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.
The Department of Health in Northern Ireland has acknowledged the efforts of community pharmacies, wholesalers and procurement teams in securing supply of
antibiotics for the treatment of Group A Streptococcus infection in Northern Ireland.
"Locally community pharmacies, wholesalers and procurement teams have been working tirelessly to secure stock deliveries into Northern Ireland. The Department
acknowledges the immense efforts from all involved," it said.
"To put this in context, it is estimated that around one month's worth of stock based on normal demand was exhausted in less than 48 hours last week."
"While demand is well in excess of what is usual for this time of year, the system has been working hard to replenish stocks as quickly as possible, as such
wholesalers are still receiving and making deliveries, with more scheduled over the coming days."
In a collaborative effort to combat the escalating threat of antimicrobial resistance (AMR), UWE Bristol and Bedminster Pharmacy have secured grant funding
from the UKRI Regional Innovation Fund (RIF) for a groundbreaking 4-month project.
This initiative aims to revolutionise antimicrobial stewardship (AMS) practices at the community pharmacy level, addressing the pressing need for evidence-based
approaches in tackling AMR.
With antibiotic misuse contributing significantly to the rise of AMR, the project underscores the vital role of community pharmacies in promoting responsible
antibiotic use.
Mr Ade Williams, Superintendent Pharmacist at Bedminster Pharmacy, emphasised the significance of this endeavour, stating:
Two new medications which fight drug-resistant superbugs could soon become available to NHS patients in England after the National Institute for Health and Care Excellence (NICE) said they offered value for money.
NICE said Cefiderocol and ceftazidime-avibactam will be the first antimicrobial drugs to be made available as part of a subscription-style payment model that incentivises research and development of antimicrobials by testing new approaches to evaluating and paying for them.
As part of part of a project with the NHS and the Department of Health and Social Care, the new payment model is designed to address the growing threat posed by antimicrobial resistance - a serious global problem - which develops when the pathogens that cause infection evolve to make antibiotics and other antimicrobial
drugs less effective or stop them from working altogether.
The NHS has signed the first-of-its-kind subscription deal for two antimicrobial drugs - cefiderocol and ceftazidime-avibactam, manufactured by Shionogi and Pfizer respectively - that will help around 1700 patients per year with severe bacterial infections.
Under this deal, pharmaceutical firms will receive a fixed yearly fee - capped at a level that represents value to taxpayers - in order to incentivise funding for innovation that can generate a pipeline of new antibiotics for NHS patients.
NHS said the deal will help patients with serious infections that have evolved so much that antibiotics and other current treatments are no longer effective can be
given a potentially life-saving alternative. The drugs will provide a lifeline to patients with life-threatening infections like sepsis, hospital or ventilator pneumonia and blood stream infection.
Announcing the deal at NHS ConfedExpo, NHS Chief Executive Amanda Pritchard called the revolutionary subscription deal a game-changer and the latest NHS success in using its commercial power to benefit NHS patients in line with the NHS Long Term Plan.
"Superbug-busting drugs on the NHS will save lives and strike a blow in the global battle against antimicrobial resistance," Pritchard said.
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."
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 Scottish government has issued a circular to inform community pharmacy contractors that the Serious Shortage Protocol (SSP) for Clarithromycin 125mg/5ml
oral suspension, an antibiotic product, due to expire on 15 December 2023, has been extended until Friday 12 January 2024.
The extension is applicable to SSP053 which allows community pharmacists to substitute this product with Clarithromycin 250mg/5ml oral suspension for patients
presenting with an NHS or private prescription.
Scotland's chief pharmaceutical officer, Alison Strath, has advised health boards to spread this information to community pharmacy contractors on their
pharmaceutical lists and area pharmaceutical committees, as well as general practices.
Community pharmacists have been advised to review and familiarise themselves with the new end date for the noted SSP.
Wales has begun the rolled-out of a community pharmacy prescribing service as part of reforms agreed by the Welsh health minister last December.
Eluned Morgan approved wide-ranging changes following re-negotiation of the Community Pharmacy Contractual Framework with Community Pharmacy Wales, the
representative body for community pharmacies in Wales.
The roll out will allow appropriately trained community pharmacists to treat an extended range of conditions that currently require people to visit their GP.
Initially pharmacist prescribers will be able to prescribe medicines, including antibiotics for acute illnesses like urinary tract and upper respiratory tract infections, and also prescribe routine contraception.
The first of its kind in the UK, the service is being rolled out progressively across Wales, building on local schemes which are already in place.
BioNTech and Pfizer are to start tests on humans of next-generation vaccines that protect against a wide variety of coronaviruses in the second half of the year.
Their experimental work on shots that go beyond the current approach include T-cell-enhancing shots, designed to primarily protect against severe disease if the
virus becomes more dangerous, and pan-coronavirus shots that protect against the broader family of viruses and its mutations.
In presentation slides posted on BioNTech's website for its investor day, the German biotech firm said its aim was to "provide durable variant protection".
The two companies are currently discussing with regulators enhanced versions of their established shot to better protect against the Omicron variant and its
sublineages.
The virus' persistent mutation into new variants that more easily evade vaccine protection, as well as waning human immune memory, have added urgency to the search
by companies, governments and health bodies for more reliable tools of protection.
As part of a push to further boost its infectious disease business, BioNTech said it was independently working on precision antibiotics that kill superbugs that
have grown resistant to currently available anti-infectives.
Are you worried about your immunity and want to strengthen your immune system? Taking care of your health and the health of your family, children, and parents
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There are things you can't influence. However, those things that you can influence to fight the virus more effectively, such as strengthening immunity, you must
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HEALTHY DIET
A healthy diet is very important for a healthy life. If you have used certain healthy habits in your life for the sake of feeling better in the body while not
paying attention to what you eat, then you have probably seen that the lack of proper nutrition won't compensate for anything.
A strong immunity can be achieved with a varied and balanced diet. Avoiding bad eating habits can be one of the key factors in boosting your immunity.
If you want to boost your immunity, include garlic in your meals. Its antibacterial properties are well-known, and it can be included in natural antibiotics.
Citrus fruits are also great for boosting immunity. Lemon, grapefruit, mandarin, and orange contain plenty of vitamin C and flavonoids, which are considered natural
guardians of the immune system.
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."
The Pharmacists' Defence Association (PDA) has urged the community pharmacies to complete a short survey on the availability of commonly prescribed medicines.
PDA is hearing from members working in community pharmacy about challenges they are facing in fulfilling prescriptions for some of the most common medicines,
including antibiotics. It wants to hear from pharmacists on the front line about their recent experiences.
The association said: "Whilst at this time of year the incidence of infections and illnesses can be heightened, demand is seemingly higher than usual, and we would
like to hear more about how this is impacting on you and the patients in your care,"
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.
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.
The UK government on Thursday (8 May) launched a new plan to tackle antimicrobial resistance (AMR), a global issue that makes infections difficult or
impossible to treat.
This is the second phase of a series of 5-year national action plans, aimed at supporting the government's 20-year vision to contain and control AMR by 2040.
With the launch of this new national action plan, the UK commits to reducing its use of antimicrobials - such as antibiotics, antifungals and antivirals - in
humans and animals.
Additionally, it aims to strengthen surveillance of drug-resistant infections before they emerge and incentivise industry to develop the next generation of treatments.
There are also plans to expand initiatives such as the world-first 'subscription model' for antimicrobials, launched in 2019 as a pilot.
More than a third of pharmacists who participated in a survey said they have seen an increase in patients declining prescriptions due to the cost in the
last 12 months.
The survey was jointly conducted by the Pharmacists' Defence Association (PDA) and the Royal Pharmaceutical Society (RPS), extending their support for the
Prescription Charges Coalition (PCC).
Responding to the survey, 90 per cent of pharmacists admitted seeing cases where patients decline all the medicines on a prescription due to cost.
Nearly all respondents said they have seen cases where patients declined some of their prescribed medicines and more than a quarter of them have experienced
such situation often.
They have warned of the impact of prescription charges as patients are denying vital medicines, including those for blood pressure and mental health, inhalers,
antibiotics, pain relief, and statins, which can have potential consequences for the individual's health.
The outbreak of Burkholderia cepacia complex (Bcc) in the UK, which is associated with contaminated eye gels imported from India, has led to the death of
one person, and many others falling ill, according to a government report.
Bcc is a group of antibiotic-resistant bacteria that are widely found within the environment. Although it rarely causes infection, it can result in severe ones in
individuals with compromised immune systems and those living with cystic fibrosis, the UK Health Security Agency (UKHSA) said.
Between January 2023 and February 2024, there were 52 confirmed and six probable cases across the UK linked to the bacteria outbreak, as revealed in the Health
Protection Report published by UKHSA.
Forty-one of these cases were hospital inpatients, 38 of which were in critical-care settings.
Twenty-five cases were considered to have "clinically significant infections attributable to Bcc", out of which 11 had eye infections, nine had respiratory
infections and four had bacteremia (bacteria entering the bloodstream).
Two individuals with cystic fibrosis (CF) were infected, and while one was treated, the other died, with the report indicating Bcc infection to have "contributed
to the death."
The Department of Health and Social Care (DHSC) has redetermined the December 2023 concessionary prices for four medicines following requests made by
Community Pharmacy England (CPE) on behalf of community pharmacy owners.
For Ezetimibe 10mg tablets (pack size 28), the price has been fixed at £17.78, up from £9.44.
Other drugs included in the list are Aripiprazole 5mg (£8.52), Digoxin 125microgram (£3.70) and Digoxin 250micrgram (£3.70) tablets.
Contractors would be reimbursed at the new prices only for prescriptions submitted for payment for the dispensing month of December 2023.
CPE said they are still working with DHSC to agree price concessions for January.
Check the final the December 2023 price concessionary here.
Additionally, DHSC on Friday confirmed that there's now sufficient stock of Clarithromycin 125mg/5ml oral suspension to meet normal demand, and the Serious
Shortage Protocol (SSP), SSP053 for the antibiotic expires on 12 January 2024.
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.