Have you noticed the medicine shortage?

Daily Life, Swiss News and General Topics
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Did you ask him why?

Gifts and Incentives for Doctors for choosing specific brands are now illegal here but I don’t believe for a second that it doesn’t go on.

I listened to a podcast about it once. There’s definitely the placebo effect here with many patients claiming that specific brands and types are more effective.

Case in point was Nurofen for Period pain, Nurofen for back pain, and Nurofen for Headaches.
They cost more but Nurofen cannot target specific areas of the body.

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And, I believe, were exactly the same although the packaging was different.

I always ask for generics and ask for the cheapest over-the-counter (ibuprofen and paracetamol).

Yes, I did ask him why and he didn’t give me a straight answer. He was quite embarrassed, just saying “It’s up to you to tell the pharmacists”.

Do I rock the boat? This likely means changing oncologists which I really don’t want to do.

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My endocrinologist always prescribes the brand name but adds a note at the end of the prescription saying they can be substituted with generics if they are available.

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I thought the Swiss insurance companies issued a directive a few years back that they would only pay x% of a brand name if a generic was available.

I have encountered only one true shortage, where the pharmacist said the medication wasn’t available and they didn’t know when it would be. They always ask if I want generic if it’s available. But even generics here are way more expensive than in the U.S.

More and more what I encounter is that they don’t have the medication in stock and have to order it, which means making a second trip to the pharmacy.

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I believe they are just too lazy to learn the generic names so stay with what they know

Or are super cautious about potential liability claims when prescribing generics

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  1. Shortages of medicines in CH occur, because (a) pharma companies are sh*t at forecasting and logistics, (b) productions are made by 3rd parties (CDMOs), and larger markets / distributors have priority (large production batches)… particularly as the Swiss market requires specific secondary packaging.
  2. There are 16 different producers of Colecalciferol (Vit. D3) currently commercialized in Switzerland; some of them with up to 4 different SKUs. Most of the products are sold under ‘B’ (some ‘D’) class (partially reimbursed with Rx), although they can be also be purchased without Rx/without reimbursement. (Calciferol, also Vit D3, requires Rx). I am not going to say that it is impossible, but the probability of a stock out of 16 different companies at once is an extremely unlikely event. I believe that probably the pharmacy was out of stock of the 1 or 2 brands that they carry (because they have better margins for large quantity purchases), and they didn’t have the others. But that does not mean that they are ‘out of stock’ in the whole Switzerland…and even less, that Vit D3 is out of stock (particularly in winter, when it is most used!)
  3. There are very good pharmacists, and then there are pharmacists that are more commercially minded. Like everybody in any profession…
  4. It is legally forbidden for the pharma companies to commercially engage with physicians. I could extend on it - but I guess that could be very boring
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It’s very interesting actually, feel free to expand on 4.

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A quick web search would show that Novartis, a prominent Swiss Pharma company has been prosecuted all over the world for bribing doctors (from S. Korea to the USA).

It’s not supposed to happen here (but then it’s not supposed to happen in those other countries either).

I read somewhere that Switzerland is one of the least corrupt countries in the world.
Unless someone can prove otherwise, I’m convinced that’s because they do all their corruption overseas (Novartis, Nestle, Glencore etc etc etc), and in a major way.

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EFPIA Homepage

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OK, it’s probably not THAT interesting =)

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