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Proposed changes to a European Union pharmaceuticals law will include stronger obligations for the supply of medicines and earlier notifications of shortages, EU Health Commissioner Stella Kyriakides said last week (January 17). Kyriakides told a session of the European Parliament that shortages of antibiotics are a growing problem for many European countries. She said the European Commission's proposal to revise the pharmaceuticals legislation is planned for March. "Our objective is and remains to secure access to medicines for all patients in need and to avoid any market disruption of medicines in the EU," Kyriakides said. Shortages of antibiotics have been reported in 26 European countries, the European Medicines Agency says. The unseasonably early upsurge in respiratory infections in Europe this winter and insufficient production capacity are the root causes of the shortages, Kyriakides said. Numerous EU lawmakers speaking at the session said the shortages needed to be tackled urgently. But experts say shortages of essential generic medicines like antibiotics are likely to be recurrent in Europe due to problems in the sector such as the gradual migration of generic manufacturing to Asia.

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.

Pharmacists in the UK are reporting significant shortages of a common antibiotic used to treat whooping cough (pertussis), amid rising cases of this bacterial infection. Dr. Leyla Hannbeck, chief executive of the Independent Pharmacies Association (IPA), told BBC Radio 4's Today programme that clarithromycin, one of the key antibiotics for treating whooping cough in children, is "completely out of stock." Clarithromycin is an antibiotic commonly recommended for babies and infants under the age of 1 month. Dr. Leyla said that as pharmacies cannot get the antibiotic, they are being forced to turn patients away or send them back to their doctors to have their prescriptions changed to azithromycin or other antibiotics for treating whooping cough.

The PSNC on Friday said it has warned the DHSC about the "very serious impact" of the limited supply of certain antibiotics on pharmacies who are "having to chase stock, purchase without sight of any concession prices, and cope with increasing patient questions and abuse." With higher than usual number of cases of scarlet fever, caused by invasive Group A Streptococci (iGAS) infections, being reported in children across the country, supplies of antibiotics for Group A Strep treatment have seen a surge in demand, leading to limited supply at certain wholesalers and pharmacies. PSNC has urged the DHSC to adopt measures that could help to manage the current crisis, such as allowing pharmacists more freedom to change strengths or formulations without prescriber approval, outside of Serious Shortage Protocols. It has also raised concerns on the significant rise in wholesale prices of many oral antibiotics as a result of the surge in demand and the ongoing supply disruptions. PSNC also said they have received reports of some suppliers putting up their prices for any oral antibiotics they do have in stock.

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."

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.

The Department of Health and Social Care (DHSC) has allowed pharmacists to supply alternative penicillin to treat Strep A. It has issued Serious Shortage Protocols (SSPs) for three penicillin medicines. "The SSPs will help mitigate local supply issues of oral penicillin and allow pharmacists to supply alternative forms of the medicine if they do not have the specific formulation stated on the prescription," said DHSC. SSPs have been issued across the UK for 3 penicillin medicines on Thursday (December 15. "Issuing an SSP allows pharmacists to legally supply a specified alternative medicine, removing the need for the patient to return to the prescriber - which saves time in GP practices and inconvenience for patients." "Demand for penicillin has risen recently as it is used to treat strep A and scarlet fever, and the increased demand means that some pharmacists are experiencing temporary and localised supply issues and may not have the specific formulation listed on the prescription."

As whooping cough cases rise sharply across the UK, the NHS has reactivated the serious shortage protocols (SSPs) for clarithromycin - a commonly prescribed antibiotic to treat this bacterial infection. Pharmacy bodies had recently warned that community pharmacies were struggling to obtain source clarithromycin for patients. Two SSPs, covering clarithromycin 125mg/5mL and 250mg/5mL oral suspensions, were reactivated on 22 May 2024, and extended until 21 June 2024. These protocols state that for every 5mL of clarithromycin 125mg/5mL oral suspension, pharmacy contractors must supply 2.5mL of clarithromycin 250mg/5mL oral suspension; and for every 5mL of clarithromycin 250mg/5mL oral suspension, one clarithromycin 250mg tablet must be supplied. The SSPs apply to cross-border prescriptions, both NHS and private.

The Royal Pharmaceutical Society (RPS) has urged people across Scotland to be kind to their pharmacy teams this winter through its campaign called 'Be Kind'. The pharmacies are facing lot of pressure and challenges during winter, RPS has heard from its members that abuse towards pharmacy teams, particularly those in community pharmacy, has 'unfortunately' risen. The campaign has been running throughout December, to promote 'be kind' message to the public at a time when pharmacy services are particularly stretched by winter pressures and other factors, including the recent shortages of antibiotics. "Throughout December, leading figures have provided a series of powerful videos, which all encourage the public to be kind to their pharmacy teams. The campaign has highlighted personal video messages from many figures including Jason Leitch, Scotland's National Clinical Director, Maree Todd, Minister for Public Health, Women's Health and Sport, and Andrew Carruthers, RPS Scottish Pharmacy Board Chair," said RPS.