DRUG SHORTAGES


WITH MORE THAN 70 PER CENT OF UK PRESCRIPTIONS PERTAINING TO GENERIC MEDICINES, IT’S OBVIOUS THAT ANY DISRUPTION TO THE SUPPLY CHAIN IS LIKELY TO CAUSE MAJOR PROBLEMS...AS THE CURRENT SITUATION HAS CLEARLY DEMONSTRATED…


DRUG SHORTAGES LENGTHEN


SOURCING PROCESS I


t’s the main - if not only - topic of conversation in Scottish community pharmacy at the moment. From the Orkney Islands in the north to Kirkcudbright in the south, community pharmacists are battling to ensure continuity of supply to their patients.


Unlike the generics shortage of five years ago, which was caused by the increase in parallel imports, these shortages have been caused by two generics companies failing inspections and subsequently having their export licences withdrawn.


Bristol Laboratories was the first to have its manufacturing certification pulled after regulators found data reporting issues following an inspection of the company’s facility in Luton in July. This was then followed by Dr Reddy’s Laboratories failing a European cGMP manufacturing inspection. The company was told that it wouldn’t be able to export to the European Union until it had cleared its next inspection.


The repercussions of not one, but two, manufacturers ‘disappearing’ from the generics landscape have been felt throughout the UK.


In the small Glasgow suburb of 26 - SCOTTISH PHARMACIST


Stepps, pharmacy contractor, Eddie Ceresa, is - like most Scottish pharmacists - ‘managing’ but, he admits, with great difficulty!


‘Like most pharmacists, I’d say we’re managing the situation,’ he told SP, ‘but I’m certainly not happy with the way things have been - and indeed, how they will probably be for some time to come.


‘A lot of people are obviously talking about the shortages caused by the closure of Dr Reddy’s and Bristol Laboratories, but I think the situation has been brought about by a combination of factors that have simply occurred simultaneously - unfortunately for us!


‘The shortages have occurred at the same time that Alliance have been experiencing IT problems. These problems were initially a nationwide issue, which caused a week or so of disruption, but was further compounded in Scotland by the problems caused by the move of distribution centres from Livingston to Coatbridge the following week. Thankfully, these problems all seem to have been getting sorted and everything is starting to fall into


place - although there are still some invoicing issues - so I’m hoping that the resolution of these issues will help the situation overall.


‘There’s no doubt that, over the last six weeks, we’ve really struggled to get many of our supplies. It’s not just a question of specific items - it’s right across the board - but obviously it’s mainly the generics that are causing the supply and demand problems.


‘Naturally, with limited stocks available, the prices are fluctuating dramatically. I’ve seen items that have cost ten pence one day and £10 the next, while other products have gone from £10 to £100 or more! The delay between us dispensing a product and a revised price hitting the tariff means that we are being left to meet the shortfall. Obviously this situation can’t continue for too long or pharmacists really will start to feel the pinch!


‘We’ve had some issues with GPs in terms of asking them to prescribe branded items. Some are happy to do so, but others certainly aren’t and this has caused a few problems. We have to keep the Health Board informed about what’s happening and this is time consuming in itself.


‘The real problem, however, that I - and I would imagine - most pharmacists are facing is the time that’s having to be spent in sourcing products. While there’s nothing that’s totally unavailable - although vaccinations are a major issue at the moment, with some postponed until the New Year - the time that’s being spent on the phone trying to source items is absolutely crazy.


‘I would say that, realistically, I’m spending an extra five or ten hours per week sourcing products across the board: from the pharmaceutical companies to the Specials manufacturers. That’s time that could be spent much more productively in delivering services to patients. As


I said, however, we are managing to continue to deliver an excellent and comprehensive service to our community, but the extra time being spent sourcing products is tiring and non-productive.’


Meanwhile, further north in Buchanhaven, contractor Sam Reid and her team are also feeling the effects of the shortages!


‘There’s no doubt that sourcing products is taking up a lot of time,’ Sam told SP. ‘Looking on the bright side, we were pretty well warned by the reps from the various companies, who knew what was going to happen and so were able to give us advance notice about a month ago. The shortliner reps in particular were very good and kept us informed about the situation.


‘This advance notice meant that we were able to order products in advance and, by doing this, we were able to protect our supply to some extent.


‘I totally agree with Eddie about the amount of time we’re spending each day trying to source what we need though. We also have to report everything - shortages for example, or products that we can’t buy below tariff price - to Community Pharmacy Scotland, and this is another time- consuming task that isn’t normally on our daily ‘to do’ list.


‘Generics is obviously the main area where the shortages are affecting us and I’m not sure how this situation is going to be rectified in the near future. For the time being, we’ll just have to carry on as best we can and ensure that our patients aren’t affected by what’s happening. As pharmacists, it’s up to us to once again ensure continuity of service for them regardless of the problems that we are experiencing.’


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