Why more than 700 medicines are in short supply in Switzerland

More than 700 medicines are caught in supply bottlenecks across Switzerland. The figure comes from drugshortage.ch, a platform operated by hospital pharmacist Enea Martinelli, and covers individual medicine packs reported as unavailable or difficult to obtain. The database offers a wider view than the federal system, which concentrates mainly on shortages and interruptions involving medicines classified as essential.

The distinction matters for patients, pharmacies and hospitals. A shortage can force pharmacists to search for an alternative pack, contact several wholesalers or ask doctors to change a prescription. Hospitals face a more complex task when an injectable drug, antibiotic or cancer treatment becomes unavailable. Substitutions can require new clinical decisions, different dosing procedures or additional monitoring.

The platform's figures also show that the problem extends beyond a single therapeutic area. An analysis found 67 medicines containing 42 distinct active ingredients with shortages rated critical or very critical. The list includes products used in oncology, infectious disease treatment, ophthalmology, haematology, neurology, pain relief and cardiology. Switzerland's medicine supply problem has therefore moved from isolated pharmacy disruptions into a broader question of healthcare resilience.

Cancer care, antibiotics and hospital medicines sit among the most exposed categories. Of the 42 active ingredients linked to critical or very critical shortages, 10 are used in cancer treatment. Five are used against bacterial or other infections, five treat eye conditions and five concern blood disorders. The list also includes ingredients used in neurology, pain relief, heart disease, addiction treatment and psychiatry.

Several further shortages affect endocrinology, obstetrics, anaesthesia and supportive care. The source does not identify every product or explain the clinical severity of each individual case, so the database should not be read as a measure of patients left without treatment. It does show how many points of care can be affected when a common medicine or a specialised hospital product disappears from normal distribution.

Older generic medicines, antibiotics, injectable cancer drugs and opioids are especially vulnerable internationally. They can have few suppliers, narrow profit margins or technically demanding manufacturing processes. When a manufacturer fails a quality inspection, loses access to raw materials or delays production, buyers may have nowhere else to turn quickly. Hospitals can draw on reserves, but reserves are designed to buy time, not replace a functioning supply chain indefinitely.

A concentrated global supply chain can turn one factory problem into a shortage across several countries. Many active ingredients and finished medicines are now produced by only a small number of manufacturers. A quality failure, production delay, raw material shortage, transport disruption or sudden rise in demand at one site can reduce supply far beyond the factory's home market.

That structure leaves older generics and complex products with limited room for manoeuvre. Manufacturers may have little commercial incentive to maintain multiple production lines for medicines that sell at low prices. Wholesalers and healthcare providers then compete for constrained deliveries, while regulators and hospitals try to identify safe substitutes.

Switzerland carries additional exposure because it is a relatively small market and depends heavily on international production. Manufacturers may be less inclined to maintain several suppliers for Swiss distribution or prioritise the country when stocks tighten. The country can also face delays linked to cross-border logistics and decisions made at production sites serving multiple national markets. These are structural weaknesses, not problems that pharmacies can solve through better shelf management alone.