The Austrian Medical Chamber (Ärztekammer) has raised an early warning about looming medicine shortages, stating that hundreds of drugs are already regularly unavailable. “We’ve unfortunately almost grown used to that,” said Chamber President Johannes Steinhart on Tuesday. Due to current developments, the situation could worsen further—especially during the colder months. Key reasons include mounting price pressure on pharmaceutical manufacturers and the possible introduction of ingredient-based prescriptions.
At a press conference, Steinhart and Ernst Agneter—specialist in pharmacology and president of the Society of Physicians in Vienna—painted a troubling picture for the months and years ahead. “Sick people not receiving urgently needed medications is medically unacceptable and shameful for a wealthy country like Austria,” Steinhart emphasized.
Austria No Longer Attractive for Drug Manufacturers
The drug pricing system introduced in 2017 capped the reimbursable price of medications at just 20% above the cheapest identical drug. This has led Austria to be perceived internationally as a low-price country for medications, according to Steinhart. As a result, manufacturers increasingly withdraw from the Austrian market. Agneter cited the example of the broad-spectrum antibiotic Amoxicillin—often used for children—whose price has been cut five times.
Another “fatal mistake,” Steinhart argued, would be the proposed shift to ingredient-only prescriptions. This system would have doctors prescribe only the active ingredient, while the specific drug dispensed would be chosen by the pharmacist—often favoring cheaper generics. Steinhart criticized this approach, stating, “The doctor knows the patient and their needs best.” He warned that financial incentives, inventory levels, or profit margins could start influencing dispensing decisions instead of patient needs.
Patients Struggle With Changing Medications
Frequent changes in medication brands or forms can confuse patients and reduce adherence to treatment plans, Steinhart noted. Patients often rely on the color, shape, or packaging of a drug for identification and don’t recognize the names of ingredients. “Many just say, ‘I don’t understand anything anymore,’” Steinhart added.
He also warned of the risk of dosing errors, such as with generics that lack scoring lines, leading patients to accidentally take whole pills instead of halves. Agneter noted that for the ingredient Simvastatin alone, there are seven variations in form and strength—raising the chance of dangerous mix-ups.
Diabetes Drug Metformin at Risk
Generics have driven drug prices down to the point where many manufacturers are pulling their products from the market. On average, 20 generic drugs exit Austria’s reimbursement system each month due to unprofitability. For example, Atorvastatin entered the list in 2005 with a factory price of €33. Today, the cheapest version is just €3.24—almost a 90% drop in 20 years.
Adding to the concern, Agneter warned that an upcoming EU urban wastewater directive could endanger the supply of Metformin, a widely used and affordable medication for type 2 diabetes relied on by around 130 million patients globally.
Industry Joins in Opposition to Prescription Reform
Alexander Herzog, Secretary General of the pharmaceutical industry association Pharmig, also opposed ingredient-based prescriptions in a public statement. He argued this measure would only increase confusion without solving shortages. “Concrete measures to fight supply bottlenecks have already been taken,” Herzog said, stressing that medicine shortages require coordinated action on a European level, as the issue transcends national borders.
