“When children are in pain, it hurts parents twice as much,” Nojan Nejatian describes the feelings he sometimes has to deal with in his pharmacy. Mothers and fathers who want to buy fever juice for their sick small children are currently being disappointed almost everywhere. The market has been swept empty, supplies are 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 to blame for the current shortage of ibuprofen and paracetamol-containing juices for children. According to Ursula Funke, President of the State Chamber of Pharmacists in Hesse, the cost pressure, the dependence on production in the Far East and the concentration on a few manufacturers of active ingredients make a significant contribution to this. “If the active ingredients are only manufactured by two or three companies and one of them fails, you can feel it all over the world,” says Funke. Paracetamol production, for example, was curtailed by a manufacturer in June, Nejatian knows.
Funke complains that drug production for the German market takes place primarily in China and India, which creates incalculable dependencies, especially in times of crisis. There are always bottlenecks in the supply of medicines, says the pharmacist, but she currently sees the shortage as “extreme”.
Own production in the pharmacy possible, but not economical
“This morning, a certain antibiotic could not be ordered,” reports Funke. In most cases, an alternative preparation can then be issued after consultation with the prescribing doctor. Before the pandemic, in such a case, a patient would be sent back from the pharmacy to the general practitioner and had to have a new prescription issued there. However, the SARS-CoV-2 Drug Supply Ordinance allows patients to be supplied with the necessary drugs without additional doctor contacts.
But there are no such alternatives to alleviate the pain of small children. Anyone who believes that they will be more successful on the Internet will be disappointed there too: “Not available”, “Not available”, “Temporarily out of stock” is what you read there as soon as you look for fever syrup for children that is said to contain ibuprofen or paracetamol.
Nejatian therefore decided to produce it himself. He now makes his own fever juices in his pharmacy. Although every pharmacist can do this in smaller quantities, the production is not commercially worthwhile. The wholesale drug, if available, would cost about three euros. In order to at least be able to cover his costs, Nejatian estimates around 10 euros. The fact that he got permission from the regional council to produce larger quantities is due to his assumption that the fever suppositories could soon become scarce. “I can see that in the ordering behavior of the pharmacies, everyone is trying to store some of it.” Then there were only juices left to calm the pain of small children – or the way to the hospital.
Since suppositories are more difficult to produce himself, he relies on the juice, which he can then sell to other pharmacists. The production is complex in any case: because the labor is expensive and the documentation of the production has to be extensive. “But ultimately it’s about being able to help the children.”