Medication Shortages in Luxembourg-Causes and Solutions

Luxembourg is currently experiencing a medication shortage in both hospital and community settings, which is a cause for concern to patients, health professionals and the wider public. 

The international community in Luxembourg faced an absence of some of the more popular medications used to stave off colds and flu this winter in the Grand Duchy. The trusted Lemsip is unfortunately no longer available in Luxembourg pharmacies, leading to many a packet being brought back to the Grand Duchy, from trips to the UK and Ireland, where it is still freely available. Sinus sufferers were confronted with the need for a prescription for the previously over-the-counter Sinutab. From November 2024, medications containing pseudoephedrine, such as Sinutab and Sudafed, require a trip to the doctor for a prescription. However, these changes to supply are but the tip of the iceberg in Luxembourg. The predominant challenge in the Grand Duchy at the moment seems to be in relation to supply chain issues for many medications, including some significant ones. 

There are currently almost 280 medicines in short supply in the country, including chemotherapy medication, heart medication and antibiotics. The inability to access a required medication can impact treatment plans, treatment times and outcomes, with a potential increase in stress, anxiety or even fear for the patients and families concerned. However, this problem is not just confined to the Grand Duchy. The World Health Organization states that pharmaceutical supply chain issues are a global problem, occurring with greater frequency throughout all of Europe. That may be of little consolation to the many that are affected in Luxembourg, but confirms that it is not just a local issue.

Chronicle.lu reached out to Luxembourg’s Ministry of Health as well as to Luxembourg’s Association Pharmaciens Hospitaliers GDL (Hospital Pharmacy Association – APHL) to better understand the reasons behind why the country is currently experiencing a shortage of some medications and what actions can and are being taken to alleviate the situation.

Hospital pharmacists work within clinical settings, providing specialised care and ensuring the safe and effective use of medications in hospitals. Community pharmacists, as their name indicates, are healthcare providers that work closely with the public in pharmacies throughout the country. Community pharmacists in Luxembourg are represented by the Syndicat des Pharmaciens Luxembourgeois. 

According to Luxembourg’s Ministry of Health, the country faced a shortage of 278 different medications on 12 March 2025.  It states that the medicines that are currently most affected by are: antineoplastics (used in cancer treatment and including chemotherapy medication); cardiovascular medication; genitourinary system and sex hormone medication; general anti-infectives (including antibiotics) and medicines for the nervous system.

APHL also cited antibiotics, certain anaesthetic and chemotherapy medication as being the most affected in the hospital setting. The association also stressed that shortages in sourcing sterile medical devices and equipment have also become increasingly common, adding further complexity to hospital operations and patient care. The APHL added that prior to the pandemic, the association reported approximately 40 medication shortages per year, but this number has now surged to around 200 shortages annually.

According to the Pharmaceutical Group of the European Union (an association representing Europe’s community pharmacists - PGEU) the three classes of medicines most frequently in short supply in the community are cardiovascular medications, anti-infectives for systemic use such as antibiotics and medication required for the nervous system.

What lies behind the current supply chain issues in Luxembourg?

The reasons behind medication shortages both in Luxembourg and globally are multifactorial and complex. Both the Health Ministry and APHL confirmed that the most common explanation given by pharmaceutical companies is production-related issues. The production of a medication involves several steps, each subject to strict controls and none can be skipped. If an issue is detected, an investigation will be launched and if it cannot be resolved right away, production must be temporarily halted to ensure the medication's quality. Production issues include the unavailability of active ingredients, failures in the production chain or quality problems. For example, if a specific active ingredient is produced at a single site, any disruption, whether due to technical issues, climate events, or geopolitical tensions, can lead to global shortages. 

Another major factor affecting supply chain issues is an increase in demand. This can happen for example if there is a sudden rise in infections, leading to an increased demand for antibiotics or when a medication shows positive clinical results. There is much talk nowadays of a shortage of vital medication used to treat Type 2 diabetes, since the discovery that these medications are of significant benefit to those suffering from obesity. However, the medications are also highly sought after by some people who do not have obesity issues. In an effort to safeguard supply in Luxembourg, the Ministry of Health has advised that these medications can only be prescribed to patients suffering from Type 2 diabetes and not for weight loss.  Luxembourg’s CNS will not reimburse the cost, unless they are prescribed for insulin-related (diabetes) disorders. 

Maintaining large stocks of medication to safeguard against disruptions is costly for pharmaceutical firms, leading many to minimise these reserves, which further increases vulnerability to supply chain interruptions.

Regulatory issues, such as delayed approvals or changes in manufacturing standards, can also contribute to supply chain interruptions. Additionally, some medications are produced by only a few manufacturers globally, so any disruption at those facilities (e.g. severe weather events) can have a wide-reaching effect.

Also, some medicines may be discontinued, often for economic reasons, which also contributes to their unavailability.

Who is responsible for acting when supply issues are identified?

Luxembourg’s supply of medicines is regulated by the Ministry of Health which works closely with the European Medicines Agency (EMA) and other EU bodies to monitor and manage supply issues. The EMA, together with national authorities, plays a key role in monitoring and responding to critical medicine shortages within the EU. 

In the Grand Duchy, the Division de la Pharmacie et des Médicaments (Pharmacy and Medicines Division - DPM) of the Health Directorate, which operates under the Ministry of Health and Social Security, is responsible for managing supply chains and addressing any related issues. To minimise the impact of shortages on patients, the DPM has established management mechanisms. As a result, pharmaceutical companies are legally required to report any potential shortages at least two months in advance, allowing authorities time to react, provided companies meet this obligation. Additionally, the DPM actively gathers information from hospital pharmacies and other sources in the field, enabling real-time monitoring of supply conditions. This proactive approach helps identify critical shortages early and, if necessary, explore alternative supply sources to prevent prolonged or severe disruptions. The APHL emphasised that there is close collaboration between the DPM and Luxembourg hospital pharmacies to monitor, anticipate and solve medication shortages and to improve access to medication for patients in the Grand Duchy. 

Earlier this month, on March 11 2025, the EU Commission proposed a new Critical Medicines Act. This act aims to improve the production and supply of critical medicines, by increasing manufacturing capacity within the European Union and by encouraging member states to work together when buying medicines to ensure fair access. It also aims to reduce dependencies on a small number of suppliers by forming partnerships with other countries to make supply chains more stable.

Is there a list of critical medicines that are in short supply in Luxembourg and who maintains that list?

The Health Ministry explained to Chronicle.lu that, at a European level, a medicine is considered critical if it is used to treat serious illnesses and cannot be easily replaced in case of a shortage. In December 2024, the European Commission, the  Heads of Medicines Agencies (HMA) and the European Medicines Agency (EMA) published the second version of the EU list of critical medicines. This list includes active substances used in human medicine that are essential for healthcare systems across the EU/EEA: ensuring their continuous supply is a priority and shortages must be avoided.

Is there a reserve/safety stock of critical medicines within Luxembourg?

The APHL confirmed that for some medicines, such as antidotes, there is a legal requirement to keep a minimum stock for emergencies. Hospitals are also responsible for maintaining their own reserves for certain medicines. Additionally, in specific situations and for a targeted and limited number of medicines, wholesalers’ stock levels can be increased with a buffer. This must be assessed in advance where necessary, with close consultation between the authorities and wholesalers. There is also an efficient collaboration system between the authorities and healthcare providers on the ground to monitor supply levels and respond quickly to emerging shortages. 

The Health Ministry explained that hospitals in Luxembourg do not yet have the infrastructure to maintain dedicated safety stocks of critical medicines, as shortages can be difficult to predict. However, the creation of the Centrale Nationale d’Achats et de Logistique (National Purchasing and Logistics Centre - CNAL) aims to improve the management of safety stocks for critical medicines and medical equipment in hospitals. This initiative, which is currently in the legislative process, will help ensure better preparedness for potential supply chain disruptions or health crises.

The APHL also confirmed that the CNAL is expected to centralise procurement for critical products. The CNAL will have the status of a “hospital pharmacy” and will optimise processes, ensure a steady supply of essential medicines and improve distribution efficiency across the healthcare sector. By reducing the administrative burden on hospital staff and securing stock levels of vital medications, the CNAL is expected to enhance the overall resilience of the Luxembourgish healthcare system.

What impact do such supply chain issues have on the day-to-day life of a pharmacist in Luxembourg?

Hospital pharmacies are affected by supply chain issues in a different manner to community pharmacies. The APHL explained that regardless of the workplace, both hospital and community pharmacists spend a significant amount of time each day ensuring that the correct medication or a suitable alternative, can be provided to patients

According to the APHL, managing medication shortages adds a significant burden to the daily work of a hospital pharmacist. Hospitals deal with a large range of specialised medications, including injectable medications and chemotherapy agents, which are complex to produce, handle and store. More time is spent monitoring supply levels, securing alternatives and working with doctors to identify suitable replacement therapies. This often means adjusting treatment plans or switching patients to alternative medications, which requires additional communication and coordination with medical and nursing staff. Increased paperwork, regulatory reporting and administrative work also take up time that could otherwise be spent on patient care. There is also the risk of medication errors for a patient when an alternative must be provided.

The Pharmaceutical Group of the European Union recently published its Medicine Shortage Report for 2024. This survey of community pharmacists in Europe, including Luxembourg, was conducted from November 2024 until January 2025. The survey indicated widespread shortages of medicines in all 28 countries that took part. 
The survey revealed that community pharmacists spend almost eleven hours per week addressing the shortage issue, an increase of four hours per week since 2019. 71% of those surveyed reported increased administrative responsibilities as a result of supply chain issues. The pharmacists also reported that the public had lost confidence and trust in the pharmaceutical supply chain. 

Moving Forward

Pharmacies in Luxembourg dispense a large amount of prescription medications each year. There has been a significant rise in supply problems of certain medications in recent years, most especially since the pandemic. These shortages, which occur across all healthcare settings, affect patients, healthcare providers, pharmacists and the general public, despite the best efforts of authorities both in Luxembourg and in the EU to confront and resolve the problem. 

Luxembourg’s Ministry of Health will continue to play an active role in monitoring, managing and responding to supply chain issues both at a local and EU level in order to minimise the adverse impact on the public both in the community and hospital setting