Key Summary
- War is not the sole reason for the current medicine shortage crisis in the country.
- Suggesting alternative medicines is not always a straightforward solution.
- The UK must ensure improved investment to tackle the situation.
A recent study by the University of Manchester shows that the reasons for UK’s medicine shortages are varied and cannot be solved by quick-fix measures.
The common reasons cited for shortages are manufacturing errors, fluctuating demand, regulatory changes, and wars.
Among this, 60 per cent of the shortage faced by the NHS comes from manufacturing bottlenecks or the limited manufacturing capacity along with poor reserves for medicines as well as its raw materials.
Although the ongoing war has aggravated the situation, it is not the sole reason for the shortage, on the other hand several systemic failures have been leading to this situation.
The recent House of Lords report had called for better leadership strategies on medicine supply in the UK, as shortages affects public health and endangers national security.
The country is heavily dependent on foreign manufacturing from companies based in India, Ireland and Israel to cater to the NHS demand.
Currently, around 120 drugs spanning from Ritalin (methylphenidate) for ADHD, propranolol used for angina, heart arrhythmia, high blood pressure and anxiety, hormone replacement therapy medications, medicines for diabetes and epilepsy face shortage risk in the UK.
The study calls for long-term solutions to resolve the medicine shortage crisis through sustained investment in domestic manufacturing, genuine political intervention considering this as a priority.
The NHS must urgently diversify its foreign suppliers, while the frontline staff must judiciously use the existing resources during the crisis by providing transparent information about the changes in medication to the patients.
Remedial measures
The research highlights various measures taken by the government to tackle this shortage, such as the National Supply Disruption Response protocol, pharmacists and GPs given the authority to prescribe alternative medications or doctors avoiding the prescription of medicines that might run out soon.
While prescribing alternative equivalent drugs is an option, the researchers do not find it a straightforward solution as the differences in their production and delivery makes it not a complete equivalent.
They explain this difference using the example of immediate-release versions of drugs, which peaks and clears in the body rapidly, which can lead to a sudden drop of the drug in the patients’ blood resulting in difficulties with symptom control.
On the other hand, the extended-release version drugs are stable in nature, with better symptom control.
So, providing patients who have been used to a particular drug with something similar all of a sudden is still not a proper solution with high chances of side-effects of withdrawal troubles.
However, all these measures are short-term medicine shortage management steps, and not a prevention.
In the absence of effective preventive measures, the NHS is often under pressure and fail to safely de-prescribe medications, which often leads patients with withdrawal effects.
