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From over-the-counter flu tablets to crucial antibiotics and antidepressants, medicines are running scarce in UK pharmacies this year, causing concerns among patients, the government, and the wider pharma industry. Drug shortages have accelerated over the past year due to a clutch of problems including the after-effects of the pandemic on supply chains, the war in Ukraine, and soaring input costs weighing on manufacturers. More recently, a sudden spike in respiratory infections - another by-product of Covid-19 that neither pharma companies nor the government were able to predict - has deepened the crisis, with 70 commonly taken drugs out of stock in Britain as of February. The problem is not unique to the UK. In a recent survey of groups representing pharmacies in 29 European countries, three quarters said shortages were worse this winter than a year ago, with a quarter reporting more than 600 drugs in short supply. The US is also facing significant shortages of popular prescription drugs like amoxicillin and Adderall, an ADHD medication. To some extent, the current disruption is laying bare wider challenges facing the industry for several years that were only exacerbated by the pandemic. The over-reliance on foreign suppliers for most active pharmaceutical ingredients (APIs) is one of them. This model has left companies more susceptible to supply shocks, which have in turn increased in frequency and severity due to pandemic lockdowns, the war in Ukraine and other issues such as the shortage of shipping containers. Pharma's long and opaque supply chains, alongside regulatory complexities, also mean it is taking longer for drugmakers to reconfigure manufacturing and distribution in times of additional need.

There has been extensive national media coverage today (August 11) on how medicine shortages have forced patients to visit multiple pharmacies to get their prescriptions filled or return to their GP to be prescribed alternative drugs. These media reports have been based on a survey involving more than 1,500 pharmacists in the UK, in which over a half of those polled said that their patients' health had been put at risk in the last six months. In response to a query from Pharmacy Business, the Department of Health and Social Care (DHSC) said it monitors the medicines supply chain closely to prevent any shortages and acts swiftly when any issue arises. A DHSC spokesperson told Pharmacy Business: "We take patient safety extremely seriously and we routinely share information about medicine supply issues directly with the NHS so they can put plans in place to reduce the risk of any shortage impacting patients, including offering alternative medication.

Drug shortages have become a global issue, with many countries struggling to maintain a consistent supply of common medications, including antidepressants, immunosuppressants and drugs to treat type 2 diabetes and ADHD. Earlier last month, the British Generic Manufacturers Association (BGMA), the trade body for off-patent medicines, warned that 111 products were facing supply problems, the highest on record in the UK, and more than double the number recorded at the start of 2022. More than half of products affected (55) are branded generic drugs, which represent 10 per cent of prescription products used in the UK. The trade body blamed the escalating rebate rate of the government's voluntary scheme for branded medicine pricing and access (VPAS) for these shortages, but Brexit is also cited as another reason for the problem.

The British Generic Manufacturers Association (BGMA) on Monday alerted the Health and Social Care Committee that medicines shortages have increased and are "around double what they were a year ago." BGMA chief executive Mark Samuels told the committee that they have been highlighting the medicine shortage risk to ministers since July 2021 and the association is "very concerned" about the current situation. "We've been monitoring it for several years now, and as you saw in the written evidence, shortages have increased. They're around double what they were a year ago. We have them at 101 shortages in February this year," said Samuels. Dr Rick Greville, director of distribution and supply at the Association of the British Pharmaceutical Industry (ABPI), highlighted that the problem of drug shortages in the UK is a "long-standing issue" and the scarcity of certain medications "continues to be challenging".

When Ignasi Biosca-Reig heard there were shortages of amoxicillin in Spain, he quickly added shifts at his drug company's factories to boost production of the popular antibiotic. But a few extra shifts was as far as he could go. Much as he would have liked to significantly increase supplies, Biosca-Reig said he couldn't justify investing millions of euros in new production lines unless he was paid more for the generic drug to cover sharply rising costs. But, like many other European countries, Spain set the price manufacturers are paid for paediatric amoxicillin when the generic version of the drug was first launched in the country two decades ago, and it has barely budged since. "It's a non-business," said Biosca-Reig, chief executive of Spanish drugmaker Reig Jofre. "We wanted to react, but we had a problem," he said. "The costs go up, the price remains the same."

Switzerland is experiencing medicine shortages due to supply chain issues linked to COVID lockdowns in China and war in Europe, the country's pharmacists association said. "We have the biggest problems with children's medications, especially fever-reducing syrup," Enea Martinelli from pharmaSuisse told Swiss broadcaster SRF. "There are also shortages of blood pressure medications, psychiatric medications and Parkinson's medications," he said.

The Department of Health and Social Care (DHSC) and NHS England last month issued a "safety critical" national patient safety alert, warning about the UK-wide shortage of a life-saving drug used to treat patients with chronic breathing issues. NHS trusts, health authorities, ambulance services, GP practices, private healthcare providers, and community pharmacy contractors were informed that salbutamol 2.5mg and 5mg nebuliser liquid unit dose vials are in short supply, with the latter likely to remain "out of stock" until mid-April 2024. As per the alert, the shortage of the drug resulted from a combination of manufacturing issues, leading to heightened demand for alternative suppliers. It was mentioned that while terbutaline, salbutamol with ipratropium, and ipratropium nebuliser liquids remained available, they could't meet the increased demand.

The Department of Health and Social Care (DHSC) has issued a Serious Shortage Protocol (SSP) for Salazopyrin EN-Tabs 500 mg due to ongoing shortage of the medicine. With SSP014 in place from today (November 26), for every prescription one Sulfasalazine 500mg gastro-resistant (GR) tablet will be supplied. This SSP will expire on December 20, 2021, and PSNC will update contractors in case of any change. PSNC has advised pharmacists to notify the patient's prescriber while supplying in accordance with this SSP. Besides, the supervising pharmacist should refer back to the prescriber if a non-chewable atorvastatin tablet would not be appropriate for the patient.

The British Association of Dermatologists (BAD) has raised concerned about rising cases of scabies in the UK, and suggested that the current shortage of medicines is contributing to the outbreak. Usually, this skin condition is treated using topical creams or oral medication in more severe cases, but shortage of scabies drugs has been reported since May 2023. Both permethrin 5% cream and malathion liquid, which are two main topical treatments for scabies, are in limited supply in the U.K. Paula Geanau, a spokesperson for BAD, told Fox News Digital on Friday (19 January) that the rate of scabies is double the seasonal average, with three cases per 100,000 of the population recorded at the end of November by the Royal College of GPs.

In a recent meeting with the head of the government's HRT Taskforce, Madelaine McTernan, the National Pharmacy Association (NPA) board members gave a gist on the ongoing medicines supply issues in community pharmacy. The meeting, which explored possible solutions to end the nationwide shortage of some Hormone Replacement Therapies, took place on Friday (May 20). Independent contractors Reena Barai and Olivier Picard gave the so-called 'HRT tsar' an overview of the medicines supply issues in community pharmacy and discussed the new Serious Shortage Protocols (SSPs) which the government introduced in response to the on-going HRT disruption. Earlier this month, the NPA attended an HRT summit organised by the Department of Health and Social Care, alongside other pharmacy bodies, wholesalers and manufacturers. Health secretary Sajid Javid and pharmacy minister Maria Caulfield said they would be working collaboratively with manufacturers to meet demand and boost supply.

The severity of the ADHD medication shortage in the UK has been exposed as former Hollywood extra Lee Cato revealed that he was forced to quit his job but hasn't been able to access his medicine. A resident of Berkhamsted, Hertfordshire, Lee had worked as a film extra in big movies like 'Thor' and 'Edge of Tomorrow'. The 48-year-old told Mirror that he has been taking Concerta for years to manage ADHD symptoms, but he hasn't been able to get the drug or any alternatives for over a month. He said that he first experienced shortages of the medicine in December 2023 but was initially able to take Delmosart, which he took to maintain focus despite experiencing its side effects such as headaches, nausea, tooth erosion, and a dry mouth. But now, he can't get access to any of these ADHD drugs as "they're completely out-of-stock and it's been over a month now." His chemist also tried to get hold of his medication but failed.

A report released by the Independent Commission has blamed Brexit supply issues for medicine shortages. NHS is forced to pay extortionate prices to fulfil the demand for vital antibiotics, anti-depressants, Attention Deficit Hyperactivity Disorder (ADHD), and Hormone Replacement Therapy (HRT) drugs. The report highlights the impact of affected medicine supply issues on community pharmacies and patients. Janet Morrison, the chief executive of Community Pharmacy England, backed the report and said that the "medicine shortages and market instability appear to be as bad as they have ever been". She also explained how the Ukraine conflict, the COVID-19 pandemic, and broader economic instability also play a major factor in the situation.

The Department of Health and Social Care (DHSC) and the Medicines and Healthcare Products Regulatory Agency (MHRA) have added five more medicines that cannot be hoarded or exported from the UK market. The government has taken the following action to address the "critical shortage" of attention deficit hyperactivity disorder (ADHD) drugs. In a crucial development on October 9, this strategic move aims to enable wholesalers to fulfil their legal obligation to supply these essential medicines to patients across the UK. The updated list of drugs incorporated "all" available strengths and pharmaceutical formulations, ensuring comprehensive coverage for patients' medical needs.

Danish drug developer Novo Nordisk on Wednesday (February 1) warned of supply constraints on its best-selling drug. The company, which develops diabetes and obesity drugs, said it expected "periodic supply constraints" this year, partly driven by higher than expected demand for its blockbuster diabetes drug, Ozempic, and manufacturing constraints. "Supply of Ozempic cannot keep up with demand in some markets," Novo's Chief Financial Officer Karsten Munk Knudsen told journalists on Wednesday, but said Ozempic was available in the United States, the firm's biggest single market. Shortages of human growth hormone would also cause sales in its rare disease franchise to drop by a "mid-single digit" percentage in 2023, as its Norditropin drug would be out of stock in certain markets, Knudsen said.

Carolyn Harris, Labour MP for Swansea East and co-chair of the Menopause Taskforce, has raised concerns over overcharging of HRT medicines by some online pharmacies, The Telegraph reports. Carolyn, according to the newspaper, has claimed that some HRT products are being sold online for up to "three times as much as they're worth". She has also accused the companies of "profiteering" from HRT shortage. Carolyn has vowed to raise this issue in parliament and will also ensure that health secretary Sajid Javid is aware. She also intends to write to Javid to make sure he is up to date with the alleged "profiteering" taking place. "Get your act together, this is just exploitation. Anybody who thought it was a good idea to hike the price up because there was a shortage… it's awful, it's just complete profiteering, and making a profit off the back of somebody's desperation is never a good look," she told The Telegraph.

Following intermittent shortages during the holiday period and amid continued high level of demand for lateral flow tests (LFT) in pharmacies, the industry has voiced concerns over supplies. Royal Pharmaceutical Society in England chair Thorrun Govind recently gave numerous media interviews over the issue, supporting pharmacists and reassuring the public. She said it is 'frustrating' for pharmacy teams who are unable to access enough test kits to meet the growing demand and highlighted that placing all supplies with a single distributor as a key issue. Many in the sector have raised questions about the government's strategy for LFT distribution after it emerged that the sole distributor to pharmacies closed for four days shortly after receiving 2.5 million tests. Alliance Healthcare, from whom pharmacies receive LFTs, reportedly took delivery of the tests on Christmas Eve and then shut.

Hospitals and healthcare providers across the UK have been notified about the shortage of an anti-inflammatory medicine caused by a manufacturing failure. The Department of Health and Social Care (DHSC) on Friday (3 May) issued a National Patient Safety Alert stating that Erelzi 50mg solution for injection in pre-filled pen will be out of stock from early May until mid-July 2024. "The supply issues have been caused by a manufacturing failure resulting in delays in production and the implementation of global allocations," it said. However, it noted that homecare providers (Alcura, Healthnet and Sciensus) have sufficient stock to supply existing patients until mid/late May 2024. Although Erelzi 50mg pre-filled syringes (PFS) are still available, they cannot support a full increase in demand, the DHSC warned.

A Lake District pharmacy is grappling with significant medication supply issues, affecting its ability to provide essential drugs to customers amidst nationwide drug shortages. According to Simon Butterworth, whose family has operated Collins & Butterworth Pharmacy in Hawkshead for nearly 40 years, voiced his concerns to the ITV stating that the staff is "having to spend time hunting for (medications), looking for it or doing our best to find ways to solve that problem" for distressed patients. "They've got to know when they can get the medications they need," he added. Butterworth also highlighted the financial strain pharmacies face due to the NHS's fixed tariff system. "Certain items are actually costing more to buy than we get paid for them by the NHS. An item we were trying to get this morning was 250 per cent higher than the tariff price, which is significant and builds up over lots of items," he explained.

A total of 14 Serious Shortage Protocols (SSP) will expire today (12 May) as the Department of Health and Social Care has confirmed availability of the products to meet normal demand. The products include Sandrena 0.5mg and 1mg gel sachets, Lipitor 10mg chewable tablets, Phenoxymethylpenicillin 125mg/5ml and 250mg/5ml oral solution, sugar free variant of both doses and 250mg tablets, and Paracetamol 120mg and 240mg suppositories. The expiring SSPs include three related to Sandrena gel sachets, one for Lipitor, eight concerning Phenoxymethylpenicillin and two for Paracetamol. These will expire at 23.59pm on Friday 12 May and any prescriptions for these products must be dispensed in accordance with the prescription after that.

Pharmacists can dispense Paracetamol 120mg suppositories in accordance with the prescription, as the Department of Health and Social Care (DHSC) has confirmed that sufficient stocks are available to meet normal demand. This means the Serious Shortage Protocol - SSP033 - for Paracetamol 120mg suppositories has now expired since 26 August 2022. Top tips for SSP claims NHSBSA advise that contractors must follow the specific endorsement guidance issued with each SSP and endorsements should be clear and unambiguous - NHSBSA processing staff must be able to determine what has been supplied. NHSBSA have published information on common SSP endorsing errors they see when processing claims. Any paper prescriptions with SSP claims need to be placed in the red separator provided by the NHSBSA. Although an SSP cannot be used outside its period of validity, claims can be submitted up to three calendar months after expiry or withdrawal of the SSP to help manage any owings for other items issued on the same prescription form. For example, for SSP033 Paracetamol 120mg suppositories, which expires at 23.59pm on Friday 26 August 2022, the NHSBSA would continue to look for the "SSP" endorsement on prescriptions for Paracetamol 120mg suppositories that are submitted with the August batch (submitted by 5 September), September batch (submitted by 5 October) and October batch (submitted by 5 November).