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Government focus on supply alone won't solve shortages


Government focus on supply alone won't solve shortages

Pharmacists can take the lead by reviewing patients' medicines to reduce unnecessary polypharmacy. But let's hope Sajid Javid takes notice, says Claire Ward... 



The volatility around British politics and a rapidly approaching Brexit deadline has caused the usually quiet British media to continue to be full of political coverage. There may well be a general election looming too before Christmas and even the odd constitutional crisis.

A week is a long time in politics. One story that has had increasing coverage is the shortage of medicines and not just in the context of a no deal Brexit.

Pharmacists are now spending several hours each week attempting to source short supply drugs, which are often at inflated prices, with an impact on a range of different conditions including blood pressure, epilepsy, depression and motor neurone disease. There has been more focused coverage on the fact that HRT pills, gels and patches are running into severe shortage, with many menopausal women forced to swap brands which has caused side effects and depleted limited stocks. One company admitted they will be unable to resume supply until mid-2020.

Patients are becoming increasingly concerned as they are forced to wait longer for prescriptions to be fulfilled as their pharmacists search for supplies. Shortages are getting worse and none of this is yet related to a no deal Brexit where even the government’s own forecasts expect a severe impact. Well pharmacy has admitted to stockpiling in advance of Brexit, no doubt because they see the current problems with supply and fear that a no deal Brexit will exacerbate shortages significantly.

I strongly suspect others are doing so too. Well has simply been the first to go public. Inevitably, this has an impact not just on patients but on pharmacy staff too. Frustrated and worried patients might just take out their concerns on the messenger. Being a front-line pharmacist or owner of an independent pharmacy continues to be fraught with worry and stress.

Why are patients at the mercy of supply issues? The Department of Health and Social Care (DHSC) regulates prices and we are told they are kept informed of supply shortages, but isn’t healthcare and medicine supply too important to be left to the market? If we have to face a brave new world without a trade deal, surely having a secure supply of medicines is the least we should expect. 

Whatever our individual views on the rights and wrongs of Brexit, the PDA has rightly decided there needs to be a different approach. Although all organisations across the sector have been part of the DHSC Community Pharmacy Brexit Forum for some months, the focus has been very narrow. When the PDA challenged the focus on logistics alone to tackle supply problems, they were told this was not the forum to do so.

Shortages occur when demand is greater than supply and to date the government's preparation has only looked on the supply side of the equation. So the PDA has called on the chancellor Sajid Javid and the Treasury to use some of the considerable funding available for Brexit preparations to reinforce the deprescribing programme and help reduce the demand for medicines.

As we know, there are many people, especially the elderly, taking medicines that are not improving their quality of life. The chief pharmacist has been tasked by the health secretary with reducing polypharmacy and ensuring that people understand the impact of their medicines. This is an opportunity to tackle both of these issues - appropriately reducing demand while protecting supply for those who need it most - with additional funds being made available for Brexit preparations.

Pharmacists should be taking the lead in this work by reviewing patients to ensure those who should be taking fewer medicines do so and understand the value of the ones they take. A recent report published in August by Age UK highlighted the detrimental impact on the elderly of taking so many tablets each day and the cocktail of side effects they have.

So if the government wants to tackle the underlying problem of demand on medicines as well as supply, it needs to take a different approach. It can help reduce inappropriate medication. 

A simple focus on the logistics of supply alone to tackle shortages fails to see the bigger picture. 

Let's hope the chancellor takes this opportunity to do the right thing.



Claire Ward is director of public affairs at the Pharmacists’ Defence Association.





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