Drug shortages affected 111 products in the UK thisyear – but the outlook for 2024 may be better

Over the previous 12 months there was a constant stream of drug provide points within the UK and internationally. Current figures present greater than 111 merchandise have been affected within the UK alone. That is greater than double the determine recorded for 2022.

These provide points have led to shortages of quite a few merchandise. Whereas international shortage of Ozempic and Wegovy have obtained a lot consideration, many different medication within the UK have been in brief provide – together with medication used to handle sort 2 diabetes, ADHD and menopause signs.

These shortages have affected tens of millions of individuals throughout the globe and within the UK – with many discovering it tougher up to now 12 months to get their common prescriptions disbursed.

This may occasionally have many questioning why 2023 has been a 12 months characterised by so many drug shortages – and whether or not the scenario shall be comparable in 2024.

Causes of shortages

There are 4 major causes for the present international drug shortages.

Manufacturing points are essentially the most generally cited explanation for drug shortages. Based on a report from 2022, 60% of world drugs shortages have been resulting from manufacturing issues. That is more likely to have been the identical in 2023.

Prescribed drugs are manufactured to tightly monitored high quality specs. As such, creating, increasing and shifting manufacturing are tough processes. Shortages of supplies and halting drug manufacturing to resolve high quality points and technical faults can even contribute to shortages.

Shortages of a spread of pharmaceutical merchandise this 12 months have additionally been linked to a rise in affected person demand. This has been cited as the first explanation for shortages of hormone alternative remedy (HRT), ADHD medicines, Ozempic (used to deal with diabetes) and Wegovy (which comprises the identical energetic ingredient as Ozempic, however is licensed for weight reduction) this 12 months. Ozempic is a very good instance of how a speedy enhance in demand can have severe penalties on provide chains.

Ozempic is simply licensed to deal with sort 2 diabetes. But it surely turned fashionable through social media due to off-label use to help in weight reduction. Elevated use, licensed and unlicensed (off-label), had such a big have an effect on on provide that docs in lots of international locations have been suggested to not start new sufferers on the drug.

This additionally meant sufferers who required Ozempic couldn’t entry it. It even led to black market promoting and faux merchandise, which had questionable security.

Will increase in demand for some merchandise have additionally been fuelled by seasonal elements. Final 12 months’s strep A outbreak brought about an uptick in antibiotic prescriptions. The ensuing shortages have nonetheless lasted into this 12 months.

Whereas protocols have been put in place to authorise pharmacists to make use of different merchandise the place crucial, typically these measures weren’t enough. This led to the NHS offering steering on crushing tablets and opening capsules to help youngsters taking remedy when liquid variations weren’t obtainable.

Whereas it’s tough to correlate present drug shortages with Brexit, anecdotally, the adjustments in commerce agreements between the UK and EU have led to further forms, prices, provider adjustments and delays.

Within the UK, for a lot of medication we depend on just one producer – which could be a dangerous technique. Alteplase, for instance, is the one drug licensed within the UK to deal with acute ischaemic stroke – and that is produced by only one producer. However provides are operating extraordinarily low, which may have a severe have an effect on on sufferers.

There are considerations that authorities agreements relating to pricing and provider taxation (through the Voluntary Scheme for Pricing, Entry and Development) could discourage suppliers buying and selling with the UK. This might result in fewer suppliers and merchandise within the UK system.

Globally, it’s difficult to set inexpensive costs in a number of markets and likewise present producers with acceptable returns on funding.

Some provide points within the UK are additionally resulting from international spikes in demand – both resulting from elevated prescribing of sure medication or due to spikes in seasonal infections.

2024 outlook

Motion is being taken to handle drug disruptions within the UK and Europe. The European Commmission has put various initiatives in place to scale back shortages within the EU – reminiscent of requiring suppliers to report shortages earlier, transparency and sharing of inventory between international locations and joint procurement methods. It’s not clear if it will profit the UK, however robust provide chains throughout Europe ought to be optimistic for international drug provide.

Among the provide disruptions that affected UK medication in 2023 shall be resolved in 2024. For instance, Besins, a pharmaceutical conmpany which manufactures HRT merchandise, has elevated its manufacturing capability after opening a brand new manufacturing unit in Spain.

The UK authorities can be working with producers to make sure sufferers have steady entry to ADHD medicines. It’s anticipated ADHD medication ought to be extra available from April 2024.

One other measure that may assist scale back drug shortages is issuing advisory notices about who ought to, or shouldn’t, be prescribed sure medication. For instance, a nationwide directive was put in place advising that sufferers shouldn’t be prescribed Ozempic for weight reduction. The approval of Wegovy for weight reduction (which comprises the identical energetic ingredient as Ozempic) may even assist to enhance Ozempic inventory ranges – making certain sufferers with sort 2 diabetes can entry this product.

Creating strategic stockpiles of necessary medication may even assist mitigate doable shortages and scale back provide disruption. This method has already been adopted by the European Union. This method is particularly helpful for medication that will see seasonal spikes in demand – reminiscent of liquid antibiotics used for strep A.

All of us can even assist scale back drug shortages and their impacts on our care. Order prescriptions sensibly (so don’t order extra at one time than you want), take remedy as prescribed and don’t purchase from unregulated sources in case your common prescription is unavailable. Hopefully, with the measures the federal government and suppliers have already taken, it will imply fewer shortages in 2024.