The COVID-19 pandemic has shone a spotlight on serious pre-existing issues for the delivery of cancer care in Europe, including those of medicines, products and equipment shortages.
Medicines shortages are a global problem for the treatment of many diseases, including cancer. Delays and interruptions to chemotherapy can be detrimental to the patients’ treatment and highly distressing for them, their families and carers.
Furthermore, cancer medicines affected by shortages often have few or no proven effective alternatives. During the peak of the COVID-19 pandemic in Europe, 50% of oncology pharmacists experienced shortages of essential anticancer medicines, and in some hospitals and regions, these shortages affected more than ten different drugs34.
Dramatic shortages have been experienced across Europe in a wide range of medical products and equipment, including ventilators, disinfectants, and diagnostic tests. Availability of personal protective equipment (PPE; masks, medical gloves, protective garments) has also been compromised in hospitals. These disruptions have contributed to impairing the continuity of cancer care and to placing at risk both patient and professional safety.
Measures such as urgent reprofiling of existing manufacturing capacity in-country have a strong role to play in handling surges in demand, alongside pragmatic stockpiling for this eventuality. In this regard, the development of the European Commission’s RescEU common reserve following the first wave of the COVID-19 pandemic demonstrates how lessons have been learned quickly. Furthermore, the participation of 7 non-EU countries in this health solidarity approach is a powerful sign of strong leadership by the EU in fostering health cooperation within the entire region.
To build back better from COVID-19, and to demonstrate policy lessons learnt, the medicines shortages crisis in Europe needs to be resolved. Through Europe’s Beating Cancer Plan and the new EU Pharmaceutical Strategy, we need to:
• Strengthen the EU legislative and operational framework in respect to prevention, early notification, monitoring and management of shortages;
• Promote an increase of production sites of active pharmaceutical ingredients and manufactured products;
• Strengthen cross-region collaboration to ensure the highest quality standards;
• Enable easy redistribution of medicines across European borders in case of emergency;
• Foster permanent action-oriented dialogue with all relevant actors of the supply chain (including the European Medicines Agency, national regulators, pharmaceutical industry, patients and healthcare professionals); and
• Bring about the urgent improvement of early warning systems and information-sharing between European countries with respect to medicines shortages.
Furthermore, the recent proposal of the European Parliament to build a European contingency reserve of medicines of strategic importance35 should be the most serious and urgent consideration.
Protecting the safety and health of all healthcare providers is an absolute requirement for the delivery of quality cancer care. As COVID-19 respects no borders, and in a time when nations should come together to support one another’s citizens, we recommend other non-EU countries be welcomed to participate in RescEU’s COVID-19 support mechanisms.
European countries should make a joint and public expression of the right of every individual working within Europe’s hospitals to access the best quality PPE.