenon”
Disruptions in the supply of drugs in general and antibiotics in particular “are not a new phenomenon,” according to the CSH and ASCII. Since 2014, however, bottlenecks have steadily increased in frequency and severity. With the measures to contain the SARS-CoV-2 pandemic, the circulation of other pathogens was also reduced in 2020 and the consumption of antibiotics fell by about 20%.
With the return of “normality” in 2022, demand for antibiotics has increased “and geographically concentrated production systems have led to antibiotic shortages in large parts of the world,” the researchers reported.
production concentration
There is a clear tendency for production to be concentrated in a few countries, he said in the background. This accelerated during the pandemic. 76% of intermediate production facilities are located in China and India. 59% of active pharmaceutical ingredient (API) manufacturers are also based in these countries.
Due to the higher concentration of intermediates and APIs, these segments are more affected by shocks than packaged products. The scientists emphasized that the estimated number of bottlenecks that could be solved with substitute products has already halved by 2020. The negative impact on patient care has increased.