A backdoor way to know where the inventory is… “Drug Loss” – Doctors teach how to deal with the crisis of no cough medicine, no antibiotics, and no vaccines.

A patient who had to run to the pharmacy made a tearful phone call

The lack of medicines – something unthinkable in the Heisei era – is now a reality in Reiwa, 2025. In fact, many people have faced a situation where they could not get many medicines, such as cough medicine and antibiotics.

How should we cope in this age of drug loss? We asked Ohji Obayashi, director of the Shinjuku Higashiguchi Primary Care Clinic, about this question.

–When I hear the words “drug loss,” I get the feeling that Japan has become such a dystopia. In fact, what kind of medicines are in short supply?

Cough suppressants, expectorants, and antibiotics. In some cases, there are no medicines that are not particularly rare. There are cases where there are no drugs that are in demand, that is, there are many patients who use them.

–Is it because there is demand, in other words, because there are many patients who use them?

There is a chronic shortage of cough medicines because various infectious diseases that cause coughing as a symptom have been spreading for a long time.

–When did the drug loss begin?

Around the COVID-19 crisis in 2020. From that time to the present, many drugs, including cough medicines, antibiotics, and vaccines. Then there has been a much more severe shortage in the supply of generic drugs in particular, and the drugs we want are not available.

Patients call us in tears because they are not feeling well and have gone to several pharmacies with their prescriptions only to be told by the pharmacist that they don’t have the medicine they need.

–That’s quite a long period of time since the COVID-19 crisis. How did you get into that situation?

For example, after the Corona epidemic there was an outbreak of mycoplasma pneumonia, and we had to prescribe antibiotics to treat this disease. As a result of the huge increase in demand, there was a shortage of antibiotics.

Last year we had a whooping cough epidemic, but this too cannot be cured without antibiotics. Diseases caused by bacteria continue in such a way, plus there is also an outbreak of streptococcal infections, mainly among children. It’s a big reason why infections have been going on for so long.”

–The illnesses that cause coughing in particular have been going on.

Yes. So, there are not enough cough medicine and expectorants. When you have a persistent cough, you cannot sleep at night or concentrate on your work, so there is no end to the number of people asking for cough suppressants or expectorants. So we have to go to various medical institutions for prescriptions, and we are running out of medicines, and we have to go to …….

–Did you have any signs of the disease?

There were not only the effects of Corona, but also problems in the pharmaceutical industry, such as scandals …… of medical manufacturers, tampering with quality tests, and manufacturing using procedures that were not approved by the government. This is compounded by a labor shortage.

The reason for the labor shortage is a structural problem. In Japan, the government sets drug prices, and because manufacturers cannot set drug prices, they are required to provide their products at low prices. This has resulted in an unreasonable production system with thin profit margins. Then Corona followed suit.

The raw materials for the drugs were dependent on China and India. Logistical delays, such as the lack of shipping, further accelerated the shortage of medicines.

–Is there still no sign of improvement in the current situation?

The situation is much better than the COVID-19 crisis, and the supply of diabetes-related drugs has stabilized, but there are still shortages of antibiotics and cough medicines. Also, recently there was one drug loss that was caused not by illness, but by health concerns.

–What is it?

It may be the influence of the “intestinal activity boom,” but it seems to have become a hot topic in the media and on social networking services, and demand for intestinal preparations has risen so quickly that supply has not been able to keep pace with demand. I thought it was a strange phenomenon unique to Reiwa.

How to Know Where the Drugs Are

–What should we do when we encounter a situation where we don’t have medicine?

There is a law that says we cannot mediate between pharmacies, so medical institutions cannot recommend that you go to this pharmacy because they have the medicine in stock,” he says.

–So, what should we do about ……?

If patients simply ask, “Where do you have that medicine? We naturally know what the patient is looking for, and we have a general understanding of the situation in the surrounding pharmacies. We can’t give them a pinpoint referral, but we can provide them with multiple referrals.

Prescription pharmacies located inside the stores of major chains with high purchasing capacity often have the drugs. Also, we can often get them from places with a large distribution volume, for example, pharmacies in Shinjuku. If I try to get the medicine at a pharmacy near my home, a little further away from the city center, there are cases where they don’t have it there.”

-He said that if you go to a hospital in the city center, you should head to a pharmacy near there.

There are also some pharmacies in rural areas that share information with other pharmacies, order drugs from them, or have alternative medicines, and are flexible.

–So you are not saying that there are no medicines in Japan at all?

That’s right. There are people who panic when they are told at the pharmacy that there are no medicines available. It is a burden for them to visit pharmacies when they are not feeling well. This is especially true if the symptoms are severe or the child is suffering.

It is important not to lose your cool in such situations. It is a good idea to call the pharmacy in advance and inquire about the availability of medications before you go. As I mentioned earlier, medical institutions often collect information about which pharmacies have what medications and how much they have, so I can’t say that this is true everywhere, but if you ask, they may be able to tell you.

-Is the situation the same everywhere in the country?

I don’t know the details of the situation in other regions, but even in Tokyo, there are often pharmacies in Shinjuku Ward that have the drug, but pharmacies in Nakano Ward, which is only a short distance away, don’t have it. From the patients’ point of view, they don’t think that something that is not available in Nakano Ward is available in Shinjuku Ward, and if they are told that it is not, they will leave. ……”

–What is the reason for the continued drug loss?

One reason is that, despite the prevalence of cough-related infections, more people have stopped wearing masks since the dawn of the COVID-19 crisis. Last year, we had a flu pandemic, and we realized how wearing a mask prevented the flu. It is possible that the changing times have also had an impact, as people have become more careful about coughing illnesses and are taking more medication than in the past.

–What are the countermeasures against diseases that make people suffer from coughs?

Mycoplasma pneumonia does not respond to ordinary cold medicine, so it is important to get a diagnosis as soon as possible and to treat it quickly with appropriate medicine.

–Don’t you see a shortage of hay fever medicine this season?

We don’t hear much about shortages of allergy medicines. We have a rough idea of the number of allergy patients, but we may not have read that demand for cough medicine would increase due to the prolonged outbreak of infectious diseases. Antibiotics are used not only for coughs, but also for the treatment of sexually transmitted diseases, which have recently become an epidemic, and are serious because of their wide range of uses.

-Another survival method in the age of drug loss.

I understand that you may feel hopeless when you are told that there are no medicines available, but you should remain calm and ask the hospital, ask the pharmacist, and if that doesn’t work, call a different pharmacy.

If you are receiving medication on an ongoing basis, I think it is important to request a visit to the hospital and a prescription well in advance, not just before the medication runs out. It is also important to find a doctor or pharmacist who is respectful of the patient’s feelings and with whom you can build a personal relationship.

It is essential to gather information and be prepared so that when the time comes, you will not be in a hurry. There is no point in lamenting. It is time to adapt to the times we live in.

Photography and text by Miyu Kurusu

Miyu Kurusu is a freelance writer. Her main areas of expertise are humanities, social issues, and subcultures, and she is active in reporting and writing articles for magazines, newspapers, the Internet, and other media. He is the author of numerous books.

Interviewed at: Shinjuku Higashiguchi Primary Care Clinic
6F Shinjuku Pandora Building, 3-23-12 Shinjuku, Shinjuku-ku, Tokyo
03-3226-7777 (weekdays 18:00-22:00, weekends and holidays 14:00-20:30)

URL: https://shinjuku.clinic/