Medicine shortages in Europe



Over the past 20 years, drug shortages have surged in Europe. Although this phenomenon grabbed headlines during the pandemic, the energy crisis and the start of the war in Ukraine, this phenomenon is by no means new, nor is it solely dependent on these events. The underlying reasons are in fact much more structural, despite governments often claiming otherwise.

As there is not yet a single database recording drug shortages at the European level, MIIR and seven other EDJNet partners have created one, recording 22,107 entries from 9 countries over a 5-year period.

Main findings:

  • From 2000 to 2018 there has been a 20-fold increase in recorded drug shortages in Europe. The situation continues to worsen: according to a 2022 report, all EU countries that responded to the survey experienced drug shortages in pharmacies in the last 12 months.
  • Between 2018 and 2023, Italy registered the most shortages in absolute number (10,843) for human medicines, quite far from the second, Czechia (2,699), and the third, Germany (2,355). Greece (389) was the country with the fewest shortages.
  • The indicator that best describes the situation in each country is the median duration of a shortage. The average is 94 days; Greece has the longest median duration of shortages (130 days), followed by Germany (120 days) and Belgium (103 days).
  • Drugs related to the neural system are those missing the most in the countries where data is available (19.0% of the total), followed by cardiovascular drugs (14.5%) and anti-infectives for systemic use, i.e. antibiotics (12.5%).
  • The problem ultimately depends on a combination of economic, structural, and regulatory causes. The main ones are: the globalization of pharmaceutical manufacturing (with production concentrated in fewer sites); shifts in demand; pricing strategies and regulatory changes that impact on supply; the imposition of fixed quotas of medicines by the pharmaceutical industry; the removal of the traditional role of full-line wholesalers in some markets; the abolition and ineffectiveness of public service obligation and minimum national stock keeping requirements in some countries; the lack of priority given to smaller markets; and the effects of European internal market dynamics.


The data unit

Nikos Morfonios (MIIR, coordinator) is a Greek journalist specialised in covering public administration, immigration, human rights, nationalism and racism. A former staffer of the daily AVGI, he is among the co-founders of the Mediterranean Institute for Investigative Reporting (MIIR).

EDJNet members which took part in this investigation: