Patients remain at risk as drug shortages continue

GPs want action to ensure patients receive medicines they need. Tom Moberly reports.

Some pharmacists have profited from exporting drugs abroad (Photograph: M Alsford)
Some pharmacists have profited from exporting drugs abroad (Photograph: M Alsford)

Patients across the UK are still unable to get hold of vital medicines they have been prescribed, despite DoH guidance issued in February in a bid to address the problem.

Since the pound began to fall against the euro in late 2007, a small minority of pharmacists have profited from exporting branded drugs abroad.

Such exports cause huge problems for GPs forced to reissue prescriptions and pharmacists having to spend hours phoning round to track down supplies.

Such shortages may also be putting patients' health at risk, according to the Association of the British Pharmaceutical Industry (ABPI).

Despite the fact that pharmaceutical companies are supplying more stock than is prescribed in the UK, drugs for a huge range of conditions are affected by the shortages.

These range from hypertension, diabetes and cancer to depression, anxiety and psychosis.

Staffordshire GP Dr Mark Welton, who has an interest in vascular disease, said the shortages had created 'a very unsatisfactory situation'.

'It involves quite a bit of our time, either looking up alternatives, contacting the patient or contacting pharmacies to find out what they have in stock,' he says.

'Information on unavailable products is scarce and the dissemination mechanisms for this seem disorganised.'

Dr Welton also believes that supply problems are affecting GP-patient relationships. 'We quite often seem to get the blame from patients despite this not being our fault.'

In February, the DoH issued best practice guidelines for manufacturers, drug wholesalers and pharmacists.

The guidelines were designed to ensure that patients could obtain any medicine within 24 hours of presenting a prescription to a pharmacy. But pharmacy representatives and wholesalers say the guidelines have made no real difference.

Lindsay McClure, head of information at the pharmaceutical services negotiating committee (PSNC), which represents pharmacists, says it has seen 'no significant change in the situation' since guidance was published.

'Much more needs to be done if pharmacies are to be able to give confidence to patients who have experienced delays in sourcing the medicines they need,' she says.

Ms McClure says the PSNC will look at how 'enforcement action' from the DoH could help ensure appropriate practice in future.

GPC deputy chairman Dr Richard Vautrey agrees that there has not been any improvement since the guidelines were introduced.

Obtaining products
'Patients are still finding they have problems obtaining some products,' Dr Vautrey says.

'They are irritated by it and are puzzled as to why it is happening. It is something the government needs to take seriously.'

Dr Vautrey says changes to legislation may now be necessary to ensure patients can obtain medicines.

Pharmacy wholesalers also argue that, if the guidelines are not being followed, new laws may need to be introduced to enforce duties to supply.

Martin Sawer, executive director of the British Association of Pharmaceutical Wholesalers, says monitoring will be introduced in the coming weeks to ensure supply duties are being observed.

Regulations imposing a public service requirement or a duty on manufacturers, wholesalers and pharmacists to supply may then be considered, he says. The ABPI argues that the number of pharmaceutical wholesaler licences issued in the UK must be cut.

At present the UK has around 1,800 wholesalers' dealer licences, far more than most other countries.

Richard Barker, director general of the ABPI, argued in a recent blog on the association's website that this situation needs to change.

'It is clear we have too many wholesalers for the MHRA to reasonably police,' he said.

The DoH says it carefully monitors data about supply problems and will 'continue to review the situation and take appropriate action as necessary to help ensure patients receive the medicines they need'.

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