A study, commissioned by healthcare company Viatris, found that between 2020 and 2024, the average price of the top 10 off-patent antibiotics dropped by 10pc across EU markets that were examined, including Ireland, despite rising productions costs. In the same period there were a number of years of double-digit inflation, including soaring energy costs, that hit drugmakers.

Viatris commissioned an independent study by New Angle, a consulting and research agency, into reasons behind the shortages of essential off-patent medicines, with a particular focus on antibiotics.

It looked at 16 markets, including Ireland.

That study found shortages of key antibiotics result from a confluence of factors including rising production costs and persistent price decreases.

Pricing of prescription drugs in European markets is determined by national pricing and procurement systems, rather than supply and demand dynamics.

Under the current system prices can only go down

Adrian van den Hoven of Medicines for Europe – a representative organisation for the generic drugs industry – said if manufacturers cannot increase prices in line with the inflation that impacts their supply chains drugs will become unavailable.

“Under the current system prices can only go down, so you have cases of medicines where we haven’t been able to increase prices for 20 years, even though all of the costs are higher,” he said.

Between 2022 and October 2024, national authorities in Europe reported 136 instances of critical medicine shortages to the European Medicines Agency, according to a report earlier this month by the European Court of Auditors.

Mr Van den Hoven said European structures, including single vendor contracts to bulk supply populations that can run into millions of people, is driving a consolidation of the generic drugs supply chain with potentially damaging long-term consequences to diversity of suppliers and supply chain vulnerabilities.

The head of Europe and Canada at Viatris, Artur Cwiok, said it is “preposterous” that the price of a course of antibiotics would be less than a cup of coffee in some European countries.

“We need to rethink the value of these medicines to society, and have an open and critical discussion” he said.