Medicine Shortages in Spain: Why They Occur and How Pharmacies Act

In 2026, medicine shortages in pharmacies are not due to a single factor, but rather a perfect storm of global and local causes. Below we break down why this phenomenon occurs, what the official data says, and how new regulations are giving pharmacists more tools to ensure your health. All according to the current pharmacy agreement regulations.

What is a shortage and why it's not the pharmacy's fault

When a medicine disappears from the shelves, it is rarely due to an error by the pharmacy or the local distributor. The roots of the problem are structural and affect the entire supply chain.

The three real causes of shortages

1. The price of medicines in Spain
   Spain has one of the lowest regulated prices in Europe. For many laboratories, manufacturing certain medicines (especially older or commonly used ones) ceases to be profitable. Given limited production capacity, they prioritise countries with higher margins such as Germany or the United Kingdom.
2. Dependence on Asia and fragile production chains
   The vast majority of Active Pharmaceutical Ingredients (APIs) and excipients are manufactured in India and China. Any alteration (quality, raw materials, geopolitical crises or logistics) paralyses the global chain.
3. Parallel export
   Medicines are cheaper in Spain, so some distributors buy them here to legally resell them in other European countries at a higher price. Although monitored, this puts pressure on national stock.

Data from the Spanish Agency of Medicines and Medical Devices (AEMPS): a snapshot of the problem

The Spanish Agency of Medicines and Medical Devices (AEMPS) monitors and publishes supply problems. Its updated reports show that there are always hundreds of presentations with active supply problems. Please check with your own regulator for any regulatory information.

Most affected types of medicines: nervous system, cardiovascular system, antibiotics and respiratory treatments.

Action at the counter: how the pharmacist experiences it

Each shortage involves hours of management: calling warehouses, finding alternatives and reassuring patients. The sector has developed collaborative tools:

• CISMED: Information Centre on Medicine Supply. Pharmacies report shortages in real time, anticipating official alerts from the Spanish Agency of Medicines and Medical Devices (AEMPS). Please check with your own regulator for any regulatory information.
• FarmaHelp: A professional platform that connects nearby pharmacies. If one does not have urgent stock, it can refer the patient to another local pharmacy that does.

The pharmacist's new power of substitution

The update to the Spanish Law on Guarantees and Rational Use of Medicines and Medical Devices has made substitution more flexible during official shortage episodes:

• Substitution of pharmaceutical form: If a capsule presentation is out of stock, it can be dispensed in tablets (under Spanish Agency of Medicines and Medical Devices (AEMPS) guidelines) without the need for a new prescription. Please check with your own regulator for any regulatory information.
• Dose adjustment: In authorised situations, if the 1000 mg tablet is out of stock, the 500 mg tablet can be dispensed with instructions to take two.
• Extemporaneous preparation: Compounding pharmacies can prepare the medicine to order when commercial alternatives have disappeared.

Real example: how a shortage is resolved day-to-day

Imagine a patient arrives with a prescription for a common antibiotic that is out of stock. The pharmacist consults CISMED, verifies that an equivalent generic from another laboratory exists, locates it on FarmaHelp at a nearby pharmacy, and refers the patient. In less than 30 minutes, treatment continues without interruption.

Sources: Spanish Agency for Medicines and Health Products (AEMPS) · Law 3/2020 on Guarantees and Rational Use of Medicines · CISMED and FarmaHelp 2026 reports