Medicine shortages are a “new normal” in Britain and are being exacerbated by Brexit, a report from health think tank Nuffield Trust has warned. A dramatic recent spike in the number of medicines being unavailable has caused serious problems for doctors, pharmacists, the NHS and patients, it emerged.
The number of warnings pharmaceutical companies have issued about impending supply problems for certain products has more than doubled from 648 in 2020 to 1,634 last year.
Mark Dayan, the report’s lead author and leader of the Nuffield Trust’s Brexit programme, said: “The rise in the shortage of essential medicines from rare to commonplace has been a shocking development that few would have expected a decade ago.”
Britain has been struggling with major shortages of medicines for the treatment of ADHD, type 2 diabetes and epilepsy since last year. The intention was that three ADHD drugs that were in short supply would be back in normal circulation by the end of 2023, but are still difficult to obtain.
Some medicine shortages are so serious they are putting the health and even lives of patients with serious illnesses at risk, pharmacy bosses have warned.
Healthcare charities have seen a sharp increase in calls from patients unable to receive their usual medication. Nicola Swanborough, head of external affairs at the Epilepsy Society, said: “Our helpline has been inundated with calls from desperate people who have to travel miles and often visit multiple pharmacies to get their medicines.”
Paul Rees, the chief executive of the National Pharmacy Association, which represents most of Britain’s 7,000 independent pharmacies, said: “Supply shortages are a real and present danger to patients who depend on life-saving medicines for their well-being. Pharmacy teams have seen the problems in this country worsen in recent years, putting more patients at risk.
‘Pharmacists… spend hours a day looking for supplies, but all too often have to turn away patients. It is worrying when pharmacy teams are unable to deliver medicines quickly through no fault of their own.”
Global manufacturing problems linked to Covid, inflation, the war in Ukraine and global instability have contributed to Britain’s failure to ensure patients have access to medicines.
But Britain’s departure from the EU in 2020 has significantly exacerbated the problem, exposing the “fragility” of the country’s drug supply networks and could lead to a worsening of the situation, the report said.
“A clear picture emerged of the underlying vulnerabilities at global and UK level, which are not fundamentally rooted in Brexit but are exacerbated by it in a number of specific ways, particularly as some companies cut Britain out of their supply chains removed,” the report said.
Britain’s departure from the single market has disrupted the previously smooth supply of medicines, for example through the introduction of a requirement for customs checks at the border, as well as the UK’s decision to leave the EU’s European Medicines Agency and start medicating itself approve. Britain is now much slower than the EU in making new medicines available, the report shows.
The post-Brexit red tape has prompted some companies to stop supplying Britain altogether.
The fact that the depreciation of the British pound after the Brexit referendum in 2016 coincided with medicines becoming much less available worldwide as pharmaceutical companies faced ingredient shortages, which drove up prices, also played a key role in the development. of the shortages.
That has forced the Department of Health and Social Care (DHSC) to agree to paying more than the usual price for medicines that are in short supply, to try to ensure continuity of supply much more often than before. “Price concessions” increased tenfold from around 20 per month before 2016 to 199 per month by the end of 2022, costing the NHS in England £220m in 2022-23, the think tank found.
The report is based on freedom of information requests to health authorities, as well as interviews and a roundtable discussion with key drug industry figures, senior DHSC officials and European health authorities.
It warned that Brexit had created “further risks for Britain”. The Nuffield Trust said medicine shortages could worsen because the EU’s 27 countries recently decided to act as one bloc and try to minimize the impact of global shortages, making Britain’s supplies even less of a problem. could become a priority for pharmaceutical companies.
Dr. Andrew Hill, a drug industry expert at the University of Liverpool, said: “With this background stress on global supplies, Britain is now more vulnerable to drug shortages. Britain now sits behind the US and Europe in the queue for essential medicines. Other countries offer high prices and easier access, with simpler rules for delivery.”
Ministers should agree to pay more for generic drugs, which are usually much cheaper than branded drugs, to help tackle shortages, Hill added.
The Royal Pharmaceutical Society, which represents pharmacists, has urged ministers to change the law to allow community pharmacists to avoid shortages by giving patients slightly different prescriptions, as their hospital counterparts already do.
“If a liquid version of a medicine is currently available, but tablets have been prescribed and are out of stock, the pharmacist will not be able to supply the liquid version,” said James Davies, the association’s director for England. “The patient has no choice but to return to the prescriber for a new prescription, which creates unnecessary workload for GPs and delays for the patient.”
DHSC said most medicines remained available. “Concessional prices can arise for a variety of reasons and cannot be linked to shortages,” a DHSC spokesperson said.
“Our priority is to ensure that patients continue to receive the treatments they need. There are approximately 14,000 registered medicines and the vast majority are in good stock.”