Heiskanen Kati, Ahonen Riitta, Kanerva Risto, Karttunen Pekka, Timonen Johanna
School of Pharmacy/Social Pharmacy, Faculty of Health Sciences, Kuopio Campus, University of Eastern Finland, Kuopio, Finland.
Espoo I Tapiola Pharmacy, Espoo, Finland.
PLoS One. 2017 Jun 28;12(6):e0179479. doi: 10.1371/journal.pone.0179479. eCollection 2017.
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.
本研究旨在从芬兰制药公司和药品批发商的角度探讨药品短缺背后的原因。该研究采用半结构化访谈的形式。邀请了41家制药公司和药品批发商参与研究。制药公司包括芬兰制药工业协会（PIF）的成员组织（N = 30）和芬兰非专利药品协会（FGPA）的成员组织（N = 7）。还邀请了一家在芬兰药品市场中处于核心地位但不属于PIF或FGPA的公司。药品批发商是那些拥有全国性分销网络的批发商（N = 3）。2016年3月至6月期间共进行了30次访谈。对数据进行了定性主题分析。芬兰药品短缺最常见的原因是药品市场规模小（29/30）、需求突然或波动（28/30）、库存规模小（25/30）、交货时间长（23/30）以及生产链长或复杂（23/30）。药品短缺的原因与供应相关的情况比与需求相关的情况更常见。然而，原因往往很复杂，一种短缺情况背后通常有不止一个原因。短缺背后与供应相关的原因通常与芬兰的国家特定特征相关，而与需求相关的原因通常与市场的可预测性和吸引力相关。一些原因，如原材料短缺，被认为是全球性的，因此对其他国家有类似影响。
