Seems to be every single day we have issues being discussed in threads here.
For a change, this is the view from the pharmacists' end of things:
‘Worse than ever’: Which medicines are pharmacists struggling to stock?
30 Aug 2022
ANALYSIS
Pharmacies across the UK are struggling to source a variety of medicines, with some reporting that shortages have never been more acute. Pharmacy teams have told C+D which products they cannot seem to get hold of.
Thank you for this link. Last month my GP prescribed Capsaicin cream to help manage dreadful neuropathy in my hands/wrists. The pharmacy didn’t have any… GP prescribed again today so will phone the pharmacy tomorrow and hope they can give me this medicine. Why are there such problems in the availability of certain medicines, do you have any idea?
Cephalon Axsain 0.075% capsaicin cream is (supposedly) going to be back in stock at the end of October. Which I think is a jolly long time. Especially as there have already been major supply problems with it this year.
You can check with Teva who distribute it. I did about a week or so ago.
Get a paper prescription and visit or call every pharmacy in the country. I struck lucky on my first try! They ordered a tube in for another patient and just happened to have added a second tube to the order - so it was sitting in the shelf. Itself a miracle as it usually takes a few days.
Anyway, I have absolutely no idea why supply of Axsain should be a problem.
Have you tried Fiery Jaxx? When I thought I wasn't going to be able to get any Axsain, I ordered some from an eBay seller Not arrived yet (thanks to postal issues, I hope).
Thank you for your helpful reply. I will go to my local pharmacy this morning to see if by any miracle they have Capsaicin gel (made a mistake it wasn’t cream my GP prescribed). If not will ask them to give me my prescription and will try Boots in the nearest town… and another independent pharmacy. Fingers tightly crossed. Is Fiery Jack uses for peripheral neuropathy too? Sounds “really fiery” so wonder whether it will be painful, adding more pain?
So, how are patients responding to these medicine shortages?
Mr Ahmad said that while the “minority are understanding”, most “get annoyed and frustrated, especially if they are close to, or have run out of, that particular medicine”.
“It can be very stressful for them, and for the pharmacy teams,” he stated.
In the not-so-distant days of people being issued paper prescriptions, if I couldn't get a particular medicine from my usual source I would phone around (or walk to) various pharmacies asking if they had drug X available. I think there was only once I was completely stumped, and in that case I got what I wanted by asking my GP surgery for the prescription to be changed to 2 x 250mg of an antibiotic from an unavailable 500mg antibiotic.
I take a liquid medicine for IBS, its the best one for me. Kolanticon gel, I haven't been able to get it since last year. I've been told October is when they're expecting stock again. I know HRT shortages are regularly reported.
Quite why they put just nine shortages on each page and spread them out in a grid, I don't know. The nine images are all generic and, to me, add nothing whatsoever. Might have looked nice when they only had a handful but now there are twelve pages of them. And that does not include products for which there might appear to be an alternative - e.g. one make of levothyroxine or liothyronine - no matter the patient can only tolerate that and none of the others.
For Sparklingsunshine they say this:
Update: (10/01/2022) Resupply date now expected to be October 2022
That is something that went into shortage in June 2021!
In among the specific reports is this - which reads as a plea and apology all in one:
Medicine supply: Contractor Update from PSNC
Wednesday 20th July 2022
PSNC is becoming increasingly concerned about the sustained pressures on medicines supply and the very serious impact that this is having on community pharmacy teams and their patients.
As we move into the second half of the year, we are asking contractors and their teams to continue using our regular reporting tools to help us to demonstrate the scale of the problems to the Department of Health and Social Care (DHSC) and to support escalations as needed.
The sustained increases in price concessions that we have seen so far in 2022 – with more than 100 concessions being granted in some months – show no signs of abating, and we know that many pharmacies now find themselves in a critical situation trying to source medicines in timely manner and facing significant financial risk due to greater uncertainty around expected reimbursement prices for a large number of medicines.
We know that some concessions being imposed by the Department do not match contractors’ experience on the ground, and we would ask all contractors to continue reporting pricing issues to us on a regular basis to support our representations: Report product over Drug Tariff price.
We have escalated the situation and our concerns with the Department and are seeking both an improved price concession process to streamline processes and give contractors better information, as well as recognition of the impact this is now having on pharmacy teams.
Our Pharmacy Pressures Survey has confirmed the consequences of the issues pharmacy teams are now facing, finding that 83% of pharmacies had seen a significant increase in medicine supply issues in the past year, leading to extra work and additional stress for staff. Two-thirds of respondents said that medicines supply chain issues are now a daily occurrence, with 97% reporting that this led to frustration from patients.
The situation is distressing, adding both operational and financial pressures on pharmacy teams. We have updated our guidance for contractors, including revising our medicines supply factsheet. This, as well as further practical steps can be viewed at the bottom of this article.
Our work to raise this in the wider policy environment also continues following previous national media work (e.g. The Guardian and The Telegraph), and work to brief MPs. We are also working with the other pharmacy organisations to continue to raise the pressures on the sector, including via a petition calling for action to stop violence and abuse in pharmacies: Petition · Stop violence against local pharmacies and help us do more for patients · Change.org
Gordon Hockey, PSNC Director Legal, said:
“The current volatility and pricing issues in the medicines supply chain are extremely concerning to PSNC: we know that they are having a very negative impact across the sector, often on a daily basis. It is also particularly concerning to hear from pharmacy teams who report that some patients are showing aggression to pharmacy teams as a consequence of these sustained issues.
Pharmacies are doing everything that they can to manage supplies and patient expectations, but it is not acceptable that they are being put in this situation, on top of all the other critical issues and pressures that they are facing at the moment. We are continuing to seek Price Concessions from DHSC on a monthly basis, alongside escalating this within the Department.”
If they provided a way for patients to report shortages, they might get more reports. I'd understand if they simply used patient reports as a sort of second line of information. But it would also help to identify where for unknown (to us) reasons, one pharmacy can't supply and insists something is not available, while there is no known shortage.
I imagine some big chains do all their reports centrally which will also limit the reports received.
I’ve used half a tank of fuel going backwards and forwards to a pharmacy multiple times - they don’t answer the phone and isn’t always even open when I get there… despite opening hours saying something different. I feel we’re approaching meltdown.
But also, I think “shortages” are sometimes a creation of the supply route agreed in local areas to fix prices within a narrow range. “Can’t get it” sometimes means “can’t get it for the price pharmacy is willing to pay” or “can’t get it for the price supplier is contracted to provide for”. I’m not sure this is legal? Is it price fixing?
Doncaster Pharmaceuticals continues operating after being snapped up by new owner
31 Aug 2022
News
A UK wholesaler that had previously filed for administration will continue to serve pharmacies under a new name, following the announcement that Dutch pharmaceutical wholesaler BModesto Group has purchased its business and assets.
There has been lots of suggestion that the failure of Doncaster Pharmaceuticals precipitated a long list of supply issues. If they are going to be back and operating fully, it just might help where the issue lies in the distribution arena.
Is there an explanation for why we're experiencing such issues, is it a result of covid, or cost of living crisis or the B word, (like Voldemort our leaving the EU shall not be named) 😉. I'm curious as to what the root causes are.
What happened to those Brexit medicines shortages?
Long read: Before the UK left the EU’s single market at the start of this year, many warned of the risk of medical supply shortages. But did that prove to be the case? Mark Dayan takes a closer look at what’s happened since January 1st, and looks ahead to what might happen in future.
Whenever there's a war going on, some drugs are in short supply. Antibiotics, local anaesthetics, etc, etc. I've been around long enough to know. They have priority with manufacturers. Now
with the Ukraine situation, loads of meds are being sent over there and many wounded are being shipped to Ramstein airforce base to stabilize and then to the USA for surgery and rehab.
War is big business. Not just military hardware but also drugs.
My friend who was stationed in Afghanistan told me that they all had to take Ciprofloxacin as a preventive due to all the pests. It did damage to his and other's guts and microbiome which took concerted effort after retiring from the air force to become healthy again. Meantime he developed hypothyroidism and became type 2 diabetic.
The war in Ukraine hasn't helped matters but drug shortages have been reported long before the conflict started. My IBS drug has been out of circulation since June 2021. HRT supply has been a big problem for many women. I'm sure they aren't diverting that to Ukraine.
Its a bit like the current utility bill crisis, the government has made several allusions to the Ukraine war pushing up prices of Gas and Electricity and that maybe true but its also true prices were rising anyway. Before it all started.
I dislike convenient scapegoats and feel that the Ukraine situation is being unfairly blamed for supply issues that are arising for other reasons.
Just copying here a comment I’ve just put on another thread, as it seems appropriate -
There are no shortages, no manufacturing problems, the only problem is that, although MP is in stock at suppliers, pharmacies can’t get it, because pharmacists cannot specify brand and the supplier provides one of the other brands. Pharmacists feel that it is out of their control, they cannot get MP by asking for it specifically from a supplier. They can only hope to obtain it by repeatedly ordering and hope that by chance it is sent to them eventually…. Advanz have confirmed that they are now only providing MP through their suppliers.
(Re: Liothyronine)
Entirely financially driven, person-centred care eliminated
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Been on levothyroxine for seven weeks and feeling worse than ever
Feeling worse than ever
Worse than ever on medication
