Global supply problems have caused a
“shock rise” in shortages of life-saving drugs like antibiotics
and epilepsy medication, new research reveals today. These
shortages come at a cost to the patient and the taxpayer,
and are happening despite the
NHS spending hundreds of
extra millions trying to mitigate the
problem.
The
UK risks being left in the cold when it comes to
co-ordinated EU
attempts to tackle
them.
That's according to a new report by the Nuffield
Trust think tank and a
group of academics, funded by the Health
Foundation, which examined key
indicators on drug shortages in the UK in the context of global
problems with supply chains and the availability of key
ingredients. It finds that the past two years have seen
constantly elevated medicines shortages, in a "new normal" of
frequent disruption to crucial products.
Key findings on drugs shortages
include:
-
Price concessions
(where the government gives
extra funding because there are no drugs
left at the NHS
price) have risen sharply in recent months: prior to 2016
there were rarely more than 20 per month but in late 2022
they peaked at 199 and have remained high ever
since.
-
The excess cost for medicines in
months when they were subject to price concessions was
£220m
across the year to
September 2023.
-
There are now over double the
number of notifications by
drugs companies warning of
impending shortages than
there were three years ago: in 2023 there were
1,634
such alerts issued, compared
to 648
in 2020
(a spike in 2021 was caused by
concerns over supply fears in Northern Ireland
following
Brexit).
-
The UK has been slower to approve
drugs than the EU
for new drugs that are authorised
centrally. Of drugs authorised in the year to December
2023,
56 drugs authorised
in Europe were approved later in the UK and
eight have
not been approved. Four
were approved
faster.
The report shows that the EU Exit has
not caused the recent spike in medicine shortages, but it is
likely to significantly weaken the UK's ability to respond to
them by splitting it from European supply chains, authorisations
and collective efforts to respond to shortages. In particular,
the research highlights the risks posed to the UK from being left
out of key initiatives like the Critical Medicines Alliance and
Voluntary Solidarity Mechanism, led by EU member states to work
together to insulate themselves from the impact of medicines
shortages.
The research, published as part of a
wider report supported by the Health Foundation entitled “The
future for health after Brexit”, also reveals that Brexit has
forced the NHS to rely on ethically dubious sources of migration
to shore up its workforce, with recruitment from “red list”
countries rising by almost a third in one
year; and that life science and medicine regulation is
lagging behind the EU.
Nuffield Trust Brexit
Programme Lead, Mark Dayan said:
"The rise in shortages
of vital medicines from rare to commonplace has been a shocking
development that few would have expected a decade
ago. More and more
patients
across the UK are
experiencing a pharmacist telling them
that their medication is not available, it may not be
available soon, and it may not be available anywhere nearby. This
is also creating a great deal
of extra work for both GPs and
pharmacists.
“We know many of the problems are
global and relate to fragile chains of imports from
Asia, squeezed by Covid-19 shutdowns, inflation and global
instability. Officials in the UK have put in place a much more
sophisticated system to monitor and respond, and
used extra payments to try to keep products flowing. But exiting
the EU has left the UK with several additional problems –
products no longer flow as smoothly
across the borders with the EU, and in the long term our
struggles to approve as many medicines
might mean we have fewer alternatives
available.”
Professor Tamara Hervey, of the City Law School,
said:
“There is nothing inevitable about this ‘new normal' where Great
Britain is isolated in efforts to manage fragilities in global
supply of the products and people we need to run the NHS. It is
the consequence of policy choices and those could be different.
If the Covid-19 pandemic taught us anything, it is that the world
is an interconnected place, and having cordial relations with our
near neighbours will help us to deliver the health services our
population deserves."
The research is based on analysis of
freedom of information requests on drug shortages and public
data, and informed by a series of interviews and roundtables with
experts and top officials. Its authors argue that solving the
problems identified will require a more co-operative and
proactive approach to EU/UK relations than currently in place and
calls on the Government to better anticipate medicine shortages,
be more open with patients and the NHS about the prospect of such
shortages and better planning on stockpiling
drugs.
