526 shortage notices, and why most of them are not empty shelves

Germany’s Federal Institute for Drugs and Medical Devices (BfArM) published 526 supply-shortage notices in its public database on Tuesday morning¹. The newest updates, all dated Monday 26 October, concern products many people take or meet in hospital: sertraline 50 and 100 mg tablets from one maker, three strengths of amitriptyline from another, the contrast agents Accupaque and Visipaque used in CT scans, the potassium binder Resonium A and an acne-strength doxycycline¹.

Read the entries slowly. Each notice is for a named product from a named company, with a start and an expected end date. The sertraline notices run from April 2025 to 16 November 2026; the amitriptyline ones to 20 November; Resonium A from 26 October to 23 November¹. Most give the reason as “Sonstige”, other. The production problems are listed separately: gabapentin and levetiracetam from one generic maker, and a biosimilar adalimumab until January 2027¹.

A notice is not the same as an empty shelf. Sertraline, amitriptyline and escitalopram, which also appears with three strengths from one supplier¹, are made by several companies, and a pharmacist can often switch to another brand of the same molecule. The register exists so that doctors, hospitals and pharmacies see the gap before the patient does. The BfArM itself says it usually has no information beyond what the companies report, and points readers to the makers’ contact details¹.

What you can do: if you take one of these medicines regularly, ask your pharmacist at the next refill whether your brand is affected, and do not change dose or brand on your own. The machinery works best when nobody hoards and nobody panics.

The dull truth is the reassuring one. A system that publishes 526 problems, with dates, is a system that is counting. The worrying lists are the ones nobody keeps.