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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.

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 Serious Shortage Protocol (SSP) for Salazopyrin EN-Tabs 500 mg due to ongoing shortage of the medicine. With SSP014 in place from today (November 26), for every prescription one Sulfasalazine 500mg gastro-resistant (GR) tablet will be supplied. This SSP will expire on December 20, 2021, and PSNC will update contractors in case of any change. PSNC has advised pharmacists to notify the patient's prescriber while supplying in accordance with this SSP. Besides, the supervising pharmacist should refer back to the prescriber if a non-chewable atorvastatin tablet would not be appropriate for the patient.

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.

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.

The Department of Health and Social Care (DHSC) has extended the Serious Shortage Protocols (SSPs) for Fluoxetine 10mg tablets (SSP005) and Lipitor 10mg chewable tablets (SSP032) to Wednesday, 7 December 2022. SSP005 for Fluoxetine 10mg tablets was due to expire on 12 August 2022. DHSC has also updated that SSP032 for Lipitor 10mg chewable tablets was due to expire on 12 August 2022 but the end date has been further extended to Friday 26 August 2022. SSP005 provides that for every Fluoxetine 10mg tablet originally prescribed, one Fluoxetine 10mg capsule must be supplied: "Expiry dates of an SSP may be brought forward or extended, and the content may be amended at any time during the life of an SSP. Pharmacists should ensure they are using the latest version of an SSP before considering the supply of an alternative product," said DHSC.

The Department of Health and Social Care (DHSC) has issued two new Serious Shortage Protocols (SSPs) for Estraderm MX 25mcg and 100mcg patches. Effective from 8 September 2022, SSP035 and SSP036 provide that for every Estraderm MX 25mcg or 100mcg patch originally prescribed, one Evorel 25mcg patch or 100mcg patch must be supplied, respectively. Both SSPs are currently set to expire on 16 September 2022. Both SSPs, authorised by the secretary of state for health, have been developed by clinicians and provides pharmacists with procedures to follow in providing either of these suitable alternative products to help reduce the number of patients having to return to their prescriber for a replacement prescription. DHSC informed that there are no SSPs in place for Estraderm MX 50mcg patches and 75mcg patches - these strengths are not affected by supply disruptions and should continue to be dispensed in accordance with the prescriptions "The SSP035 and SSP036 only allow substitution of Estraderm MX 25 or 100 patches with Evorel 25 or 100 patches, respectively."

Victoza (liraglutide) 6mg/mL pre-filled injection pens, previously used in the treatment of type 2 diabetes mellitus (T2DM), have been out of stock in the UK since August 2023. Novo Nordisk has confirmed to The Pharmaceutical Journal that the product has now been discontinued as part of their broader strategy to consolidate their portfolio. The Danish pharmaceutical company said that they are in close dialogue with the Department of Health and Social Care (DHSC), which is expected to release guidance outlining timelines, alternative treatments, and recommended next steps for healthcare professionals. However, the company clarified that they have no plans to discontinue Saxenda (liraglutide) pre-filled injection pens, though this product has also faced supply restrictions in the UK since shortages began. The DHSC initially announced a national shortage of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), including Victoza, in June 2023. At that time, prescribers were advised to limit use of these drugs for their licensed indications and to avoid initiating new GLP-1 RA therapies for T2DM patients during the shortage.

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.

The Department of Health and Social Care (DHSC) has issued a further five new Serious Shortage Protocols (SSPs) for Phenoxymethylpenicillin (Pen V) to enable the continued supply of antibiotics to patients. "The new SSPs, introduced with immediate effect, allow community pharmacists to consider different oral antibiotic preparations, to enable the continued supply of antibiotics to patients and mitigate the ongoing supply disruptions affecting Phenoxymethylpenicillin," said DHSC. On Friday (16 December) SSP043-SSP047 has been authorised by the Secretary of State to provide pharmacists with procedures to follow in providing suitable alternative oral antibiotics to substitute Phenoxymethylpenicillin. "For each SSP, DHSC has included specific patient counselling points which must be taken into account when deciding whether supply in accordance with an SSP is suitable for a patient."

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."

The Department of Health and Social Care (DHSC) has suggested Estradiol patch as an alternative for patients who use 1 pump of Oestrogel daily. DHSC has updated Annex A of SSP022 and SSP023 for Oestrogel Pump-Pack 0.06 per cent gel to include a dose conversion to a specific alternative Estradiol patch. Previously, only dose conversions for patients using 2 to 4 pumps daily were included in Annex A of SSP022 and SSP023. Separately, the supporting guidance for three SSPs which allow quantity restriction have been updated to reflect the requirement to endorse the reduced quantity supplied in accordance with these SSPs. SSP019 - Oestrogel pump-pack 0.06% gel SSP020 - Ovestin 1mg cream SSP021 - Premique low dose 0.3mg/1.5mg modified release tablets "When endorsing an SSP for a reduced quantity, contractors must ensure that the correct SSP number is endorsed along with the product name and the reduced quantity supplied in accordance with the SSP," said PSNC.

The Department of Health and Social Care (DHSC) and the Medicines and Healthcare Products Regulatory Agency (MHRA) have added five more medicines that cannot be hoarded or exported from the UK market. The government has taken the following action to address the "critical shortage" of attention deficit hyperactivity disorder (ADHD) drugs. In a crucial development on October 9, this strategic move aims to enable wholesalers to fulfil their legal obligation to supply these essential medicines to patients across the UK. The updated list of drugs incorporated "all" available strengths and pharmaceutical formulations, ensuring comprehensive coverage for patients' medical needs.

Department of Health and Social Care (DHSC) has issued a medicine supply notification for GLP-1 receptor agonists used in the management of type 2 diabetes on Tuesday (27 June). "There are very limited, intermittent supplies of all glucagon-like peptide-1 receptor agonists (GLP-1 RAs) licensed in the management of Type 2 Diabetes Mellitus (T2DM)," said DHSC. The supply issues have been caused by an increase in demand for these products for licensed and off-label indications and it is not expected to return to normal until at least mid-2024. Pharmacists are urged to refer to the SPS Tool for Medicines Shortages for an up-to-date supply stock situation and clinical guidance on alternative treatment options.

The Serious Shortage Protocol (SSP), for Estradot 50mcg patches will expire at 23.59pm on Friday 24 February 2023. Department of Health and Social Care (DHSC) has confirmed that sufficient stock of Estradot 50mcg patches are now available to meet normal demand. "After 24th February, any prescriptions for Estradot 50mcg patches must be dispensed in accordance with the prescription, and SSP048 will no longer be valid for use," said DHSC. Top tips for SSP claims by PSNC: Where available, use the claim amend facility on the PMR system to rectify any incorrect EPS claims already submitted this month. For any supplies made in accordance with SSPs, check that the correct number of patient charges are collected and declared on the end of month FP34C submission. 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.

The Department of Health and Social Care (DHSC) published a notification regarding the shortage of Guanfacine 2mg and 3mg modified-release tablets has raised concerns within the healthcare community. This critical medicine supply notification, issued on March 28th, projects the unavailability of these tablets until the week commencing May 6, 2024. Guanfacine tablets, commonly prescribed to alleviate symptoms of hyperactivity and impulsivity while enhancing attention and concentration, play a vital role in managing conditions like attention deficit hyperactivity disorder (ADHD). However, the scarcity of these specific strengths poses challenges for patients reliant on this medication. Last year, several countries across the globe experienced shortages of medications for the treatment of attention deficit hyperactivity disorder (ADHD)including the UK, the US and Australia. Community Pharmacy England (CPE) has cautioned that while alternative strengths of Guanfacine remain accessible, they may not adequately meet the heightened demand, potentially resulting in treatment interruptions for patients.

Pharmacists are being notified of a limited supply of hydrocortisone sodium phosphate 100mg/1ml solution for injection ampoules, with stock expected to be exhausted by late March 2025. The Department of Health and Social Care (DHSC) has issued a medicine supply notification, indicating that resupply is not anticipated until May 2026. NHS provider Trust pharmacy procurement and clinical teams are advised to collaborate in reserving existing stock of the solution for injection, specifically for patients who require hydrocortisone sodium phosphate during an adrenal crisis. The DHSC added that this stock has an expiry date of June 2025. Hydrocortisone is used to replace steroids in individuals with adrenal insufficiency, such as those with Congenital Adrenal Hyperplasia (CAH) or Addison's disease, where the adrenal glands produce insufficient natural steroids. People with adrenal insufficiency or anyone who is "steroid-dependent" require a hydrocortisone emergency injection kit to prevent an acute adrenal crisis, which can be life-threatening.

The Department of Health and Social Care (DHSC) has issued Serious Shortage Protocols (SSPs) on three HRT medicines to limit dispensing supply to three months. To ensure women across the UK will be able to more reliably access HRT products SSPs has been issued on the supply of Oestrogel, Ovestin cream and Premique Low Dose. DHSC stated, "Women who have a prescription for more than three months but are only able to access three months' supply will not have to pay an additional prescription charge." "This means women will not incur any additional costs. Imposing a three month limit will mean more women are able to access the medication they want. Any woman who is worried about access to HRT or is unable to access HRT should speak to her GP." Recently, Vaccine Taskforce Director General Madelaine McTernan has been appointed to spearhead a new HRT Supply Taskforce, applying lessons learned from the successful procurement seen during the Covid vaccination programme to identify ways to support the HRT supply chain ensuring it can meet both short and long term demand. The move will save time for patients as well as pharmacists and prescribers who are working tirelessly to tackle the covid backlog.

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).

Considering the shortage of Fluoxetine 10mg tablets, the Department of Health and Social Care (DHSC) has extended the serious shortage protocol (SSP) for the medicine to February 11, 2022. Earlier the SSP for Fluoxetine 10mg tablets was set to expire on November 12. Extension of the transition period will enable use of No Cheaper Stock Obtainable (NCSO) endorsement and use of EPS tokens to claim for supplies made in accordance with SSPs. The NHS Business Services Authority (NHSBSA) has accepted that either the new 'SSP' or existing 'NCSO' endorsement for any SSP claims can be submitted using electronic prescriptions (EPS) tokens of FP10 paper prescriptions, during the period.