Understanding UK’s Medicine Supply Shortages | Health Policy
TL/DR –
The UK is currently experiencing a shortage of numerous medications, with Tegretol, used for treating epileptic seizures, being the latest affected, with supplies not expected until mid-January. Other medications experiencing shortages include a drug used to treat high levels of calcium in the blood in cancer patients, treatments for heart-related chest pain, heart failure and oesophageal spasms, and a range of tablets for angina. Reasons for the shortages include the impact of the war in Ukraine on supply chains, shipping attacks in the Red Sea, extra regulatory paperwork due to Brexit, and the UK’s falling pound value making it more expensive for the NHS to buy medicines.
UK Medicine Shortages: Epilepsy, Diabetes, and Cancer Treatments Affected
UK health professionals have been notified by the Department of Health and Social Care that the epilepsy drug Tegretol (carbamazepine) 200mg tablets will not be available until mid-January. This shortage is classified as having a “medium impact”, and low-risk therapeutic alternatives, unlicensed imports, or alternative strengths or formulations are suggested.
Furthermore, the supply of glucagon-like peptide-1 receptor agonists, a type 2 diabetes treatment, is predicted to be problematic throughout 2024. Doctors have been advised to stop prescribing it for weight loss purposes. A national patient safety alert has also been launched, calling for healthcare providers to take action to reduce the risk of death or disability.
Other medicines facing shortages include a tablet for treating high blood calcium in cancer patients, a brand of tablets for heart-related chest pain, heart failure and oesophageal spasms, as well as the Estring 7.5 micrograms estradiol vaginal ring for menopausal women. Patients with angina are also facing supply issues with a range of relevant tablets.
As of mid-December, the UK medicine shortage list included 96 items, down from 111 at the end of October. However, the total has almost doubled from the 52 medicines facing issues in January 2022.
Trends and Global Impact
A 2023 survey by Community Pharmacy England revealed that 92% of pharmacy teams are dealing daily with supply issues, a significant increase from 67% the previous year. Furthermore, 87% of pharmacy staff believe patient health is at risk due to these shortages. The issue extends beyond the UK, with a recent survey by the European Association of Hospital Pharmacists reporting that 95% of hospital pharmacists across Europe are experiencing shortages.
The reasons for these shortages are manifold, including the impact of the war in Ukraine on supply chains, regulatory paperwork due to Brexit, and attacks on shipping in the Red Sea. The weakened pound post-Brexit has also made it more costly for the NHS to purchase medicines.
UK-Specific Problems: Brexit and Financial Caps
The UK is facing specific problems such as a voluntary scheme introduced by the government in 2019 to cap NHS spending on branded medicines. This cap, along with a 26% levy on revenues of drug manufacturers earned beyond the cap, has reportedly made the UK an unattractive place to do business for pharmaceutical companies. From 2022, this cap will be raised to allow a 4% annual rise in spending, but the British Generic Manufacturers Association still accuses the government of penny-pinching.
There are also issues with planning and communication. For instance, a 2015 guidance published by the National Institute for Health and Care Excellence prompted a surge in HRT prescriptions, causing manufacturers to struggle to meet demand. Similarly, in November 2022, amid reported difficulties in procuring the antibiotic amoxicillin, a medicine shortage notification was issued and an export ban followed — just a week after assurances of ample supply.
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