Paracetamol juice: Prescription only soon?

Pro Generika pointed out another looming supply bottleneck this week. This time from paracetamol. Pharmacies have noticed for a long time that there are always supply problems with the preparation. Already in mid-March, it was clear that many wholesalers were sold out and manufacturers were not replenishing them. Now 1A Pharma has also announced that it will stop producing paracetamol juice due to lack of profitability.

The first supply bottlenecks in March

Top dog Ratiopharm was unable to deliver paracetamol juice in March. Full stock was delivered to wholesalers in early March, according to a spokesperson at the time. “The background of the temporary supply disruption is an extremely short-term increase in demand. This has also led to supply disruptions among competitors. Our own pharmaceutical production cannot cover this uncalculated need at such short notice.

And now Ratiopharm seems to be the only producer of paracetamol juices. As of May 1, 1A Pharma announced that its product is no longer available for sale. According to the currently available March sales data, the market shares are divided as follows:

  • Ratiopharm: 60 percent
  • 1A Pharma: 30 percent
  • Bene (Ben-u-ron): 10 percent

“Since Ben-u-ron is well above the fixed amount, we expect that most of the volumes will be transferred from 1A to Ratiopharm and our market share will be 90 percent in the future.”

The obligation that the market must continue to be supplied with goods is known, said the spokesperson. As a result, the company announces that it will continue to sell paracetamol juice. Nevertheless, according to Ratiopharm, only the suspension of fixed amount and discount contracts would alleviate the situation in the long term.

“With frozen prices, rapidly rising drug and production prices make the production of drugs such as paracetamol juices an unprofitable business. No company can keep up with this in the long term,” warns Andreas Burkhardt, General Manager of Teva Germany and Austria and Vice Chairman of Pro Generika. “We finally need to ease the cost pressures on generics – especially for critical drugs that are made by only a few manufacturers. Fixed amounts and discount deals need to be suspended until more companies start supplying them again. Otherwise, supply bottlenecks will occur – and we know this not just with tamoxifen.

For Pro Generika, the shrinking market for liquid paracetamol is the best example yet again of how dangerous the cost pressure of generics is on patient supply nationwide. The fixed price of 1.36 euros per bottle of paracetamol juice has been valid for 10 years. Growing production costs, for example due to the rise in energy prices, have not led to an adjustment of these amounts so far.

What about empty drawers?

One way to compensate for the missing product is patient-based manufacturing based on a prescription. For example, the active ingredient can be processed at a dose of 50 mg/ml in Syrspend base. The shelf life of the preparation is 90 days. It can be stored both at room temperature and in the refrigerator. Processing in SyrSpend SF pH4 powder is also possible. Therefore, SyrSpendSF is not suitable for the preparation of Alka suspension. “Base for oral suspensions DAC” is also suitable for the preparation of paracetamol suspension. The shelf life of the 40 mg/ml suspension is four weeks. Since shakeability is not optimal, the primary container used should hold about twice the intended volume. Parents should be advised to shake vigorously before administration.

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