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 Department of Health and Social Care (DHSC) has issued a medicine supply notification for antibiotics for the treatment of Group A Strep.
"Supplies of antibiotics for the treatment of Group A Strep have seen a surge in demand and may be temporarily in limited supply at certain wholesalers and
pharmacies," said DHSC.
"Supplies are available with manufacturers, and deliveries into wholesalers and pharmacies are being expedited and are expected in the coming days."
If the formulation of antibiotic prescribed is unavailable, DHSC has asked clinicians and local pharmacy teams to consider prescribing an alternative form or
strength of the antibiotic where appropriate, ensuring the patient is not intolerant to any of the excipients in the alternative and is counselled on the
appropriate dose (and volume) required.
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.
Hospitals and healthcare providers across the UK have been notified about the shortage of an anti-inflammatory medicine caused by a manufacturing failure.
The Department of Health and Social Care (DHSC) on Friday (3 May) issued a National Patient Safety Alert stating that Erelzi 50mg solution for injection
in pre-filled pen will be out of stock from early May until mid-July 2024.
"The supply issues have been caused by a manufacturing failure resulting in delays in production and the implementation of global allocations," it said.
However, it noted that homecare providers (Alcura, Healthnet and Sciensus) have sufficient stock to supply existing patients until mid/late May 2024.
Although Erelzi 50mg pre-filled syringes (PFS) are still available, they cannot support a full increase in demand, the DHSC warned.
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.
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.
harmacists in the town of Barnoldswick in Lancashire are reportedly suffering from various problems including a lack of medicines and the movement or loss
of pharmacy staff.
Problems, including delays with supply of insulin, were reported at a recent Pendle Council West Craven meeting.
And this week the head of one pharmacy chain, Whitworth, highlighted a range of issues faced by his teams including supply chains, costs, loss of staff and NHS
reimbursement for contractors.
In Barnoldswick, queues have formed inside and outside pharmacies as people attempt to get prescriptions. Some said they had to wait for days to get what they
needed, had made repeat-visits to pharmacies and were unsure when medicines might arrive.
They also said the number of pharmacies in the area have fallen over the years.
Two town centre pharmacies, Whitworth and Well, are located opposite each other, close to a doctors' surgery. Standing in one queue outside Whitworth was Marilyn
King.
She said: "I have been waiting seven days to get my prescription for blood pressure and some other medicines. This week, I've come back time after time. But the
staff say sorry, they have not got it in because nobody has delivered it.
"I came here on Saturday, when there was a queue. But the pharmacist was not here. I came again on Tuesday and then Wednesday. Then finally, just when I reached
the front of the queue, they asked me to come back in an hour…
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 Medicines & Healthcare products Regulatory Agency has initiated a recall of three batches of Quantum Pharmaceutical's Diltiazem HCl 2% Cream, which is an
unlicensed medicine. MHRA issued a precautionary recall of the cream due to a change in the product's appearance that affected its thickness.
Pharmacists are instructed to halt supply, quarantine remaining stock, and contact Quantum Pharmaceutical to return affected batches M1402497, M1402574, and M1402680.
Patients using this product may encounter application issues with the cream due to its consistency. However, MHRA said that this has not impacted the product's
effectiveness or posed any risk to patient safety.
The MHRA also reported that medac GmbH (t/a medac Pharma LLP) is conducting a recall of two batches of Sodiofolin 50 mg/ml solution for injection/infusion
(400mg/8ml vial) with batch numbers G220393B and G220393C. This class 2 medicines recall is a result of particles detected during long-term stability tests.
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.
With the UK General Election set for 4 July, pharmacy bodies are actively engaging with all political parties to secure support for the community pharmacy
sector. They are pressing parties to address urgent issues such as pharmacy closures and medicine shortages.
"The upcoming general election is a critical opportunity for us to strengthen supporters of community pharmacy in readiness for the new Parliament," said Janet
Morrison, chief executive of Community Pharmacy England (CPE).
She stressed the need for unity within the sector in advocating for community pharmacy and raising awareness of the issues with election candidates from all parties.
As the general election approaches, CPE has called upon all political parties to support pharmacies by "introducing a long-term sustainable funding model and
reviewing the medicines supply chain, including much-needed short-term relief measures."
The Competition and Markets Authority (CMA) has launched an investigation following 'rocketing prices of antibiotics in the wake of Strep A cases', Sky News
reported on Wednesday (December 14).
On Monday, the Department of Health issued a medicine supply notification for antibiotics for the treatment of Strep A.
"Supplies of antibiotics for the treatment of Group A Strep have seen a surge in demand and may be temporarily in limited supply at certain wholesalers and
pharmacies. Supplies are available with manufacturers, and deliveries into wholesalers and pharmacies are being expedited and are expected in the coming days" said
DHSC.
Sky quoted a spokesperson for the CMA as saying: "People have got real concerns about the price of antibiotics used to treat Strep A, and we want companies to be
clear about their obligations under the law.
While responding to the consultation on hub and spoke dispensing, trade unions for pharmacists have emphasised that the patient safety and care must be the priority in hub and spoke dispensing.
The Royal Pharmaceutical Society (RPS) has welcomed the opportunity provided by a change in legislation to enable community pharmacies to make use of hub and spoke
dispensing but reaffirmed that patient care must be at the heart of future changes.
With regards to patient safety, the Pharmaceutical Services Negotiating Committee (PSNC) considers that only Model 1 is appropriate, with manageable risks related
to patient safety, and is a model that has the potential to allow the whole sector to benefit fairly.
In its response to the consultation on Hub and Spoke dispensing, PSNC highlighted that Model 2 in the consultation, a hub direct to patient supply of dispensed medicines, raises patient safety issues and it cannot be supported.
RPS President Professor Claire Anderson said: "In all models, patients need to continue to have access to a pharmacist at the time of supply of medicines so they
have the opportunity to discuss, ask questions or raise concerns, and receive appropriate information with counselling and advice.
The Royal Pharmaceutical Society (RPS) has confirmed that the recall of blood pressure drugs amlodipine and olmesartan by the Food and Drug Administration is
only for the US market and will not have any impact in the UK.
MHRA also clarified that the manufacturer of these drugs, Macleod Pharmaceuticals, does not supply amlodipine medicines in the UK.
It was published online in both the Daily Record and Daily Express on the morning of Monday, March 21, that the drugs had been recalled in the US by the FDA due to
deviations from standard manufacturing protocols by the manufacturer.
RPS intervened to ensure the articles were edited to make clear that this is not an issue in the UK after confirmation from the MHRA. Amlodipine tablets from Macleod
Pharmaceuticals aren't available for wholesale distribution in the UK.
The Medicines and Healthcare products Regulatory Agency (MHRA) has asked the pharmacies and wholesalers to stop supplying and quarantine all remaining stock
of Dr Reddy's Laboratories (UK)'s Lacidipine 4 mg Film-Coated tablets.
The company has recalled two batches of Lacidipine 4 mg Film-Coated tablets as a precautionary measure due to the presence of an unknown solvent-like odour.
MHRA said: "The tablets are normally odourless. However, in the affected batches, a solvent-like odour is present when the individual blisters are opened.
Additionally, some patient complaints have noted that the tablets have an unusual taste. The investigation to determine the root cause and to identify and quantify
the odour is ongoing.
"The issue is confined to batches B2202043 and B2202044 only. Other batches of Lacidipine 4 mg Film-Coated tablets marketed by Dr Reddy's Laboratories (UK) are not
affected."
Well Pharmacy, a subsidiary company of Bestway Group is donating US$400,000 worth of medicines to help the victims of those impacted by the recent flooding in
Pakistan.
The Bestway Group has raised funds to the tune of $2.3 million, which will be deployed urgently on the ground in Pakistan.
The monies raised has been pledged to build homes (or shelters) for 5,000 families, provide usable water for more than 100,000 individuals and provide food and
medical supplies to over 20,000 people.
In addition to appealing for donations, the Group held a fund-raising event (23 September) at London's Intercontinental on Park Lane, which was attended by over
650 guests including the Lord Chancellor, the Deputy State Bank of Pakistan, UK Cabinet Ministers, and Members of Parliament in addition to leading City' figures
and business community.
The Lord Chancellor Rt Hon Brandon Lewis MP said that the British Government has committed funds of £16.5 million for Pakistan and we are dealing with wider climate
change issues as well and we are committing to that effort.
PCCA Limited has issued a recall for its Ketamine 50mg/5ml and 100mg/5ml oral solutions after a small number of bottles have been observed to contain
crystalline material.
The company said it is recalling impacted batches from patients, pharmacies and hospitals as a precautionary measure.
"This recall is being issued as a company-led medicines recall, as this product is only supplied to a small number of customers and the company has traceability
of the onward distribution by their customers to patients directly," the MHRA said in an alert.
Check the website.
The severity of the ADHD medication shortage in the UK has been exposed as former Hollywood extra Lee Cato revealed that he was forced to quit his job but
hasn't been able to access his medicine.
A resident of Berkhamsted, Hertfordshire, Lee had worked as a film extra in big movies like 'Thor' and 'Edge of Tomorrow'.
The 48-year-old told Mirror that he has been taking Concerta for years to manage ADHD symptoms, but he hasn't been able to get the drug or any alternatives for
over a month.
He said that he first experienced shortages of the medicine in December 2023 but was initially able to take Delmosart, which he took to maintain focus despite
experiencing its side effects such as headaches, nausea, tooth erosion, and a dry mouth.
But now, he can't get access to any of these ADHD drugs as "they're completely out-of-stock and it's been over a month now."
His chemist also tried to get hold of his medication but failed.
A survey of over six thousands pharmacies has revealed that the community pharmacy sector is buckling under growing cost and capacity pressures.
The survey conducted by the Pharmaceutical Services Negotiating Committee, which also involved two thousand community pharmacy confirms, rising costs, patient
demand and
medicine supply issues continue to grip the sector.
PSNC's 2023 Pharmacy Pressures Survey, run as a follow up to the 2022 pressures survey, provides clear comparative data showing the worsening situation across
the sector.
Govt must act now
The result of the survey indeed paints a bleak picture for community pharmacies and it is clear that without urgent action from government and the NHS this will
only get worse: more community pharmacies will either be forced to reduce the number of services they provide or, in the worst-case scenario, will be left with
no option but to close their doors for good.
The PSNC has urged the government to act now "to save our pharmacies, before it is too late for patients, the public, and the rest of the NHS".
"This year's survey clearly shows that community pharmacies are buckling under growing cost and capacity pressures," said PSNC Chief Executive Janet Morrison.
A new report commissioned by the National Pharmacy Association (NPA) has revealed harsh financial realities faced by community pharmacies in England.
The report by Professor David Taylor of University College London warned that 1000s of community pharmacy closure might take place by 2024 in England if the sector
was not supported with additional funds.
At the launch of the report titled 'Protecting UK Public Interests in NHS Community Pharmacy', Prof Taylor said: "There will be several 1,000s of closures over the
next few years unless we take appropriate action, which doesn't mean to pour money all over it, but it is to fund appropriately when necessary.
"At the moment, if we got a partial collapse in the pharmacy network it would disrupt medicine supply and increase health inequalities… For me, it's missing out on
the future development of better and more accessible care, which would be the tragedy of reducing, harming and damaging the pharmacy network unnecessarily."