Johanna Timonen

Medicine shortages – A study of community pharmacies in Finland

OBJECTIVES To explore the frequency, the reasons behind, and the consequences of medicine shortages in Finnish community pharmacies. METHODS During the 27-day study period in the autumn of 2013, randomly selected pharmacies reported on medicines that were in short supply from orders made to wholesalers. RESULTS Altogether 129 (66%, n=195) pharmacies participated in the study, and the study material consisted of 3311 report forms. Of the study pharmacies, 79.8% had medicine shortages daily or almost daily. Medicines in short supply were most commonly medicines that affect the nervous system (30.8%) and the cardiovascular system (17.5%). The reason behind the shortage was reported to the pharmacies in 11.2% of the shortage cases. The medicine shortages caused problems for the pharmacies in 33.0% of the cases. In most cases (67.0%) the medicine shortages did not cause problems for the pharmacies, usually because a substitutable product was available (48.5%). CONCLUSIONS Medicine shortages are common in Finnish community pharmacies. Medicines in short supply were commonly used medicines. The reason behind the shortage was rarely told to the pharmacies. Medicine shortages caused problems for the pharmacies in one-third of all the shortage cases. These shortages may be significant for the customers or the pharmacies, as they cause customer dissatisfaction and increase the workload of the pharmacy staff.

Generic substitution in Finland: lessons learned during 2003–2008

Obligatory generic substitution (GS) was introduced in Finland in 2003 with the aim of containing medicine costs. In this article The materialized impacts of GS are compared with the impacts that were anticipated before GS was introduced. The implementation of GS in Finland is described from the perspectives of generated savings, patients, physicians and the pharmaceutical distribution chain during the years 2003–2008.

The impact of generic substitution on the turnover and gross margin of pharmaceutical companies a survey 1 year and 5 years after the introduction of generic substitution in Finland

OBJECTIVES To explore and compare the impact of generic substitution (GS) on the turnover and gross margin per cent of pharmaceutical companies representing mainly original or generic products in Finland. METHODS A mail survey to pharmaceutical companies with an office in Finland and substitutable medicines in the Finnish pharmaceutical market 1 year (2004) and nearly 5 years (2008) after GS. The questionnaire were answered by 16 original and 7 generic product companies in 2004 (response rate 56%, n=41) and by 16 original and 6 generic product companies in 2008 (response rate 56%, n=39). RESULTS Turnover had decreased in the original product companies and increased in the generic product companies. The gross margin per cent had decreased in the original and generic product companies, and the companies had also compensated for it in many ways. CONCLUSIONS The study suggests that GS has promoted the sales of generic product companies in Finland. However, price competition caused by GS has generally decreased the proportion of profit from turnover in the original and generic product companies. The companies have also compensated for their decreased gross margin, which suggests that the profit in euros has not been sufficient to cover fixed costs in the companies.

The reasons behind medicine shortages from the perspective of pharmaceutical companies and pharmaceutical wholesalers in Finland

The aim of this study was to explore the reasons behind medicine shortages from the perspective of pharmaceutical companies and pharmaceutical wholesalers in Finland. The study took the form of semi-structured interviews. Forty-one pharmaceutical companies and pharmaceutical wholesalers were invited to participate in the study. The pharmaceutical companies were the member organizations of Pharma Industry Finland (PIF) (N = 30) and the Finnish Generic Pharmaceutical Association (FGPA) (N = 7). One company which is a central player in the pharmaceutical market in Finland but does not belong to PIF or FGPA was also invited. The pharmaceutical wholesalers were those with a nationwide distribution network (N = 3). A total of 30 interviews were conducted between March and June 2016. The data were subjected to qualitative thematic analysis. The most common reasons behind medicine shortages in Finland were the small size of the pharmaceutical market (29/30), sudden or fluctuating demand (28/30), small stock sizes (25/30), long delivery time (23/30) and a long or complex production chain (23/30). The reasons for the medicine shortages were supply-related more often than demand-related. However, the reasons were often complex and there was more than one reason behind a shortage. Supply-related reasons behind shortages commonly interfaced with the country-specific characteristics of Finland, whereas demand-related reasons were commonly associated with the predictability and attractiveness of the market. Some reasons, such as raw material shortages, were considered global and thus had similar effects on other countries.

The impact of electronic prescriptions on the medicine dispensing process in Finnish community pharmacies – a survey of pharmacists

To explore the impact of electronic prescriptions (ePrescriptions) on the dispensing process in Finnish community pharmacies.

Impact of electronic prescription on the job descriptions of community pharmacy staff in Finland – a survey of pharmacy owners

A fully operational and nationwide electronic prescription (ePrescription) system has been implemented by law in Finland. The aim was to explore the impact of ePrescription on the job descriptions of pharmaceutical and technical staff in Finnish community pharmacies from the pharmacy owners’ perspective. The effects of ePrescription on measures related to equipment and furnishings in pharmacies were also explored.

Electronic prescription anomalies: a study of frequencies, clarification and effects in Finnish community pharmacies

To investigate the frequency of e‐prescriptions containing prescription anomalies (=errors, ambiguities and other shortcomings), and the types of e‐prescription anomalies occurring in Finnish community pharmacies. Further objectives were to investigate how these anomalies were clarified, together with the time required, as well as the effects such anomalies had in the pharmacies concerned.

Information received and information needed on electronic prescriptions - Finnish pharmacy customers’ experiences during the nationwide implementation

To investigate (1) what Finnish pharmacy customers have learned about the implemented electronic prescriptions (e‐prescriptions), (2) from whom or where have they learned about them, (3) whether they are satisfied with the information received and if not, (4) what more information they would like.