From: Impact of medicine shortages on patients - a framework and application in the Netherlands
Impact | Alternative product | Disease (disability weight) | Susceptibility | Costs | Number of patients affected (% of population) | |||
---|---|---|---|---|---|---|---|---|
 | primary aspects | secondary aspects |  | vulnerability | trust in alternative therapy | to patients | to society |  |
Low | - same substance, licenced, on-label | - same regimen, strength, concentration or instruction for use - different excipients or labelling | 0–0.058 | - 19 - 75 years | full trust | full reimbursement | no extra medicines costs and/or personnel costs | <  0.05 |
Medium | - different substance, licenced, on-label - same substance, unlicenced, on-label - different substance, licenced, off-label - different substance, unlicenced, on-label - different substance, unlicenced, off-label | - interchangeable with extra control - different regimen, strength, concentration or instruction for use or storage | 0.058–0.224 | - 2 – 18 years, - pregnant and nursing women - patients with divergent metabolism | moderate trust | additional payment | minor to moderate extra medicines costs and/or personnel costs | 0.05–0.5 |
High | - no or inferior therapy available | - different route of administration | 0.224–1 | - < 2 years - > 75 years - patients depending on social care | no trust | full payment | high extra medicines costs and/or personnel costs | >  0.5 |