UK drug that prevents brain damage in alcoholics in short supply
Doctors are warning that a severe shortage of an “essential” drug designed to protect alcoholics from degenerative brain disorders could disproportionately impact “the most vulnerable” in society.
Pabrinex, a multivitamin injection, is used to protect heavy drinkers from conditions such as Wernicke’s encephalopathy and Korsakoff’s syndrome, which can have symptoms similar to dementia. Doctors are concerned that the incidence of these debilitating conditions may increase because of the deficiencies.
The Department of Health and Social Care warned in april that intravenous injections of Pabrinex would likely be in short supply through August 2025 and that intramuscular injections were being discontinued.
Dr Marcus Bicknell, a GP specialising in addiction, described the situation as “an absolute disaster”. “This is a cheap, highly effective drug that we have been using for over 50 years, and next year it will no longer be available to us at all. If this was a cancer drug, withdrawing it would never be acceptable.”
Bicknell said his center had already begun rationing the drug and reducing doses of “essential” medications given to patients, which he called “outrageous.”
A spokesman for Kyowa Kirin, the licensee of Pabrinex, said supplies of the drug were affected by the closure of manufacturing facilities that needed to be modernised to comply with changes in EU regulations.
The spokesperson said: “We have identified a new manufacturing partner for Pabrinex® IV and are actively working to facilitate a transfer of production to this new partner. The transfer is being expedited, but it is a complex process.”
Bicknell said he believed manufacturers pulled the drug from the market because it wasn’t profitable enough. “Addiction patients shouldn’t be treated like second-class citizens — it’s outrageous,” he said.
The UK has seen a dramatic rise in the number of unavailable medicines in recent times, with supply problems doubling from 648 in 2020 to 1,634 last year. A Nuffield Trust report in April concluded that while global production problems linked to Covid, inflation and the war in Ukraine had contributed to shortages, the situation in the UK had been exacerbated by Brexit.
Alcoholism impairs the body’s ability to absorb vitamins, which can increase the risk of developing the degenerative brain disorder. Pabrinex contains five vitamins, including thiamine, and is described as a “gold standard” treatment to protect heavy drinkers from irreversible brain damage, and there are limited alternatives.
The drug, which costs £2 per treatment, is out of stock in some areas. Thiamine injection is an alternative treatment, but there is currently no product with marketing authorisation in the UK.
Dr David Bremner, medical director of drug and alcohol charity Turning Point, said: “The public is not a vocal group of health service users or a group that is self-motivated to oppose these types of detoxification services.
“We’re currently only giving Pabrinex to 10% of the people we used to give it to. The problem with a preventative drug is that it only works if we give it to as many people as possible. It starts to get alarming when we start rationing drugs, because until something catastrophic happens, you don’t really know if you’ve given it to too few people.”
Wernicke-Korsakoff syndrome is a form of brain injury that has two distinct stages. If left untreated, it can lead to disorientation, balance disorders, and dementia-like disorders.
Sharon Bright, 63, from Nottingham, was treated with Pabrinex. “Pabrinex probably saved my life,” she said. “My parents were told I would be in a care home for the rest of my life because of my brain injury, but with rehabilitation and medication my neurological pathways opened up again and now I work, drive and live independently again.”
A Department of Health and Social Care spokesperson said: “We know how frustrating and distressing medicine supply issues can be for patients. This Government has inherited ongoing global supply issues which continue to impact the availability of medicines, and we are working closely with industry, the NHS, manufacturers and other partners in the supply chain to resolve the current issues as quickly as possible.
“We have been working to secure imports and support new products to enter the UK market. As a result of these actions, the expected delivery date of Pabrinex has been brought forward by almost a year.”