Czechia is running critically low on tamoxifen — a vital drug for breast cancer patients

Pharmacies across Czechia are facing a critical shortage of tamoxifen, a drug essential for breast cancer patients. As of Tuesday morning, only 81 packages of the medication remained in the entire country, according to Tomáš Boráň, director of the State Institute for Drug Control (SÚKL).

The shortage has forced the Ministry of Health to take an unusual step. The ministry has approved conditions for a special treatment programme that will temporarily allow pharmacies to prepare individual tamoxifen doses of 10 mg and 20 mg using medications not otherwise registered in Czechia. In practice, this means pharmacists will be able to dispense tamoxifen products that normally wouldn't be allowed on the Czech market because they lack local registration. The only requirement is that these medications must be registered in at least one other EU country.

According to Boráň, there's no need to worry about the quality of these drugs — they meet strict European standards, and supplies will come exclusively from verified sources through legal distribution channels. Changes should be visible on the market within a few days.

Pharmacists will repackage the pills by hand

Since medications not registered in Czechia may differ in packaging and dosage from what local doctors typically prescribe, pharmacists will need to repackage them manually. As SÚKL spokesperson Jitka Zinke explained, pharmacists will open the original packaging, remove the blister packs, and — based on the dosage and strength prescribed for each patient — assemble an individual two-month supply. Patients will receive detailed instructions on how to take the medication correctly.

Already on Monday, the Ministry of Health authorised pharmacies to open standard packages — usually boxes of a hundred tablets — and dispense only a few blister packs at a time. While this shortens how long the supply lasts for each patient, it helps stretch the scarce medication across a larger number of patients during this critical period.

A nationwide problem

Tamoxifen supplies have been disrupted since last year, and since June its substitute has also become unavailable. The problem affects the entire country. According to Aleš Krebs, president of the Czech Chamber of Pharmacists, most pharmacies rely on the same suppliers, which is why the shortage is being felt everywhere. The shortage is most acute at pharmacies near oncology centres, where consumption of the drug is especially high.

However, Krebs notes that patients won't have to search for pharmacies that still have the drug in stock themselves: tamoxifen has been placed in the category of medicines with limited availability. This means that the doctor writing the prescription can see in the SÚKL system exactly where supplies are available and can direct the patient straight to the source.

Around Prague, based on reporting by novinky.cz