5 October 2019 — True Publica
Last week, TruePublica published an article entitled – The list of Medicines affected by no-deal Brexit, which was read by over 40,000 readers in 24 hours. We decided not to make an issue of the story and simply published the most comprehensive list of medicines either in short supply, expected to be in short supply or where significant price rises were likely.
However, the problem of medical supplies is now becoming a real issue and the mainstream media are using it for click baiting and adding all manner of scare-mongering nonsense, which is confusing and scaring a lot of people.
Here we have published a headline, short excerpt and link to articles published by the industry body – the Royal Pharmaceutical Society. The important thing to notice here is that whilst some of these articles seem alarming – it’s not as if they are publishing a list of life-saving drugs that have disappeared completely. However, you do need to know what is relevant to you.
What almost no-one in the public sphere knows about is that legislation came into force on 1 July 2019 that introduced a pharmacist’s ability to dispense against a protocol instead of a prescription, without going back to the prescriber first, as a measure to combat medicines shortages. This means that different strengths or alternatives may be used without notice to the prescriber as a direct result of supply lines caught up in a no-deal Brexit expected 31st October. At the moment, from what we can tell, this only applies to one drug (first article below) but clearly, this could be expanded if supplies of other drugs deteriorate.
The government has also announced restrictions on exporting of 19 hormone replacement therapy (HRT) products made in the UK to tackle shortages.
Exporting restrictions have also been brought in for a further five medicines, including all adrenaline auto-injectors and hepatitis B vaccines, which have also been in short supply.
TruePublica will publish more information as we get it.
Government issues first serious shortage protocols to combat shortages
The government has issued the first serious shortage protocols (SSP) to combat shortages of the antidepressant fluoxetine. The SSPs, issued on 3 October 2019, allow pharmacists to supply alternative strengths or pharmaceutical forms of fluoxetine without having to consult a patient’s prescriber, with immediate effect.
The measures have been put in place following news that manufacturing issues have resulted in shortages of some fluoxetine 10mg, 30mg and 40mg capsules. It has been estimated that some of these stocks will not be available until early December 2019.
Legislation came into force on 1 July 2019 that introduced a pharmacist’s ability to dispense against a protocol instead of a prescription, without going back to the prescriber first, as a measure to combat medicines shortages.
81% of pharmacists say medicine shortages will get worse after a no-deal Brexit, with 55% saying they thought the shortages would get “much worse”.
Some six in ten pharmacists (62%) have said they spend at least one hour every day dealing with issues relating to medicines shortages, according to results of a survey carried out by the Pharmacists’ Defence Association (PDA).
The results show that 90% of the 1,071 pharmacists who responded thought that medicines shortages had increased over the past 12 months, with shortages said to have affected 21% of prescription drugs over the past three months.
Furthermore, 81% of respondents thought that medicine shortages would get worse after a no-deal Brexit, with 55% saying they thought the shortages would get “much worse”.
Commenting on the survey, a spokesperson from the PDA told The Pharmaceutical Journal that the results “present a stark picture of the huge stresses which drug shortages are causing for both pharmacists and patients”.
A quarter of medicines yet to be stockpiled for no-deal Brexit
“Deeply concerning” report from the National Audit Office reveals that only a quarter of medicines suppliers had found alternative routes to the Dover/Calais crossing, which is expected to see big delays if the UK leaves the EU without a deal in place on 31 October 2019.
Also, as of 20 September 2019, the data show that only a quarter of medicine product lines suppliers had found and secured alternative routes into the UK for medicines that do not require the short channel crossing between Dover and Calais, which is expected to see severe delays in case of a no-deal Brexit.
“In the event of a no-deal exit, the [DHSC] would be working in a highly uncertain environment and operating all the elements of its plan would be a hugely demanding task.”
Meg Hillier, chair of the House of Commons public accounts committee, described the NAO report as “deeply concerning”.
In a statement issued on 27 September 2019, Hillier said: “I’ve seen countless examples of deadlines missed and government failing. If the government gets this wrong, it could have the gravest of consequences.”
Pharmacies may need to share medicines when shortages arise after Brexit, says government
The Department of Health and Social Care (DHSC) has suggested pharmacists share their medicine supply with other pharmacies to mitigate the impact of shortages on patients after Brexit.
In a statement issued to The Pharmaceutical Journal outlining government preparations to secure the supply of medicines after Brexit, the DHSC said pharmacists may occasionally need to obtain small amounts of a medicine or medicines from another pharmacist in order to meet the needs of individual patients when medicines shortages arise.
No-deal Brexit: pharmacy bodies question the UK government’s readiness
“We need facts, not reassurance and propaganda,” says Warwick Smith, director general of the British Generic Manufacturers Association, one of the organisations that is currently in talks with the UK government about Brexit preparations.
“We’ve been urging the government to make more information publicly available; that is the biggest thing it can do.” However, Smith adds that poor communication has resulted in a “patchy” understanding of new border procedures by manufacturers.
“I have heard everything from: ‘Yes, we’re right on top of it, we’re fine’ to ‘I’ve heard about it, but I don’t know what I need to do’,” says Smith, adding that delays will occur if truck drivers transporting medicines do not complete the right documentation before coming to the port. “Putting trucks full of medicines into a big car park is not good.”
Emergency powers could close Jersey pharmacies in no-deal Brexit scenario
Pharmacies on Jersey could be temporarily closed if a no-deal Brexit leads to severe medicines shortages, under an amendment to emergency powers passed on 10 September 2019.Their powers include the ability to restrict pharmacy opening hours, or even close pharmacies, in the event of severe medicines shortages; requisitioning “at-risk” medicines from local pharmacies to a central distribution point; and requiring pharmacists to report stock levels to the chief pharmacist.