Tackling a new decade of medicine shortages

Over 90% of UK pharmacists surveyed by the Pharmacists Defence Association have reported an increase in drug shortages over the past 12-months(9).

And shortages have continued to be driven by a variety of factors, such as the COVID-19 crisis, limited sources, and increased regulatory pressure. As we enter a new decade, bringing with it a series of novel and unprecedented impacts on medicine supply, we look at the current state of shortages in the UK, alongside our own perspective on how to tackle the upcoming challenges.

In 2019 the UK experienced drug shortages across every major medicine category, including cancer treatments, Parkinson’s disease, mental health conditions and commonly prescribed drugs such as contraception and blood pressure medication.  A leaked document from the Department of Health and Social Care (DHSC) revealed that certain anti-epilepsy drugs are expected to remain out of stock until March 2020.(3)

Public awareness of drug shortages is also on the rise. In the run-up to Brexit, the UK media coverage described the current situation as ‘unprecedented’.(7) One concern is the supply route for medicines accessing the UK. Three quarters of medicines come to the UK via France(2), with reports predicting future transport disruption and delays at the channel crossing.

These fears have directly contributed to patients stockpiling medication at home, in particular diabetic patients who rely on daily insulin.(3) Healthcare Professionals (HCP’s) have stressed the detrimental impact stockpiling can have on an already difficult situation, and have called for increased government transparency around stockpiles in order to provide reassurance to their patients.(8)

Compounding this, a government document leaked at the end of 2019 revealed that shortages of certain medicines would mean some patients receiving priority over others. One troubling recommendation was that HCPs should look to share supplies by breaking tablets in half, even noting that “'there is no data' on the safety of 'halving or crushing [tablets]' to deliver a lower dose.”(4)(5)

This is in spite of Royal Pharmaceutical Society advice to the contrary, which specifically highlights the dangers of this practice. 

2019 has seen the issue of shortages brought even further into the public eye, with concerns being vocalised across the board from patients to HCPs. Many predict that this already damaging situation will deteriorate even further.(6)

As we enter the new decade, bringing with it an unfolding COVID-19 crisis and uncertainty surrounding Brexit, the resulting impact on shortages remains unknown. However, the existing factors that drive shortages are as prevalent as ever.

What remains clear is that the industry needs to act.

 

Clinigen Direct launch UK Drug Shortages Tracker

As a business, Clinigen has a single mission: to get the right medicine to the right patient at the right time.

When a challenge such as a UK medicine shortage stands in the way, Clinigen responds to provide innovative and effective solutions to help healthcare professionals continue to provide medicines to their patients, whenever they are needed.

That’s why Clinigen have developed a new UK Drug Shortages Tracker, to help UK healthcare professionals keep abreast of shortages, and source suitable alternatives where possible. The platform is part of Clinigen Direct, which offers a dedicated service for healthcare professionals struggling with shortages, or who need access to unlicensed or unavailable medicines. 

Our drug shortages tracker is updated weekly with the most recent alternatives to medicines that our global sourcing team have procured.

Visit our UK drug shortages list

 

2019 in review:

209
Shortages reported in 20191

 

Over 50%
Lasting 3 months or more1

 

10 months
Longest shortage duration (10 medicines)1

Clinigen Insight

Graeme Petrie from Clinigen explains:

“There is an expectation that the number of drug shortages will continue its upward trajectory.

According to a survey carried out by the European Association of Hospital Pharmacists (EAHP’s 2018 Survey on Medicines Shortages to improve patient outcomes, 2019) in November 2018, 60% of hospital pharmacists in the UK have reported experiencing medicines shortages every day, double the number reported in the rest of the EU. 

An important and increasing area of focus for Clinigen’s Unlicensed Medicines operation is to meet our customers’ needs in relation to drug shortages. Clinigen proactively works with manufacturers/licence holders as their partner to manage possible drug shortages within their portfolio. 

We have a dedicated team providing an agile and speedy response, working with a global network of suppliers which allows us to source and secure stock.

We also work closely with regulatory bodies throughout the UK and Europe. These authorities can then direct healthcare professionals to Clinigen, and our customer support team are able to contact all UK and EU customers to inform them that Clinigen has stock available via a regular drug shortage newsletter. 

This is happening on a global basis and not just in the UK, to ensure healthcare professionals have access to important medicines to treat their patients.” 

References

  1. The Pharmaceutical Journal. ‘Confidential government documents reveal names of 209 medicine shortages in 2019’. 2020. https://www.pharmaceutical-journal.com/news-and-analysis/news/confidential-government-documents-reveal-names-of-209-medicine-shortages-in-2019/20207603.article  [Accessed January 2020] 
  2. ‘BMJ 2019;366:l5226’ 2019 https://www.bmj.com/direct/content/366/bmj.l5226.full [Accessed January 2020]
  3. ‘Revealed: UK patients stockpile drugs in fear of no-deal Brexit’ January 2019 https://www.theguardian.com/politics/2019/jan/18/revealed-uk-patients-stockpile-drugs-in-fear-of-no-deal-brexit [Accessed January 2020]
  4. ‘Government report recommends breaking some tablets in half amid drug shortages’ November 2019 http://www.pulsetoday.co.uk/clinical/clinical-specialties/prescribing/government-report-recommends-breaking-some-tablets-in-half-amid-drug-shortages/20039716.article [Accessed January 2019]
  5. ‘NHS patients may have to split tablets in HALF to cope with drugs shortage as leaked document reveals health service is short of 86 medications - including those to treat cancer’ November 2019 https://www.dailymail.co.uk/health/article-7696953/NHS-short-86-drugs-including-cancer-epilepsy-heart-disease.html [Accessed January 2019]
  6. ‘Brexit ‘already causing medicine shortages’ at pharmacies in England’ April 2019 https://www.theguardian.com/politics/2019/apr/09/brexit-medicine-shortages-pharmacies-england [Accessed January 2020]
  7. ‘Britain's 'unprecedented' drug shortage’ November 2019 https://www.bbc.co.uk/news/health-50465563 [Accessed January 2020] 
  8. https://www.newstatesman.com/politics/health/2019/08/stockpiling-not-good-society-will-no-deal-brexit-mean-medicine-shortages
  9. ‘Results of survey of pharmacists about problems with medicines supply and the possible