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Table 1 Examples of elements influencing the impact of a medicine shortage

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