Nojan Ngatian describes the feelings he sometimes has to deal with in his pharmacy: “When children hurt, it hurts parents twice as much.” Almost everywhere parents who want to buy fever juice for their sick little children are disappointed. The market was empty, supplies faltering. “Sometimes we have to listen to something,” says the pharmacist who runs the Heegbach pharmacy in Erzhausen, near Darmstadt.
But neither pharmacists nor wholesalers are responsible for the current shortage of ibuprofen and paracetamol-containing juices for children. According to Ursula Funk, Head of the State Chamber of Pharmacists in Hesse, cost pressure, dependence on production in the Far East and a focus on a small number of active ingredient manufacturers contribute significantly to this. “If the active ingredients are only made by two or three companies and one of them fails, you can feel it all over the world,” Funke says. Ngatian knows that production of paracetamol, for example, was curtailed by the manufacturer in June.
Funke complains that drug production for the German market is primarily done in China and India, which leads to countless dependencies, especially in times of crisis. The pharmacist says there have always been bottlenecks in supplying medicines, but she currently sees shortages as “severe”.
Owning production in the pharmacy is possible, but not economical
“This morning, it was not possible to order a specific antibiotic,” Funke says. In most cases, an alternative preparation can then be issued after consultation with the attending physician. Before the epidemic, in such a situation, the patient would be taken back from the pharmacy to the GP, and he would have to issue a new prescription there. However, the SARS-CoV-2 Drug Supply Act allows patients to be supplied with needed medication without additional contact with a physician.
But there are no such alternatives to relieve the pain of young children. Anyone who thinks they’ll be more successful on the internet will be disappointed there too: ‘Out of stock’, ‘Not available’, ‘Temporarily out of stock’ is what you read there once you search for fever syrup for kids that is said to contain ibuprofen or paracetamol.
So Negatian decided to produce it himself. Now he makes his own fever juices in his pharmacy. Although every pharmacist can do this in smaller quantities, the production is not commercially worthwhile. The drug in bulk, if available, will cost about three euros. In order to at least be able to cover his costs, Ngatian estimates about 10 euros. The fact that he got permission from the regional council to produce larger quantities is due to his assumption that fever suppositories could soon become rare. “I can see that in the behavior of ordering from pharmacies, everyone is trying to stock some of it.” Then there were only smoothies left to soothe the aches of young children – or the way to the hospital.
Since it is difficult to produce suppositories by itself, it is based on juice, which he can then sell to other pharmacists. Production is complicated anyway: because labor is expensive and documentation of production must be extensive. “But it is ultimately about being able to help children.”