The Royal Pharmaceutical Society (RPS) has backed a new framework from NHS England to reduce inappropriate prescribing of addiction-causing medicines.
It believes that the new framework is a positive step towards improving patient care by supporting medicine reviews and shared decision making to help people reduce
their use of medicines that are no longer providing much clinical benefit.
The society has also welcomed investment in innovative approaches to supporting patients and urged all pharmacists to refer people to such schemes.
Director for England at RPS, James Davies said: "Pharmacists are well-placed to help reduce inappropriate prescribing of high strength painkillers such as opioids
and other addictive medicines.
"Pharmacy teams can also often spot repeat purchases of over the counter medicines by patients so are well placed to intervene and give advice on the management of
chronic pain. Whilst opioids can play an important part in helping people with chronic pain there has long been a need for alternative approaches that are safer and
more effective for patients.
In partnership with the Prescription Charges Coalition (PCC), the Royal Pharmaceutical Society (RPS) has taken a significant step by urging political
leaders to abolish prescription charges for individuals with long-term conditions.
Tase Oputu, Chair of the RPS England Pharmacy Board, signed an open letter on Thursday, calling on party leaders to address this pressing issue.
The letter emphasises the outdated nature of the current exemption list, which forces individuals with chronic conditions like Parkinson's, cystic fibrosis,
and HIV to bear the cost of their essential medications.
It urges party leaders to urgently review and update the exemption list to ensure equitable access to necessary medicines.
"Nobody should face a financial barrier to accessing the medicines they need," Oputu stated.
Community Pharmacy England (CPE) has notified pharmacy teams that starting 1 August 2024, three Hormone Replacement Therapy (HRT) medicines will be
discontinued and will no longer be covered under the NHS HRT Prescription Prepayment Certificate (HRT PPC) scheme.
These are Bedol® 2mg tablets, Climanor® 5mg tablets and Clinorette® tablets.
Since Climanor® 5mg tablets have been discontinued, Medroxyprogesterone 5mg tablets will also be removed from the HRT PPC list, as this generic product is no
longer available as a licensed HRT medicine.
The CPE also noted that Provera® 5mg tablets, being an unlicensed HRT medicine, are not covered by the HRT PPC.
Pharmacy staff are advised to check the NHS Business Services Authority (NHSBSA) website for the most current list of HRT medicines covered by the HRT PPC.
The CPE has updated its HRT PPC medicines list to reflect these changes, which will also be updated in Part XVI of the August 2024 Drug Tariff.
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 Medicines and Healthcare products Regulatory Agency (MHRA) has maintained the prescription-only status of Aquiette 2.5mg Tablets for symptoms of
overactive bladder, following a public consultation and the review of a reclassification application from the manufacturer Maxwellia Ltd.
Aquiette, which contains the active ingredient oxybutynin, is used for the treatment of long-term symptoms of overactive bladder (OAB) in women aged between 18
and 65, such as the urgent need to urinate and frequent urination without pain.
The regulator decided against the reclassification of Aquiette 2.5mg Tablets from a prescription-only medicine (POM) to a pharmacy (P) medicine, concluding that
a medical prescription continues to be required to ensure the safe use of Aquiette.
Since an OAB diagnosis requires medical supervision to ensure that the correct treatment is received, and other health conditions are not overlooked or left untreated,
the MHRA said the decision would ensure that the medication is used safely and appropriately under medical supervision.
"After taking on board the views of the many patients and healthcare professionals who responded, we have decided to refuse the reclassification of Aquiette 2.5mg
Tablets for women with symptoms of overactive bladder (OAB)," Dr Laura Squire, MHRA chief healthcare quality and access officer, said.
The UK government has announced plans to update legislation to enable more services and individuals to provide take-home supplies of naloxone - a life-saving
opioid overdose antidote - over the next few weeks.
Naloxone can immediately reverse the effects of an opioid overdose by reversing breathing difficulties. The medicine can be administered by anyone in an emergency.
However, current legislation allows only drug and alcohol treatment services to supply it without a prescription to individuals for future use.
The Department of Health and Social Care (DHSC) confirmed on Tuesday (14 May) that more professionals, including nurses, paramedics, police officers, probation
officers and pharmacy professionals, will be able to supply the medicine without a prescription to save lives.
Health and Social Care Secretary Victoria Atkins warned that opioid addiction can ruin lives and it accounts for the largest proportion of drug-related deaths
across the UK.
A BBC investigation has found 20 UK online pharmacies selling prescription-only medicines without adhering to the regulatory standards, such as checking
for GP approval or patient's medical records.
The news organisation was able to purchase over 1,600 restricted pills, including anti-anxiety drug, painkiller and sleeping medication, from these regulated
online pharmacies easily by providing false information.
However, the report didn't mention the names of the drugs as "they can be dangerous when taken without medical guidance."
Some pharmacies were also found selling high-risk and potentially addictive medicines, including benzodiazepines and antidepressants, based on online questionnaires
and did not require further checks.
The General Pharmaceutical Council (GPhC), which regulate online pharmacies in the UK, states that selling and supplying medicines at a distance brings
"different risks which need to be appropriately managed to protect patient safety."
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.
People are advised to be mindful of medications that may cause sun reactions, and to watch out for dodgy hay fever treatments and fake weight loss pens.
For those traveling abroad, the MHRA advises considering the suitability of medicines available to reduce the risk of contracting tropical diseases.
Dr Alison Cave, Chief Safety Officer at the MHRA, said: "The summer is an exciting time for many of us, as we take time off to travel and enjoy the warmer weather.
"But it is important to understand what this time of year means for our medicines and medical devices, and take the precautions necessary to use products safely
and protect ourselves."
Watch out for dodgy hay fever treatments
Millions of Britons suffer from hay fever symptoms in the summer. The MHRA advises consulting a healthcare professional to find the best treatment for your symptoms.
People are also warned to be cautious of medicines advertised as hay fever treatments but not approved for use in the UK, such as Kenalog. This is a
prescription-only steroid injection licensed as a medicine for other conditions, but not for the treatment of hay fever.
Indian multinational pharmaceutical company, Dr. Reddy's Laboratories has made its entry into the UK consumer health market with the launch of an
over-the-counter allergy medication.
Histallay (Fexofenadine Hydrochloride 120 mg tablets) is the company's first general sale list (GSL) product introduced in the UK market.
Previously classified as a Prescription Only Medicine (POM), Dr. Reddy's Fexofenadine 120 mg is now available without prescription, under the brand
name 'Histallay'.
This allows people with allergic seasonal rhinitis (hay fever) to get direct access to the product via retail outlets such as pharmacies and supermarkets
in the UK.
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 MHRA's Criminal Enforcement Unit (CEU), working with other law enforcement partners, has seized more than two million "illegally traded medicines" this
year, with a total value of £5 million.
The products confiscated in the UK were prescription-only medicines including anti-depressants, pain medication and human growth hormones.
The MHRA launched an initiative, Operation Pangea, 15 years ago to combat "illegal internet trade in medical" products.
Andy Morling, the Deputy Director of Criminal Enforcement of MHRA, spoke about Operation Pangea's 15-year anniversary.
"Fifteen years ago, the MHRA started Operation Pangea, combining our knowledge and resources with those of international partners to disrupt and bring to justice
the criminal gangs responsible for selling medicines illegally and causing harm around the world.
NHS England will collaborate with "a number of system suppliers" to increase the number of trusts using electronic prescription service (EPS) over the next
few years.
Nishali Patel, clinical lead for digital medicines at NHS England, announced it during the Clinical Pharmacy Congress, held at the Excel, London, on Friday, 10 May
2024.
According to Nishali, at least half of all NHS secondary care trusts could be using EPS by 2026.
This digital service allows prescribers to send prescriptions electronically to a patient-nominated pharmacy. It is widely used in primary care, where over 95
per cent of prescriptions are now electronically generated. NHS recently extended the service to secondary care settings.
The Medicines and Healthcare products Regulatory Agency (MHRA) has warned the public to avoid buying pre-filled weight loss pens without a prescription.
The warning came after 369 fake Ozempic injections have been seized since January 2023.
However, Saxenda pens were obtained by members of the public in the UK through "non-legitimate routes".
The health regulator has urged the public to buy the pens after consulting a healthcare professional and with a prescription.
Dr Alison Cave, MHRA Chief Safety Officer shared her opinion on the matter, she said: "Buying products such as Ozempic or Saxenda without a prescription,
from illegally trading suppliers, significantly increases the risk of receiving something which is either fake or not licensed for use in the UK.
Increased cooperation between countries is needed to ensure better regulation of online pharmacies, said authors of a new report - 'Online pharmacy operations and distribution of medicines', published by the International Pharmaceutical Federation's (FIP) Community Pharmacy Section.
The report presents findings of a global survey of pharmacy organisations covering various aspects, such as type of medicines supplied by these pharmacies in different countries, how the authenticity of online pharmacies can be verified, and the usage of e-prescriptions and shared patient health records.
Of the 79 countries responding to the survey, 51 per cent acknowledged that no regulation of online pharmacies exists.
A quarter of the respondents reported cases of irresponsible self-medication by consumers who had purchased medicines through online pharmacies.
A lack of regulation creates "an avenue for illegal pharmacies and may impact the overall quality of medicines and services offered to consumers," authors of
the report said.
Lars-Åke Söderlund, immediate past president of FIP's Community Pharmacy Section and co-editor of the report, said that the pandemic has increased preference for online services, including in the pharmacy sector.
Approximately 25 million GP appointments and 5 million A&E visits are utilised each year for self-treatable illnesses. If these individuals chose to self-treat
using over-the-counter (OTC) medications, the potential savings for NHS could amount to at least £1.7 billion annually, according to a research commissioned by
Proprietary Association of Great Britain.
The study, conducted by analysts at Frontier Economics, revealed that embracing self-care could bring an additional economic benefit of £350 million annually, as
employees would avoid unnecessary time off from work for medical appointments.
Apart from the savings resulting from the increased OTC medicine use, the report emphasises the potential benefits of reclassifying more prescription-only
medications (POMs). A mere 5 per cent reduction in NHS prescribing levels and spending could lead to an annual cost-saving of £1.4 billion, encompassing both
prescription costs and GP appointments, it said.
"This substantial amount could greatly alleviate financial pressures on the NHS and offer essential resources for recruiting and training much-needed healthcare
professionals."
The Department of Health and Social Care (DHSC) and the Medicines and Healthcare Products Regulatory Agency (MHRA) have authorised community pharmacies
throughout the UK to dispense original full packs of Valproate-containing medicines upon prescription.
The necessary changes in regulations came into effect on 11 October which was strongly supported by 85 per cent of respondents concerned about risks to the
unborn baby if valproate-containing medicines are used in pregnancy.
The decision was made to ensure patients receive safety warnings and pictograms, including a patient card and the Patient Information Leaflet (PIL), contained
in the manufacturer's original full pack.
Valproate is a treatment for epilepsy and bipolar disorder but is also associated with birth defects and neurological disabilities.
Leading health and beauty retailer Superdrug on Monday announced that it has selected on-demand delivery network Gophr to provide its pharmacy delivery
service, following a rigorous Request for Information (RFI) process.
This means Gophr will be responsible for delivering prescriptions across the UK to people who choose Superdrug to provide their medication.
Superdrug's decision to choose Gophr was influenced significantly by the latter's strong Standard Operating Procedures (SOP), its adept ability to track and
trace all home deliveries digitally from store to door, and its commitment to offering a best-in-class doorstep experience.
According to the retailer, multiple layers of protection are implemented during delivery to uphold standards, ensuring that prescription medicines are handed
directly to the intended recipients.
Graham Smith, strategic account director at Gophr, highlighted the growing importance of pharmaceutical delivery, especially as pharmacists are now able to
provide even more services under Pharmacy First scheme.
Pharmacies across Northern Ireland are in financial turmoil, reporting that they are dispensing prescription medicines at a loss due to inadequate
reimbursement from the Department of Health (DoH).
This crisis has led to the closure of almost a dozen pharmacies over the past 18 months, with many others struggling to stay open.
Siobhan McNulty, who runs Melvin Pharmacy in Garrison, County Fermanagh, described the dire situation. "We're dispensing medicines at a loss," she said.
"The reimbursement rates don't match the cost of the drugs, and we're left to cover the gap."
McNulty relies on sales of non-pharmaceutical products to keep her business running.
The Royal Pharmaceutical Society (RPS) has welcomed the Health Secretary Sajid Javid's plan to appoint Hormone Replacement Therapy (HRT) tsar to tackle the medicine shortages.
On Sunday (April 24) Sajid Javid told the Mail that he planned to tackle the problem (shortage of HRT medicine) by appointing a new HRT tsar with the role modelled on that of Kate Bingham, who successfully led the government's Covid vaccine taskforce.
"The difficulties in accessing HRT medicine have unfairly impacted women's mental health," said RPS President, Professor Claire Anderson.
"I look forward to working with this new champion for HRT and the Government on how we can better support women's health, building on the positive move to reduce
prescription charges for HRT for women."
Anderson also stressed that "the Government should now go further and end unfair prescription charges for patients in England altogether."