The National Pharmacy Association (NPA) has asked the Secretary of State for Health and Social Care to convene a 'medicines supply taskforce', following weeks
of problems with antibiotics supplies.
The NPA's chief executive Mark Lyonette wrote a letter to Steve Barclay this week. It cited the precedent of the HRT Taskforce which this summer brought together
representatives from across the supply chain after months of supply problems affecting women.
"We strongly believe that this situation calls for a similar response from the government. It is imperative that we resolve this supply situation urgently and
therefore we request that you convene a Medicines Supply Taskforce, with all the relevant stakeholders in the supply chain, to urgently discuss and agree practical
solutions to address the disruptions to the supply of medicines. HRT and antibiotics are the most visible examples of a wider problem with medicines supply
which needs to be addressed."
NPA board members Olivier Picard and Reena Barai were among the stakeholders joining meetings convened by the HRT Taskforce this summer.
Glenmark, a multinational pharmaceutical company, has partnered with AI data-driven supply chain management platform 7bridges.
Initially focusing on their European business, where they have operations in 15 markets, the supply chain and logistics function is a big focus area for this cost
reduction.
The partnership with 7bridges will allow Glenmark to baseline their supply chain data giving them visibility of data, cost and service performance across their
network of logistics service providers.
This exercise will identify areas where invoices from their logistics service providers are being incorrectly or overcharged. With automatic dispute raising,
savings will be quickly achieved. The platform will then enable Glenmark to benchmark their data, so they can compare the performance and cost of their LSPs to the
wider industry.
With Glenmark's global vision to emerge as a leading integrated research-based global pharmaceutical company, this investment in their supply chain will be integral
to achieving this.
The next step in the partnership will be to run simulations to optimise road freight services and 3PL operations, with the aim to then roll out globally.
Northern Ireland will see changes in the regulatory landscape following the issuance of the Windsor Framework on 27th Feb 2023 and the corresponding EU
Commission proposal. An agreement, in principle, has been reached by the UK and EU.
The new path forward of the Windsor Framework marks a turning point in how both the UK and the EU will work together collaboratively and constructively to ensure
that the same medicines are available in Northern Ireland at the same time as they are in the rest of the United Kingdom.
Whilst this is a successful result for Northern Ireland patients, this is major change for companies that have made specific provisions in their supply chains for
Northern Ireland. The supply chains of companies where provisions and changes were made such as introduction of GB specific pack may be impacted as a result.
However, the burden on the UK Pharma supply chain will be eased.
Prime Minister Rishi Sunak walks with European Commission chief Ursula von der Leyen in Windsor on February 27, 2023
Pharma companies will need to carefully consider making changes within their processes and supply chains pending the issuance of clear guidance from the MHRA on
the regulation changes resulting from the Windsor Agreement and the corresponding EU Commission proposed regulatory changes associated with medicinal products
within the Northern Ireland market.
Smooth access to the EU market for Northern Ireland pharmaceutical and medical technology firms has been safeguarded within the constraints of the agreement. The
pragmatic dual-regulatory system protects business, patients and healthcare services, and reflects that it is an essential state function to maintain and oversee
the supply of medicines within the whole United Kingdom.
Community Pharmacy England (CPE) has explained MPs on instability that puts operational pressures on pharmacies, financial pressures on businesses at a
Parliamentary drop-in event held on Monday (10 July).
The association has been in Parliament today alongside patient representatives and others to highlight our ongoing concerns about medicines supply to MPs.
It said: "Medicines supply remains a critical issue for community pharmacies with disruption causing problems both accessing medicines and procuring them cost
effectively."
In CPE's recent sector polling, community pharmacy owners rated medicines supply instability as being the most severe pressure facing their businesses. This
echoed the results of CPE's Pressures Survey which found 97% of pharmacy owners survey are facing significant increases in wholesaler and medicine supply issues,
with 71% saying this was leading to delays in prescriptions being issued.
During the Parliamentary drop-in event, CPE talked MPs through the issues and set out what it believe needs to happen to resolve them, calling for- Reform of
Serious Shortage Protocols; Allowing generic substitution; An overhaul of the concessions system; and a strategic Government review of medicine supply and pricing
with a shift to focusing on how to improve the functioning of the supply chain rather than solely on the drive to depress prices and margins.
Majority of the pharmacies are facing aggression from patients due to the medicine supply chain issue, a PSNC survey has revealed.
The Pharmacy Pressures Survey by the trade body has seen nearly 83 per cent of pharmacies reporting a significant increase in medicine supply issues in the past year,
leading to extra work and additional stress for staff.
The survey of over 5,000 pharmacy premises and 1,000 pharmacy team members in England took place in early 2022.
Two-thirds of respondents said that medicines supply chain issues are a daily occurrence, with 97 per cent reporting that this led to frustration from patients.
"The results of PSNC's Pressures Survey make distressing reading for anybody in the sector - they tell a story of teams under immense pressures, and of businesses at crisis point," said Janet Morrison, PSNC chief executive.
Community Pharmacy England (CPE) to host a Parliamentary drop-in event in July to brief MPs and Peers about the ongoing medicines supply chain issues that
are negatively affecting pharmacies and their patients across the country.
CPE's Pressures Survey earlier this year highlighted the extent of both the operational and financial impacts of medicines supply issues on pharmacy businesses,
therefore it has continued to hear from both pharmacy owners and others about the problems.
The event aims to ensure that MPs understand the problems and their impact on pharmacies.
Peter Dowd MP is hosting the event, joined by representatives from Community Pharmacy England, the Nuffield Trust, patient groups and more.
The event will also be another opportunity to talk to MPs from across the political spectrum about the very serious situation that community pharmacies still find
themselves in and the need for further investment in the sector.
Janet Morrison OBE, Chief executive of Community Pharmacy England said: "The results of our Pressures Survey earlier this year showed just how much supply issues
are continuing to negatively impact pharmacy businesses and all those who work in them. The survey found that almost all pharmacy owners (97%) are facing
significant increases in wholesaler and medicine supply issues, with 71% saying this was leading to delays in prescriptions being issued.
A recent report by the British Generic Manufacturers Association (BGMA) has shed light on ongoing supply challenges in England's generic medicines market,
revealing significant issues impacting patient care.
The report highlights significant challenges faced in supply of medicines as currently, 51.72 per cent of generics in short supply lack licensed alternatives,
posing substantial hurdles to ensuring continuous patient care.
Additionally, 39.08 per cent of affected generics are branded, indicating widespread disruptions across the market.
A notable 26.44 per cent of generics experiencing shortages have been affected for over six months, highlighting persistent difficulties in supply chain management.
The report indicates that 0.15 per cent of generic medicine presentations listed in the Drug Tariff are currently facing supply issues, impacting accessibility
nationwide.
The Hormone Replacement Therapy (HRT) Taskforce head Madelaine McTernan has returned to working full time as the director general of the Vaccine Taskforce for
autumn booster campaign preparation.
She has presented a few key recommendations to help ensure continued HRT supply to meet rising demand. "Improved access to data on prescriptions to more easily see
where there are shortfalls between HRT packs prescribed and HRT packs supplied by manufacturers," she suggested. "Taking lessons from the HRT supply chain work to
inform broader medicine supply work."
Madelaine said: "I am pleased to see the situation with HRT supply is improving across the country. I want to thank suppliers and manufacturers for their engagement
and positive action to tackle this serious issue.
The only way to overcome the challenges facing the medicines supply chain in the UK is through close cooperation - the government, pharmacies, and the
industry all working together in tandem - said Andrew Stephenson, Minister for Health and Social Care.
The MP for Pendle, Lancashire made the statement while addressing the Healthcare Distribution Association's (HDA) Annual Conference at the Institute of Directors
in Pall Mall, London on Thursday (25 January), where over 130 leaders from the pharma industry gathered.
As the keynote speaker, Stephenson acknowledged the crucial role wholesalers, manufacturers, and retail pharmacy chains, play in the wellbeing of the nation.
He said: "In the first few months that I've been in this job, it's become immediately obvious to me just how important this sector is and just how important the
work that all of you do is for our country."
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.
Instability in the supply chain network is frequently undermining the profit margins in community pharmacies, former Pharmacy Minister and Chair of the Health
and Social Care Committee Steve Brine has said.
Brine emphasised that community pharmacies often lack information about the prices wholesalers charge for essential generic medications. "They lack visibility
into scarcity, and the pricing of these products is often significantly higher compared to other European countries," the former minister remarked during a
parliamentary debate focused on the future of community pharmacies on September 14.
From financial pressures to workforce crisis and pharmacy closures, the debate delved into critical challenges faced by pharmacies, aiming to propose tangible
solutions for a sustainable future in the sector.
Chaired by Sir Mark Hendrik, the debate was initiated by Conservative MP Peter Aldous and featured contributions from a host of participants including Labour MPs
Taiwo Owatemi and George Howarth among others.
The Department of Health and Social Care (DHSC) has issued Serious Shortage Protocols (SSPs) on three HRT medicines to limit dispensing supply to three months.
To ensure women across the UK will be able to more reliably access HRT products SSPs has been issued on the supply of Oestrogel, Ovestin cream and Premique Low Dose.
DHSC stated, "Women who have a prescription for more than three months but are only able to access three months' supply will not have to pay an additional
prescription charge."
"This means women will not incur any additional costs. Imposing a three month limit will mean more women are able to access the medication they want. Any woman
who is worried about access to HRT or is unable to access HRT should speak to her GP."
Recently, Vaccine Taskforce Director General Madelaine McTernan has been appointed to spearhead a new HRT Supply Taskforce, applying lessons learned from the
successful procurement seen during the Covid vaccination programme to identify ways to support the HRT supply chain ensuring it can meet both short and long
term demand. The move will save time for patients as well as pharmacists and prescribers who are working tirelessly to tackle the covid backlog.
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.
The European Commission launched an initiative to deal with the ongoing supply crisis on Tuesday (24 October).
The following announcement comes after the shortage of key antibiotics last winter identified by the European Health Emergency Preparedness and Response
Authority (HERA) and the European Medicines Agency (EMA).
The "European Voluntary Solidarity Mechanism" is a proposed short-term measure that involves a Member State's need for a given medicine to other Member States
to redistribute medicines from their available stock.
Additionally, the Commission intends to cooperate with member states to improve components of pharmaceutical reform with an aim to strengthen supply security.
They are setting up a few actions apart from the launch, a list of critical medicines to analyse the supply chain by early 2024; regulatory flexibilities;
strengthening security of supply; and availability of antibiotics and treatments for respiratory viruses by next winter.
he Healthcare Distribution Association (HDA) and the Pharmaceutical Services Negotiation Committee (PSNC) have urged the NHS England and the Department of
Health and Social Care (DHSC) to issue urgent communications requesting that all those involved in medicines supply do not hoard, stockpile or over-prescribe Strep
A antibiotics.
In a statement HDA said that the sudden spike in demand for antibiotics used for the treatment of Strep A has meant that there is not enough of these medicines in
the supply chain currently to meet this increased demand. As a result, wholesalers are working extremely hard with manufacturers to increase the supply of antibiotics.
It added: "As regards pricing, the prices charged to pharmacies by HDA wholesale distributors will directly reflect the increase in prices wholesalers are having
to pay for these medicines from manufacturers at the moment, in order to be able to continue supplying these medicines to pharmacies. This will be the case until
supply and demand are more in sync."
With the government gearing up and pushing community pharmacies in England to adopt the hub and spoke dispensing model, stakeholders of the sector and industry
leaders analyse the pros and cons related to the new concept.
The model rose to prominence in 2015 in community pharmacy and the medicine supply chain in the UK, and has undergone a few consultations and reviews at the
professional and governmental level since then.
From a broader perspective, the industry agrees that the model will bring in efficiency to the system, much needed amid community pharmacy's flat funding settlement in England, at the same time highlighting some real challenges.
The National Pharmacy Association (NPA) has so far released three reports on this matter and a review of the challenges and enablers of the hub and spoke in the UK in 2016. Besides, a review of international evidence and the report of a roundtable meeting was brought together in the supply chain with government
and regulators in early 2020.
The General Pharmaceutical Council (GPhC) has urged health and care professionals to meet relevant regulatory standards amidst the shortage of GLP-1 receptor
agonists (GLP-1 RAs).
The council said: "We are concerned to hear that people with Type 2 diabetes are experiencing problems accessing GLP-1 receptor agonists (GLP-1 RAs). We know that
these are being widely prescribed for weight loss purposes and in some cases prescribed off-label."
"We recognise the adverse impact that shortages and supply chain issues can have on patients, the public and wider health and care teams.
The Council understands that health and care professionals are using their professional judgement and making decisions in challenging situations, balancing a range
of factors such as individual patient needs, wider public health and pressures and limitations on available resources such as medicines shortages or other supply
chain issues.
Teva UK has alerted the Secretary of State for Health and Social Care to the problem posed by steep energy prices.
Teva's UK General Manager Kim Innes wrote to the minister seeking assurances that the distribution of medicines to patients will be safeguarded over what's likely
to be a difficult winter.
The problems posed by steep energy prices and the potential for power rationing is putting pharmacies under pressure from increased costs and the risk of losing power
supplies as a 'non-domestic' energy user, said the company.
Kim said: "In our letter to the Secretary of State we acknowledged that the government knows that medicines manufacture is strategically important and that it's a
vital component in maintaining patient health."
"But I wanted to make sure that the Secretary of State also realises the consequences of the energy crisis further down the supply chain - for example, the need for
a pharmacy to have a fridge switched on at all times for storing cold chain products."
AAH Pharmaceuticals Ltd (AAH) has exceeded the milestone of delivering over 70 million COVID-19 vaccination doses across England, since it was awarded a
contract in December 2020.
In addition, AAH has delivered over 100 million ancillary items to more than 3,000 healthcare providers.
David Bound, chief executive officer of AAH, said: "This is a huge milestone for AAH as we work tirelessly to support our communities. It's also a ringing
endorsement of our delivery drivers, warehouse operatives, and specialist logistics teams and the determination, dedication, and passion they continue to show
throughout this extraordinary period."
The vaccination programme was also recognized by the Supply Chain Excellence Awards.
Chris Emmott, senior project lead - Supply Chain, commented: "I'm incredibly proud that AAH was chosen for this job, particularly as we had the skills, the
experience, and a great team to help facilitate the needs of the country. To get ready for a project like this, everybody's worked very long hours, they've
worked weekends to get everything ready.
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.