Drug supply shortages and their perceived consequences for patients: a questionnaire survey of German and Austrian physicians

PURPOSE: Drug supply shortages are a recurring issue in developed countries, with consequences for patients even before the COVID-19 pandemic. Questions arise regarding the effectiveness and tolerability of alternative treatments chosen by physicians due to these shortages. METHODS: To answer these questions, a survey for practicing physicians was distributed to medical associations in Germany and Austria and conducted from November 2022 to January 2024. 895 physicians responded to the survey. The survey targeted 20 drugs with known supply shortages, namely amoxicillin, amoxicillin/clavulanic acid, penicillin V (phenoxymethylpenicillin), cefuroxime, cefaclor, erythromycin, cotrimoxazole, ibuprofen, paracetamol, urapidil, metoprolol, amlodipine, candesartan, tamoxifen, methotrexate, fluoxetine, lorazepam, human insulin, salbutamol and prednisolone. RESULTS: Physicians most frequently chose a different antibacterial drug (> 60% of the physicians), while for analgesics, they more often used a different dosage form of the same drug (> 33%). For antihypertensive drugs, physicians more often chose a different dosage of the same drug. In many cases, alternative antibiotics were chosen that carried a greater risk of antimicrobial resistance than the antibiotic originally intended. The treatment success for replacing antibacterials and analgesics with a different drug was rated with 4-5 on a predefined scale of 1 (very poor) to 6 (very good) in comparison to the original drug. Using the same drug in a different dosage/dosage form was also around 4-5/6 effective. CONCLUSIONS: Supply shortages can foster antimicrobial resistance through the use of antibacterials with a higher potential for resistance. The success of alternative treatments was not always considered to be very good in comparison to the original medication.