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. Latest 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 acquired a lot consideration, many different medicine within the UK have been in brief provide – together with medicine used to handle kind 2 diabetes, ADHD and menopause signs.

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

This will have many questioning why 2023 has been a 12 months characterised by so many drug shortages – and whether or not the state of affairs might be comparable in 2024.

Causes of shortages

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

Manufacturing points are probably the most generally cited reason for drug shortages. In line with a report from 2022, 60% of world medication shortages had been on account of manufacturing issues. That is prone to have been the identical in 2023.

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

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

Ozempic is just licensed to deal with kind 2 diabetes. However it grew to become fashionable through social media due to off-label use to help in weight reduction. Elevated use, licensed and unlicensed (off-label), had such a major have an effect on on provide that medical doctors in lots of nations had 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 pretend merchandise, which had questionable security.

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

Whereas protocols had been put in place to authorise pharmacists to make use of different merchandise the place crucial, generally these measures weren’t ample. This led to the NHS offering steerage 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 modifications in commerce agreements between the UK and EU have led to extra paperwork, prices, provider modifications and delays.

Within the UK, for a lot of medicine 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 critical have an effect on on sufferers.

There are considerations that authorities agreements concerning pricing and provider taxation (through the Voluntary Scheme for Pricing, Entry and Development) might 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 reasonably priced costs in a number of markets and in addition present producers with acceptable returns on funding.

Some provide points within the UK are additionally on account of international spikes in demand – both on account of elevated prescribing of sure medicine 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 a lot of initiatives in place to cut back shortages within the EU – comparable to requiring suppliers to report shortages earlier, transparency and sharing of inventory between nations and joint procurement methods. It’s not clear if this may profit the UK, however robust provide chains throughout Europe needs to be constructive for international drug provide.

A few of the provide disruptions that affected UK medicine in 2023 might 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 facility in Spain.

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

One other measure that may assist cut back drug shortages is issuing advisory notices about who ought to, or shouldn’t, be prescribed sure medicine. 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 incorporates the identical lively ingredient as Ozempic) will even assist to enhance Ozempic inventory ranges – making certain sufferers with kind 2 diabetes can entry this product.

Creating strategic stockpiles of vital medicine will even assist mitigate attainable shortages and cut back provide disruption. This method has already been adopted by the European Union. This method is particularly helpful for medicine which will see seasonal spikes in demand – comparable to liquid antibiotics used for strep A.

All of us may assist cut 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, this may imply fewer shortages in 2024.