Pharmacists Still Struggling with Inventory Problems After Winter Wave of Demand for Cold, Fever Medicines

By Mayumi Honda and Rena Azuma / Yomiuri Shimbun Staff Writers

13:35 JST, May 17, 2023

Cold remedies and antipyretics have been running short across the country, making it difficult not only for consumers but also for pharmacies and drugstores to get them.

They were in tight supply during the year-end and New Year holidays due to the spread of novel coronavirus infections. But pharmacies and drugstores across the country are still finding it difficult to keep them steadily in stock.

Amid concerns that coronavirus infections may spread again as early as summer, it is an urgent task for drugmakers to stably supply both prescription and over-the-counter medicines to the market.

Lending drugs among stores

“In addition to a variety of drugs for cold symptoms, it’s difficult to get lozenges. Stocks of herbal medicines, such as Kakkonto, are also low,” said Masanori Hajiri, a pharmacist in the city of Katano, Osaka Prefecture, who is a member of the Osaka Pharmaceutical Association.

In particularly short supply are drugs that relieve sore throat, such as tranexamic acid, and antipyretics — or fever-reducing drugs — such as acetaminophen.

Hajiri said commonly used drugs have become more likely to run short since the year-end and New Year holidays, when coronavirus and flu infections rose simultaneously.

A major pharmacy with branches nationwide also said that some of its stores still have to wait longer than usual before receiving the drugs they have ordered, and that its stores have to lend drugs among one another.

Scandals affected production

The Health, Labor and Welfare Ministry says the backdrop to the current situation is the fact that production of antipyretics and other cold medicines failed to catch up with demand, which skyrocketed with the spread of the omicron variant of the novel coronavirus.

Sources close to the pharmaceutical industry said drugmakers have been making efforts to increase production in response to requests from the health ministry. But no data has been disclosed to show increased production by individual drugmakers, so perceptions of scarcity have persisted.

Under such circumstances, individual drugmakers continue a practice called “limited shipment,” in which products are preferentially sold to existing customers. In fact, results of a survey released in March by the Federation of Pharmaceutical Manufacturers’ Associations of Japan showed that shipments were either limited or suspended for 80% of 59 types of acetaminophen drugs. Similarly, about half of tranexamic acid shipments were limited or suspended.

Out of concern about supply shortages, an increasing number of wholesalers and pharmacies began making excessive orders in an effort to secure drugs for their customers and patients, accelerating the sense that the drugs were running short.

“In response to the health ministry’s request, we are cooperating to adjust the supply-demand balance, but there is a limit to what we can do, as the production volume is limited,” said one wholesaler.

In addition, some people point to the lingering effects of decreased production of certain drugs as a result of some generic drugmakers being ordered to suspend production in a series of scandals since the end of 2020.

Transparency of distribution

Regarding the coronavirus outlook, a leading member of an advisory body to the health ministry indicated that if a ninth wave of the coronavirus pandemic hits, its scale could be larger than the eighth wave.

Compared with the United States and European countries, the proportion of the population who acquired immunity through natural infection is small in Japan. While the antibody prevalence rate, which shows the history of infection, is nearly 90% in the United Kingdom, the figure was about 40% in Japan as of February.

“People’s immunity acquired through infection and vaccination weakens gradually, so the infection will likely spread in summer,” said Takaji Wakita, head of the National Institute of Infectious Diseases.

Effective May 8, the government downgraded COVID-19’s status to Category V under the Infectious Diseases Law, the same level as seasonal flu, relaxing infection control measures. This raises concern that demand for antipyretics may rise again with the spread of infections.

As drugmakers are expected to further increase production, they will have to make more capital investment and secure a bigger workforce to do so. There is also a risk that they will suffer losses if there turns out to be less demand than expected despite their increased production.

As the prices of certain prescription drugs, such as antipyretics, are set low, sources close to drugmakers said it could be difficult to increase production while also maintaining quality.

“If the next big wave arrives, we may face a deepening shortage of medicines across the country,” said Yoshihiro Abe, deputy chairman of the Japan Pharmaceutical Association. “As initial measures, we’d like to share information on stock in individual regions and lend products among pharmacies.”

He called on the government to set up a system to disclose the amount of production and the state of distribution to avoid excessive orders, and take measures to help drugmakers increase production.

Health ministry officials said they would discuss with concerned parties how to make the distribution of drugs more transparent.