ACA points again to supply bottlenecks for medicines

For years, medicine supply problems have not only increased in Austria, but all around the world. Therefore, patient care is potentially at risk and additional costs are incurred for hospitals. It was as early as in 2019 that the Austrian Court of Audit (ACA) pointed to the supply problems of medicines in Austria and recommended to the Federal Ministry of Health to evaluate them and take appropriate measures. As examples, the ACA audited the Salzburg provincial pharmacy and the pharmacy of the Innsbruck provincial hospital were audited, each of which procured medicinal products for several hospitals, which were predominantly located in the respective province. The follow-up audit published today shows that the audited hospital pharmacies also had to deal with supply problems in the audited period from 2018 to 2020. A great deal of effort was required to find substitute medicines.

Supply chain bottlenecks and parallel exports

Supply chain bottlenecks often affected low-priced, generic medicines, such as in the case of antibiotics. The reasons for this include the increasing globalization of the production of medicines, the associated reduction in the number of possible suppliers, and the high cost pressure resulting from declining medicine prices. Parallel exports of medicines, which the Government Programme 2020-2024 envisaged to combat, are causing additional aggravation. Parallel exports refer to the resale of medicines abroad, primarily in order to achieve higher prices.

On 1 April 2020, the regulation of the Federal Minister of Health on ensuring the supply of medicines entered into force. This regulation decreed the prohibition of parallel exports for critical medicines. The likewise newly created obligation to report restrictions on distribution was intended to ensure transparency in the event of supply bottlenecks and to enable prescribing doctors and pharmacies to react more quickly. The Austrian Federal Office for Safety in Health Care (BASG) should publish a corresponding list on its website for general access.

Supply security: the Federal Ministry of Health should adapt the measures as needed

Under the lead of the BASG, several task forces and working groups were in charge of various aspects of supply security. The supply of medicinal products for COVID–19 therapy was also a topic addressed in these working groups. The ACA’s auditors positively acknowledged these efforts and measures but noted that the additional problem of supply bottlenecks, which was also due to global developments, continued to exist in the audited period.

In summary, the follow-up audit shows that the ACA makes an impact. Of the 25 assessed recommendations, the majority was implemented fully (13) or at least partly (eleven). As regards the future procurement of medicines, it was furthermore promised that compliance with the provisions of public procurement law would be ensured.

Outside employment of university professors

With the report "Outside Employment of University Professors", the ACA published another follow-up audit report today. Outside employment may only be pursued if it does not interfere with contractual obligations or other significant interests of the service. Universities may specify the “significant interests of the service” in a works agreement. The two audited universities failed to make such a specification – contrary to the ACA’s recommendation. Consequently, a central recommendation made to establish an objective and transparent procedure for the (non-)prohibition of outside employment was not heeded. The ACA therefore reiterated its recommendation to specify the “significant interests of the service”. 

Of the eight assessed recommendations, the University of Innsbruck implemented two fully, three partly and two not at all. Of the assessed nine recommendations, the University of Vienna implemented four fully, one partly and three not at all. The Federal Ministry of Education, Science and Research implemented one recommendation partly.