Foreword

Shortages of medical products in OECD countries – including essential medicines and medical devices – were common prior to COVID-19. The pandemic put immense strain on already stretched supply chains, as a result of both unprecedented levels of demand and widespread bottlenecks in supply. It has become clear that despite countries’ efforts to curb medical product shortages, both routinely and in times of severe crisis, urgent action is needed.

Previous analysis identified the main reported root causes of medicine shortages across OECD countries, namely issues in manufacturing quality, and economic factors such as high pressure on prices of off-patent multi-source medicines in some contexts. The high concentration of some manufacturing steps (e.g. active pharmaceutical ingredients) in a small number of sites, often concentrated in the same geographical area, was also identified as a potential supply chain vulnerability (e.g. to natural disasters). While more robust data to understand this complex problem is needed, these reports already highlighted the need for more information on supply chains to better anticipate and potentially avert occurrences of shortages.

This report, based on further investigations on medicine and medical device supply chains, on case studies (vaccines, plasma-derived medicinal products and continuous positive airway pressure devices), and on stakeholders’ consultations, aims to identify available policy options to better anticipate and reduce shortage risks, both in routine circumstances and in the context of severe crises.

Although sound evidence of the effectiveness or cost-effectiveness of policy options is not always available, the report lists several strategies to improve the security of supply of medical products. Better anticipation of risks is a key priority and depends on improvements in regulators’ visibility of manufacturing and distribution supply chains. This not only requires regulatory changes to impose information sharing but also significative investments in data infrastructure and analytics. The reduction of shortage risks should also be a key priority, and this rests on a better identification of the root causes to better address them. Public policies should focus on more strategic procurement to contribute to market shaping that is more conducive of reliable supply chains. Public policies could also support the expansion and diversification of supply of medical products for products assessed as “critical” for countries. Further trade facilitations and regulatory harmonisation would ease the movements of good across countries. Beyond all these strategies, countries also need additional capabilities to prepare for severe crises.

Co-operation between countries and between the public and private sectors will be crucial to really improve the security of medical supply chains.