Disruptions in the availability of medicines have been particularly bad this year.There have been delivery failures especially with blood pressure and mood medications and e-pills.Many familiar over-the-counter medicines, such as allergy, pain and fever medicines and yeast infection medicines, have also run out of pharmacies.Currently, there is a shortage of, for example, certain over-the-counter medicines, blood pressure medicines and antidepressants.The head of the unit, Timo Mauriala, from the Pharmaceutical Safety and Development Center Fimea, says that Fimea has so far received more than 1,400 reports of availability problems.That is already more than last year, when there were a total of 1,213 notifications.- Availability disruptions are currently a worldwide problem, says Mauriala.Iltalehti reported in August about the end of certain medicines for the treatment of breast cancer.The availability of parallel products was also weak.For example, there was a shortage of the breast cancer drug letrozole, which is used by thousands of women in Finland.Letrozole is used, among other things, as an adjunctive treatment for early-stage hormone-dependent breast cancer and as a treatment for advanced breast cancer.In the story, a patient was interviewed who said that running out of the medicine caused anxiety and fear in the women who used it.According to Emmi Puumalainen, communication pharmacist of the Finnish Pharmacists' Association, the availability of letrozole has improved considerably.- One title is already available in pharmacies normally.Even though we have to wait for several Letrozole titles to arrive on the shelves only in November or even December, pharmacies will be able to supply an interchangeable product that can be found on the shelf.However, parallel preparations are not completely suitable for all patients, even though the active ingredient is the same.Oxytocin preparations have also had an availability problem in August and September, but according to reports received by Fimea, the situation has normalized at the beginning of October.Oxytocin is used in maternity hospitals to speed up the progress of labor.There are many reasons for running out of medication.Often the reason is in production.At the beginning of the year, Fimea was informed that the reason behind the disruptions is the increasingly widespread decentralization of manufacturing.The raw material may be manufactured in China, the tablet in India and the packaging in Ireland.If someone messes up in a long production chain, it can affect the availability of pharmaceutical products worldwide.Disturbances are also often related to production quality problems.The background could be, for example, a shortage of raw materials or another problem in the manufacture or distribution of medicines.- For example, in the case of a raw material shortage, the availability problems can eventually spread to all factories using the same raw material, says Puumalainen.For example, there was a shortage of e-pills from 11 brands in the summer.- Availability disruptions can also be caused by a sudden increase in spending when one drug runs out and you switch to another similar product or one used for the same purpose.This kind of thing cannot be predicted, and stocks may not be immediately replenished in Finland, says Puumalainen.The long order and logistics chains for medicines make it difficult to react quickly in the event of unexpected disruptions, so it may take a long time before the increased demand can be met.There is still a shortage of some contraceptives, but according to Fimea Mauriala, the problems with the availability of e-pills are getting easier.Disruptions in the availability of medicines often cause headaches for the customer, says Puumalainen.- The customer can wonder if he can get the medicine at all.At worst, it can be a situation where you have had to search for a suitable product for a long time in order to make the treatment successful.It is problematic if a directly similar medicine cannot be found.However, according to him, the patient does not need to be especially prepared for the matter.For example, it is not a good idea to store large quantities of medicines, as there is a substitute for the vast majority of medicines.Just under a quarter of the delivery shortages are related to a longer-term availability problem.- Almost always, a solution can be found - most of the time when doing business at the pharmacy.However, it is good to pick up the medicines in good time before they run out, for example when there is still a week's worth of medicine left.In the event of an availability failure, there is then time to find a replacement solution.According to Puumalainen, some of the situations would be made easier if the doctor had up-to-date information on the availability of the medicine already when writing the prescription.Now the problem is that when writing a prescription at the reception, the doctor cannot see if the medicine is available and if so, from where.Such an up-to-date system, from which you can see the availability of medicines, does not yet exist.However, the situation is about to improve, because according to Mauriala, Fimea will introduce the Lääkehaku service in January.In the future, you can find information in the drug search if the requested Medicinal product is currently experiencing an availability problem.According to Puumalainen, the Apteekkariliito has not been informed that patient safety has been compromised due to availability problems.- No such cases have come to our knowledge.The reliability of the supply of medicines is monitored annually, and in connection with that it has become apparent that only in the case of less than a thousand medicine shortages, this is an opportunity to delay the start or continuation of medicine treatment.According to experts, it is impossible for Finland to solve all the root causes of availability problems alone.As a solution to the availability problems, it has been proposed, among other things, to increase the current stockpiles of medicines.In Finland, there is a compulsory storage act, according to which pharmaceutical factories, importers of pharmaceutical products, health care operational units and the Institute of Health and Welfare are obliged to maintain a stock of certain medicines in case of exceptional circumstances.There are currently a total of 1457 medicinal products in the list.According to Fimea Mauriala, mandatory storage can already combat problems caused by availability disruptions, but since it does not apply to all groups of medicinal substances, it cannot be used to prevent all disruptions.- Increasing the obligation stocks would perhaps make the situation somewhat better, but the actual problem cannot be solved with that.We listed examples of medicines whose availability is currently problematic.The listing is based on currently valid availability notices published by Fimea.You can check the status of your own medication on Fimea's website.The date when the interruption in availability of the medicine is estimated to end is also recorded in the availability disruption bulletins on the website.Aspirin Zipp granules (pain and fever medicine)Bepanthen 100 mg lozenge, 20 tabl.(stomatitis and pharyngitis)Berocca Citrus & Orange effervescent tablet (vitamin)Burana 400 mg powder (pain and fever medicine)Canesten 200 mg vaginal suppository (yeast infection)Canesten Kombi 500 mg+10 mg/g vaginal suppository and creamCarbo Medicinalis 250 mg tablet, 50 & 150 tabl (diarrhea)Histec 10 mg tablet, 100 tabl.(allergy symptoms)Oculac 50 mg/ml eye drops solution, 10 ml (dry eyes)Pamol F 125 mg, Pamol F orally disintegrating tabl.500 mg (pain and fever medicine)Scheriproct Neo Kombi, suppository and rectal cream, 15 suppositories + 30 g rectal cream (hemorrhoids)Pantoprazole Mylan 20 mg 28 and 56 tabletsZantac 15 mg/ml oral solution, 150 mg effervescent tablet, Zantac 150 mg, 300 mg tablAtenblock 25 mg, 50 mg, 100 mg tabletCandesartan HCTZ Orion 32 mg/25 mg tabletEmconcor Comp 5 mg/12.5 mg tabletLosartan Orion HCTZ 100 mg/25 mgOlmesartan medoxomil/amlodipine Accord 40 mg/10 mgOlmesartan medoxomil/Hydrochlorothiazide Krka 20 mg/25 mgPerindopril Orion 4 mg (90 tablets), 8 mg (30&90 tablets)Pravastatin ratiopharm 40 mg (30 and 100 pcs)Rosuvastatin Orion 10 mg tablet, 28&98 tabl.Alprazolam Krka 1 mg, 20&100 pcsOlanzapine Orion 7.5 mg (tab), Olanzapine Orion 5mg, 15 mg, 20 mgEvorel Conti 50 microg/170 microg/24h depot patchZoely 2.5 mg/1.5 mg 3 x 28 and 28 pcs