Medicines vital for managing epilepsy, cancer and life-threatening asthma attacks are among a record number of products which are currently facing shortages made worse by Brexit uncertainty. The Independent reports that the number of drugs which the government is having to subsidise through the “concession” pricing list for short supply medicines has more than doubled since October.
Britain’s impending exit from the EU coupled with manufacturers’ views of the country as a “less attractive market” had caused the “significant” problems, according to the Pharmaceutical Services Negotiating Committee (PSNC), which draws up the list. It has previously told MPs that government directions for manufacturers to stockpile a six-month reserve of key drugs may also have impacted supply.
The report says the news comes with the UK still no clearer on its eventual route out of the EU, and the real possibility of crashing out without a deal if Theresa May fails to negotiate an extension to Article 50.
Health secretary Matt Hancock has previously warned a no-deal Brexit will bring six months of disruption to medicines supplies, as log jams at ports mean drugs that cannot be stockpiled will need to be airlifted in. However, the Department of Health and Social Care said there was “no evidence” that Brexit uncertainty was causing the current price increases.
The report says some 96 medicines now appear on the concessions list, including diamoprphine and ondansetron, used for cancer pain relief and chemotherapy nausea, anti-psychotic drug risperidone, and several antidepressants and heart medicines.
The Epilepsy Society said its helpline had received record numbers of enquiries from patients experiencing shortages or fearing Brexit disruption. “It can take many years to finely tune a person’s drug regime, and any slight changes in strength or changing between different versions of a medication can cause breakthrough seizures,” a spokesperson is quoted in the report as saying. As well as being life-threatening a single seizure can disqualify someone from driving, which can have a huge impact on everything from work to picking up children from school.
The number of concession medicines is now higher than at any point since the scheme launched in 2014, topping the previous peak set in late 2017. “Community pharmacies are reporting increasing problems sourcing some generic medicines for their patients,” PSNC chief executive Simon Dukes said in the report. “While there have always been fluctuations in the number of generic medicines that community pharmacies have been unable to purchase at drug tariff prices (prices often rise when there are shortages), we have seen a surge since October 2018.”
Pharmacy contractors are automatically reimbursed for medicines on the list at an amount which is higher than the National Health Service's (NHS’s) Drug Tariff. Medicines are usually added when manufacturers or wholesalers up their prices because of factors like shortages or supply issues.
Meanwhile the PSNC reports some pharmacists facing “financial hardship” as a result of paying higher prices to ensure patients can still access drugs. The PSNC draws up the monthly list with feedback from pharmacists and negotiates concessionary prices with the Department for Health and Social Care (DHSC).
Dukes is quoted in the report as saying: “Community pharmacy teams are continuing to work hard to ensure that all patients receive the medicines they need when they need them, but we are becoming increasingly concerned about the impact that this is having on already busy pharmacy teams.”
Critics of no deal say Britain’s reliance on the EU to import drugs and medical equipment could ramp up costs and cause issues in the supply chain. But a DHSC spokesperson is quoted in the report as saying: “There is no evidence the small number of current supply issues we are managing are related to EU exit or increasing because of this. We have well-established processes to manage and mitigate supply issues from whatever cause, including manufacturing or distribution problems.
“We are confident that if everyone does what they need to do, the supply of medicines should be uninterrupted in the event of a no deal.”
[link url="https://www.independent.co.uk/news/health/brexit-drug-shortages-no-deal-epilepsy-cancer-psychosis-a8862106.html"]The Independent report[/link]