From 60 Causes to 10 Solutions Against Antibiotics Shortages in Sweden: Platinea's Approach to Developing Policy...

Background/Objectives: Antibiotic shortages are a growing problem which harms patient safety, increases healthcare costs, and accelerates antibiotic resistance. Based on the example of Sweden, the paper aims to illustrate and discuss how an organized collaboration platform can devise several policy interventions against shortages of antibiotics for human use. Methods: We describe how the multi-sectoral collaboration Platinea (Platform for Innovation of Existing Antibiotics) first identified, structured, and prioritized the causes of antibiotic shortages, and then identified and prioritized a set of policy solutions matching these causes. The specific methods applied include expert elicitation, interactive workshops, focus groups, and multi-criteria decision processes. Results: After an overview of about 60 causes of antibiotic shortages, we relate them to 10 prioritized solutions including, e.g., increased inventories, central coordination, integrated IT systems, increased unit prices, yearly fixed payments, and Nordic collaboration in purchasing and production. Conclusions: We propose a process with six steps to devise policy solutions by involving a multi-sectoral stakeholder group: open brainstorming of the problem's causes, framing them into a clear structure, selecting and prioritizing key causes, matching causes and solutions, and devising prioritization mechanisms about emerging solutions. This approach can be applied to other national contexts and similar policy issues.