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.
The Government has been forced to intervene formally 50 times in the past two years to authorise the use of alternative drugs because of serious medicine
shortages hitting patients, new analysis by the National Pharmacy Association (NPA) has found today.
78 per cent of all Serious Shortage Protocols, produced by the Department of Health and Social Care (DHSC) due to medicine shortages, were issued in
2022/24 - more than three times the rate in the previous two years.
The NPA, which represents independent community pharmacies in the UK, is warning that shortages are leading to pharmacists having to increasingly turn
patients needing vital medication away.
Analysis by the NPA of the NHS's Serious Shortage Protocols (SSPs) issued to pharmacies and other providers over the last five years has found that:
The number of SSPs issued in the last two years is 3.5 times higher than in the previous two years.
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.
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.
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."
Novo Nordisk, the Danish drug manufacturer, has launched Wegovy, a weight-loss drug, in the UK market. This semaglutide injection will be available
through specialist NHS weight management services for those who meet the National Institute for Care and Excellence (NICE) criteria or privately through
registered healthcare professionals.
Novo Nordisk allocated a portion of the available supply of Wegovy for NHS services, while confirming the existing shortage of semaglutide and projecting
continued constraints in the foreseeable future. The drug can be obtained through the NHS and is additionally accessible for private purchase at pharmacies in the UK.
The pricing for a one-month supply varies, ranging from £73.25 to £175.80, depending on the dosage.
"We are committed to expanding treatment options for individuals with obesity and share the Government's goal of improving access to obesity care in areas of high
unmet medical need," the company said in a statement. "We are closely monitoring Wegovy demand and collaborating with regulators and providers to ensure access
to and continuity of treatment for people living with obesity."
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.
The Royal Pharmaceutical Society (RPS) on Wednesday announced that it is spearheading a new project, which aims to delve into the root causes of the
growing challenge of medicines shortages across the United Kingdom and provide solutions to mitigate its impact on patients and pharmacy practice.
A newly formed advisory group, chaired by RPS Fellow Dr. Bruce Warner, is set to convene later this month. The group will have experts from primary and secondary
care, patient advocacy groups, the pharmaceutical industry, suppliers, regulatory bodies, governmental representatives, and NHS officials.
The group aims to formulate a robust report to provide expert thought leadership and support for the wider debate on UK policy. Their work will be informed by a
thorough literature review, stakeholder interviews, online RPS member events, and patient stories.
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).
The British Generic Manufacturers Association (BGMA) has warned that England's 42 integrated care boards (ICBs) may need to allocate an extra £37 million
from their budgets annually for the next five years due to the spiralling tax rates.
The government's Voluntary Scheme for Branded Medicines Pricing and Access (VPAS) rebate rate increased more than five-fold in the past two years, the BGMA said
in its white paper released on Monday (October 30).
The report, conducted by consultancy firm Conclusio in consultation with local NHS leaders, examined the potential effects of the VPAS on ICB budgets.
BGMA said that due to the elevated VPAS rate, each ICB in England will experience significant increases in expenses for branded generics and biosimilars
annually - a consequence of reduced competition.
Atorvastatin, a medicine to treat high blood cholesterol, is the most dispensed drug with 59 million items in England in 2022/23, revealed the NHS Business
Services Authority (NHSBSA) on Thursday (8 June).
While Apixaban (an anticoagulant) was the drug with the highest costs of £430 million. Apixaban 5mg tablets had the largest increase in cost between 2021/22 and
2022/23 in England, with an increase of £280 million.
NHSBSA's annual statistics report 'Prescription Cost Analysis-England 2022/23' published also has revealed an eight per cent rise in the prescription items that
were dispensed in the community in England.
The report highlighted that in 2022/23, 1.18 billion prescription items were dispensed at a cost of £10.4 billion in the community in England, witnessing an
increase of eight per cent from £9.69 billion in 2021/22.
In the parliamentary drop-in-event hosted by Community Pharmacy England last week, Members of Parliament (MPs) questioned the Health Secretary on the rising
issue of medicines supply.
"Eighteen community pharmacists in my constituency are reporting challenges on medicine supplies. What more is the Minister going to do to get a grip of this
situation?", Mike Amesbury MP for Weaver Vale, who was present at the event last week, asked the Health Secretary.
In his response, the Health Secretary, Steve Barclay MP said: "We have a long-standing team in the Department focused on medical supplies, which are a continual
issue; as a matter of routine business, there are often challenges in that area."
The Shadow Pharmacy Minister, Karin Smyth MP, also asked: "People across the country rely on local, accessible pharmacies, but whether it is high street closures
or supply problems leading to the absurd situation where women are phoning or visiting multiple pharmacies for a prescribed dose of hormone replacement therapy and
other drugs…They have repeatedly announced plans to expand the role of community pharmacies but have failed to update legislation that could possibly help. … Why
will they not do so?