For for anyone who relies on medications to treat a health problem, a deficiency will not be welcome. In some cases, for example with cough and cold remedies, this will be a worrying inconvenience. But other medicines, such as HRT, diabetes medicines, antibiotics and antipsychotics, have serious consequences for health and wellbeing. In extreme circumstances, the lack of a drug can pose a life threat. Recently, alarm has been raised regarding riluzole, a drug used by people suffering from motor neurone diseases to delay ventilator dependency and prolong life.
Worryingly, the Motor Neurone Disease Association claims that concerns raised with Health Minister Victoria Atkins and her department have not been properly addressed. Riluzole’s manufacturer, Glenmark, has highlighted competitive demand for limited supplies of the active ingredient. That people suffering from such serious diseases are facing these problems is obviously worrying. With approximately 100 medicines on a shortage list, the government appears to be insufficiently prepared and slow to take action.
Britain is not alone in its drug supply chain problems. This is a global issue that has risen up the agenda of both EU countries and the US. Wealthy Western countries, like much of the rest of the world, are heavily dependent on the pharmaceutical production capacity of India and China for sufficient quantities of generic, non-patented medicines. During the pandemic, the risks of this model became clear as countries were forced to compete for vaccines, and India imposed export restrictions on many products, including paracetamol.
Both the EU and the US have responded with significant steps towards reshoring. France is building a paracetamol factory large enough to meet half of Europe’s demand. Belgium has made the issue an issue theme of his EU presidency. It appears that state aid rules will be changed and pharmaceuticals will be recategorized as a strategic industry, just like semiconductors. Although European production will make supplies safer, it is also expected to make medicines more expensive and reduce CO2 emissions and other related environmental damage.
Teams from the Department of Health and NHS England, and equivalent agencies in the devolved administrations, play a vital role in overseeing the UK’s medicines supply. Thanks to stockpiling and other measures, the exit from the internal market has not led to chaos. But Brexit has increased the pressure. The fall in the value of the pound has made Britain a less attractive market. There is a balance to be struck between putting downward pressure on prices – which the NHS has traditionally been good at as a major buyer – and incentivizing suppliers. The current shortages indicate that the current system is not working properly.
In addition to day-to-day management, Britain also needs a strategy. This would mean working with the EU rather than against the EU in bringing production back to Europe. It should include planning for peaks in demand, such as that for HRT, following a campaign around menopausal symptoms and a shift in prescribing patterns. Deficiencies like those with the type 2 diabetes drug Ozempic after it was prescribed for weight loss should be anticipated even if they cannot be avoided. Poll after poll shows how much the public cares about health care. Labor shortages and a lack of investment are the biggest problems, but access to medicines is also crucial.