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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.

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Department of Health and Social Care (DHSC) has issued a supply notification for Varicella vaccine (live) powder and solvent for suspension/solution for injection 0.5ml vials (Varivax and Varilrix) until mid-October. AAH have put quotas in place for GPs to limit the ordering of Varilrix and safeguard supplies during this shortage. To override this quota or obtain stock in any other primary care setting (including community pharmacy) a prescription will be required. To obtain stock through the prescription validation system pharmacy will have to contact AAH Quota Management Customer Care team: Online https://www.aah.co.uk/s/quotarequest or by logging into AAH Point https://www.aah.co.uk/s/signin then choose Additional Services and select Quotas. The pharmacy should follow the steps and fill in the required information including their email address. The pharmacy can also call: 0344 561 8899 and select option 3 (quota) The pharmacy will need to have the prescription details available The AAH team will review the request and follow the guidance provided below to validate the prescription and approve the order.

Department of Health and Social Care (DHSC) has issued a medicine supply notification for Clomifene (Clomid) 50mg tablets on Monday (5 June). It said: "Sanofi will be out of stock of clomifene (Clomid) 50mg tablets from w/c 12 June 2023 until w/c 18 September 2023." "Generic clomifene 50mg tablets remain available from Wockhardt who are able to partially uplift supplies until the end of July 2023. Unlicensed supplies of clomifene 50mg tablets may be sourced, lead times vary. Alternative medicines for use in infertility remain available," it added. The specialist importers- Orifam and Target Healthcare have confirmed to DHSC they can source unlicensed clomifene 50mg tablets. "If there is currently no listing on dm+d for the imported product for prescribers to select using their prescribing systems an EPS prescription for unlicensed clomifene 50mg tablets cannot be issued," said Community Pharmacy England.

The General Pharmaceutical Council (GPhC) Fitness to Practise Committee decided to remove a pharmacist from the GPhC Register at a 'remote videolink' hearing held on 13 - 14 April. "The decision will not take effect until 12 May 2023 or, if an appeal is lodged, once that appeal has been concluded," the committee said. Kapil Ramesh Rabadia, a pharmacist first registered on 25 July 2011 with GPhC under registration number 2075823 was convicted of 'fraud by abuse of position' and 'being concerned in supplying controlled drugs' following a guilty plea on 13 September 2021. He was sentenced to 12 months imprisonment for the fraud by abuse of position and six months in respect of supplying a 3 Class B drug. However, the interim suspension set out in the decision takes effect immediately and will lapse when the removal decision takes effect or once any appeal is concluded. Between May 2018 and June 2019, Kapil ordered codeine linctus and Phenergan in excess of 100 bottles of each for four men who threatened him with knives and guns. The men told the pharmacist that he needed to continue to make the supplies or "there would be consequences" for him and his family.

The Department of Health and Social Care (DHSC) has notified pharmacies over the shortage of Buserelin (Suprefact) 5.5mg/5.5ml solution for injection vials is out of stock until mid-August 2022. Limited supply of Buserelin (Suprefact) 5.5mg/5.5ml solution for injection vials remains available in NHS Trusts and health boards. Buserelin (Suprecur) 5.5mg/5.5ml solution for injection vials are currently available, however, this stock is short dated (expires end of July) and further stock is expected mid-August 2022. Buserelin (Suprecur)150microgram/dose nasal spray is out of stock until late-December 2022. Limited supply remains available in NHS Trusts and Health Boards. Nafarelin (Synarel) 200microgram/dose nasal spray remains available but is currently unable to support an uplift in demand (until mid-August 2022 when it can support a partial uplift in demand).

Global instant logistics leader, Zipline is partnering with UK drone delivery startup, Apian Aero to launch a drone delivery programme of critical medical supplies for the Northumbria Healthcare NHS Foundation Trust. The new service, expected to begin in the autumn of 2024, will see delivery of medical supplies to hospitals, GPs and care homes, using electric, autonomous drones. Zipline announced the partnership on Sunday, and said drone delivery service will help provide timely access to prescription medicines, wound care products, joint replacement implants, and other frequently ordered medical products, which could allow healthcare providers to reduce the number of cancelled procedures, and thus decrease wait times. Also, the expansion of the programme will help in creating local job opportunities in the region, it added.

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.

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.

Besins Healthcare has acquired a pharmaceutical manufacturing site in Drogenbos, Belgium to boost the production of hormonal products including Oestrogel. Currently, the site which is being used as one of two manufacturing sites for their gel products [the other site being in France], is a strategic purchase to allow Besins Healthcare to increase production of its own products, offering greater efficiencies and greater integration into the company's supply line. "In the past year, demand for hormone replacement therapy (HRT) treatment in the United Kingdom and Ireland has dramatically increased, resulting in regrettable disruption to supply of Oestrogel. We are looking at a range of options for increasing supplies of this product in the short, medium and longer term," said Alexandre Besins, joint CEO for Besins Healthcare. "Besins strongly believes that by re-integrating our manufacturing capabilities we will have better control over our ability to meet demand and live up to the trust that HCPs and patients have put in us."

Department of Health and Social Care (DHSC) has issued a medicine supply notification for three tablets- Meptazinol (Meptid) 200mg film-coated tablets, Medroxyprogesterone (Provera) 2.5mg tablets and Lamotrigine 5mg dispersible tablets on Wednesday (15 February). Meptid tablets will remain out of stock until late June 2023. DHSC suggested that an alternative analgesic products including non-opioids remain available. Provera 2.5mg tablets are out of stock until mid-March 2023. "Medroxyprogesterone (Provera) 5mg and 10mg tablets remain available but cannot support an uplift in demand," said DHSC. "Norethisterone 5mg tablets remain available and will be able to support an increase in demand." Branded lamotrigine (Lamictal) 2mg and 5mg dispersible remain available but are unable to support the increase in demand as Lamotrigine 5mg dispersible tablets are out of stock until late March 2023.

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, Chief Pharmaceutical Officer for England David Webb has assured pharmacies of sufficient supply of antibiotics. In a letter, shared by the PDA, Webb also urged the pharmacies to order antibiotic stocks sensibly. "Local pharmacy teams may be experiencing a temporary interruption of supply of some relevant antibiotics due to increased demand. On a national level, sufficient stock exists for the NHS," he said. He said NHS is working closely with the Department of Health and Social Care (DHSC) and has taken actions to help ensure medicines continue to be available. He explained that the supplies of antibiotics for the treatment of Group A Strep, particularly phenoxymethylpenicillin presentations, have seen a surge in demand, leading to potential constraints at certain wholesalers and pharmacies,

The Department of Health and Social Care (DHSC) has issued an alert to update healthcare professionals on the shortage of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which are used to treat type 2 diabetes. It has informed that the supply of the drugs continues to be limited, and is not expected to return to normal until at least the end of 2024. An increase in demand for these products for licensed and off-label indications is cited as the cause of the supply issues. "Rybelsus® (semaglutide) tablets are now available in sufficient quantities to support initiation of GLP1 RA treatment in people with type 2 diabetes (T2DM) in whom new initiation of GLP-1 RA therapy would be clinically appropriate," the DHSC's National Patient Safety Alert reads.

Southwark Crown Court on Thursday sentenced two pharmacists to two years of imprisonment each, suspended for 24 months, after they were found guilty of selling 'industrial' quantities of Class C controlled drugs. Mandip Sidhu (47) of Littleover, Derby and Nabeil Nasr (42) of Cheadle, Greater Manchester, pleaded guilty at an earlier hearing following an investigation by the Criminal Enforcement Unit of the Medicines and Healthcare Products Regulatory Authority (MHRA). Both Sidhu and Nasr were pharmacists registered with the General Pharmaceutical Council at the time of the offenses, which took place between May 2013 and June 2017. Sidhu was the director of Pharmaceutical Health Limited (PHL) in Derby, while Nasr owned several pharmacies across the North West of England. Sidhu was sentenced to two years imprisonment on each of five counts of supplying Class C drugs and four months for forgery, all to run concurrently and suspended for 24 months. Additionally, she must complete 200 hours of community service for her role in the illegal supply of diazepam, zolpidem, and zopiclone.

"Our main concerns are that the use of what they call an asynchronous supply, where the prescriber neither sees nor talks to the patient at the time they issue the prescription, does lay itself open to perhaps people getting hold of medication that they shouldn't," the Head of Policy, PDA said. The Pharmacists' Defence Association (PDA) engages in a critical conversation on BBC Radio 4's Woman's Hour, shedding light on the online prescribing of weight loss drugs and advocating for safer practices. The PDA's spokesperson, Head of Policy Alima Batchelor, emphasised the importance of adhering to professional guidelines to ensure patient safety and mitigate regulatory concerns. During the feature, the PDA highlighted the complexities and risks associated with online supply chains, stressing the necessity for direct clinical consultations and pharmacist involvement in medication management. ""There are guidelines and advice about verification within the DiCE guidance, but it doesn't go quite far enough for us. We are concerned when patients decline to allow the online prescriber to advise their GP of what they're taking," Batchelor highlighted.

New amendments to the Human Medicines Regulations will soon allow registered pharmacy technicians to supply and administer medicines under Patient Group Directions (PGDs). Laid before Parliament at the end of May, the legislative changes will come into effect from June 26, 2024, the Community Pharmacy England (CPE) announced today. The introduction of this new legislation follows an announcement made by the Department of Health and Social Care (DHSC) earlier this year. The regulatory adjustments provide the legal framework for pharmacy technicians to engage in the supply and administration of medicines under PGDs in the course of their professional practice. However, there will be no immediate change in the provision of community pharmacy services, the CPE noted

In response to significant ongoing disruptions in the supply of certain Quetiapine tablet strengths, the Department of Health and Social Care (DHSC) on Tuesday issued nine new Serious Shortage Protocols (SSPs), with immediate effect. These measures aim to ensure the continued availability of quetiapine, an essential medication for managing schizophrenia and bipolar disorder. Under the new SSPs, community pharmacists are allowed to consider different options to manage the shortage of the three strengths of quetiapine tablets affected by ongoing supply disruptions: quetiapine 300mg tablets, quetiapine 200mg tablets, and quetiapine 150mg tablets. Depending on the prescribed quantity of the affected quetiapine tablet, pharmacists can either supply a reduced quantity of the same quetiapine tablet or substitute with an alternative strength or provide a reduced quantity of a specific alternative product.

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Diamorphine 5mg and 10mg powder used for solution for injection ampoules will remain unavailable until February 2022, Department of Health and Social Care (DHSC) has said in an update. These injection ampoules are used to treat severe pain associated with surgical procedures, pain in the terminally ill, and to provide relief in acute pulmonary oedema. Diamorphine 30mg and 100mg ampoules are available, however, the stock is not enough to support an uplift in demand. Separately, the DHSC has extended the Medicine Supply Notification for Kolanticon gel, which is expected to remain unavailable until October 2022.

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.