Asked by
To ask His Majesty’s Government what is their response to the
reported shortages of NHS drugs.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care () (Con)
Medicine supply chains are highly regulated and complex. Supply
disruption is a common issue that affects countries all around
the world. The department has a range of well-established
processes and tools to help prevent and mitigate risk to
patients. Most supply issues can be managed with minimal
disruption to patients. We work closely with industry, the NHS
and others to prevent shortages and resolve any issues that may
arise.
(Lab)
My Lords, I am sorry to say that I find that Answer very
complacent. We are talking about drugs for the treatment of
cancer and comments from the pharmaceutical industry that the
situation is the worst it has ever been, with cancer patients and
others seriously at risk. Surely the Government should do
something to ease the anxiety of people who are seriously ill and
depend on these drugs for their lives and their safety.
(Con)
I assure the noble Lord that a specific team, the medical supply
team, works to manages this across the piece. It is a complex
area, as we have said. There are 1,000 notifications a year about
supply shortages—that has been consistent over the last so many
years—that the team works to resolve. I am sure that, as this
debate progresses, we will talk about some of the issues,
including getting the MHRA to expedite regulatory approval,
working with alternative suppliers, buying internationally where
needed—we did that very well last year on strep A—and, where
really necessary, introducing serious shortage protocols. It is
an issue that we take very seriously, and we are managing it.
(Con)
My Lords, “may” is the wrong word; there is a shortage at this
point in time, certainly from the inquiries I have made. Is it
not time that we had another look at the existing procedures on
recompensing drug manufacturing and maybe producing a new version
of the PPRS, which worked extremely well in its time?
(Con)
Actually, we recently reached a new agreement with the drug
suppliers on this. I think we were all pleased to do that, and it
will ensure we continue to get continuity of supply. I have
quizzed the team at length on this and asked it to sit down with
the British Generic Manufacturers Association, which produced
these figures, specifically to understand where there are
differences, because I must be honest: the team does not
recognise those numbers. We did not see an increase over the last
few years. Where there are specific instances, such as ADHD,
which I worked with the noble Baroness, Lady McIntosh of Hudnall,
on recently, remedial actions are in place to ensure we can
manage through the supply issues.
(Lab)
My Lords, will the noble Earl please focus—
Noble Lords
Oh!
(Lab)
I am sorry; will the noble Lord please focus on pancreatic cancer
and say whether he is satisfied with the performance of the
National Health Service and others in respect of research into
and finding solutions to what in many respects is apparently
becoming a notifiable disease and a sentence of death?
(Con)
I thank the noble Lord for my proposed promotion. My noble friend
has also raised pancreatic
cancer a number of times. To be absolutely honest, this is one of
those cases where we are on a journey. I think we have got on top
of certain areas, such as prostate cancer, about which we have
increased awareness to ensure we get detection early on, but we
do not detect pancreatic cancer early enough and, unfortunately,
it is then often too late. We are working on something to try to
correct that. The noble Lord is quite right to bring it up, and I
am happy to write to him to tell him exactly what we are
doing.
(LD)
My Lords, I hope the Minister will revisit his department’s
response to the Times today, which comes across as quite
dismissive of genuine difficulties that many people across the
country have with access to medicines. I encourage the Government
to offer a service where people can report their individual
experiences of shortages so that they can be aggregated into
real-time public reports about what is happening across the
country. If he wants an example of what this could look like, he
could look at Downdetector, which does something similar for
access to internet services.
(Con)
I quizzed the team on exactly that Times newspaper report today,
because like the noble Lord, they were saying that they did not
recognise the numbers that the British Generic Manufacturers
Association had produced. I wanted to understand why, and asked
the team to sit down with them, and understand the differences,
because one side or the other must be right. They are absolutely
doing that, and will report back; I will be happy to update the
House on the results of that.
(Con)
My Lords, the drug Ozempic has been described as a super-drug for
the use of diabetic patients, in order to help them reduce
weight. My noble friend the Minister will be aware that diabetes
costs the NHS 10% of the budget—approximately £25,000 to £30,000
a minute—with 80% of that money spent on treating diabetic
complications. Therefore, can my noble friend the Minister say
why Ozempic can be prescribed privately but is not available
easily to NHS patients as a result of demand and constraints in
manufacturing? How can the Government address this?
(Con)
My noble friend is correct that this so-called off-label use of
these diabetes drugs for weight-loss-type treatments is causing
some of the shortages she mentions. That is exactly what we have
been tackling, and we have been making sure that the only way you
can get the Wegovy weight-loss drug is actually on a very tightly
controlled weight management programme normally run through
hospitals, and not through normal GPs, exactly to get on top of
that issue.
(Lab)
My Lords, there are reports in the media today of pharmacists
having to deal with frustrated and worried customers who are
faced with shortages of medicines including HRT and the drugs for
ADHD, diabetes and cancer. Can the Minister indicate what action
is being taken to support and gather feedback from pharmacists
who are dealing with such an unsatisfactory situation? What steps
are being taken to ensure that, in the future, the supply system
is able to cope as soon as demand for medicines increases?
(Con)
We find that each one is a different case in point. HRT is an
example: we actually saw a 50% increase in demand for it over the
last year, so suddenly that is quite a dislocation for the
market, and you need to gear up very quickly in terms of the
supply chain issues. Strep A was the example last year that we
will all be familiar with; normally, it does not come until later
in the year, but suddenly there was a very early outbreak in
October, which caused the demand there. You find that every
single drug tends to be a different case in point. There is a
range of tools that they work with; it is working with the NHS,
MHRA suppliers and pharmacists, and it is case by case. As I say,
sometimes it is the MHRA expediting medicines to get new supply
in; sometimes it is working on alternative suppliers; sometimes
it is buying internationally—that is what we did in the case of
strep A—and sometimes you do have to go as far as the serious
shortage protocols, finding substitutes or, in extreme cases,
changing doses. There is a range of programmes on it, which by
and large are managing to tackle it.
Earl Russell (LD)
My Lords, can I ask the Minister specifically about the continued
lack of supply of ADHD medication? The department said that the
supply shortages would continue until April, when previously it
had indicated that this supply issue would have been resolved by
now. Do the Government understand the serious impacts that these
shortages have, and the impact that the inability some people are
facing to get any medication at all is having on their daily
lives?
(Con)
There are 78 medicines for ADHD, 10 of which are particularly
affected. We have put export restrictions in place on that, and
we are working it through so that we can hopefully get it
resolved by April. It is something we are working very closely
on, because we know the importance.
(Con)
My Lords, I understand the Minister’s department has a cap on
total allowed sales of branded medicines to the NHS. I think it
will be a 4% cap over the next five years. Is this making the
problem worse? Is it exacerbating the problem? Is it something he
could look at with his ministerial colleagues?
(Con)
I think the cap my noble friend is referring to is actually in
terms of the price negotiations on the VPAG and how the rebates
kick in. It is not my understanding that is something that is at
issue here. We are talking about where there are specific ranges.
A study was produced by the Pharmaceutical Research and
Manufacturers of America looking at supply issues across lots of
countries over the 10 years from 2012 to 2021. The UK was
consistently in the top three. Yes, there are some issues that we
are working through, but by and large we are consistently in the
top three of supply.
