The causes of the shortage and what this means for patients
Photo by DraconianRain (Flickr)
by Moyosola Tijani
Pharmacists in the UK have warned that some patients may experience a shortage in their commonly prescribed medicines. This could lead to delays in filling prescriptions or substitutions of routinely used medicines for cheaper and readily available alternatives. Commonly prescribed drugs such as painkillers, blood pressure medications and antidepressants have been affected by this shortage and have been put on a so-called concession list by the Pharmaceutical Services Negotiating Committee. As of October 2018, this list contained about 45 drugs and is expected to increase this year. The concession list contains drugs whose prices have been subsidized by the Department of Health to prevent shortages. The Independent reported that a similar increase in the prices of drugs occurred in 2017 and eventually cost the NHS an additional £315m. The current crisis has resulted in several pharmacists directing patients to ask their GPs for a different medicine or dosage. The BBC has also reported that other pharmacists are dispensing an incomplete number of drugs and giving the patients an IOU note for the rest. Experts have advised patients to get their prescriptions to their pharmacists as soon as they get them. Similar shortages are occurring in Scotland, Northern Ireland and Wales.
In some cases, pharmacists have substituted the scarce drugs with a readily available alternative. However, this is a problem in some conditions like epilepsy where the patients must be on the same drugs the therapy was started with. A patient with fibromyalgia was given ibuprofen instead of the anti-inflammatory drug, naproxen- which is the standard therapy for this condition, and it didn’t have a satisfactory effect. She complained of intense pain. While this substitution appears to be trivial, it made a massive difference to this patient. Furosemide is a drug used to treat high blood pressure and many other cardiovascular diseases. It is 23rd most commonly prescribed drug in England. Other drugs such as fluoxetine, which is used to treat depression and propranolol, a beta blocker which is used to treat anxiety are also currently scarce. These drugs are pretty important in patient care and this shortage is extremely dangerous and inconvenient for patients.
While there is no clear reason for this shortage, there are several suggestions. Some of these include a general increase in global demand of drugs, a rise in the cost of raw materials, changes in exchange rates and the unwillingness of generic companies to manufacture unprofitable medicines. The Pharmaceutical Services Negotiating Committee (PSNC) believes that the UK has become a less attractive market for manufacturers because the NHS only pays a small amount for drugs in comparison to their actual prices. While several people believe Brexit could be a contributing factor to the shortage of drugs, some experts have stated that shortages have always been a problem and will be resolved soon enough. Others believe that manufacturers have been asked to keep a buffer stock in anticipation of potential supply problems after Brexit. The Royal Pharmaceutical Society in Scotland has stated that the shortage is a feature of pharmacy life and could be a result of many factors. A member of the Healthcare Distribution Association, which circulates a huge number of medicines in the UK said some businesses could be investing in the stock of medicines in order to make a profit from it later in the event of Brexit.
