Paxlovid became the first-line treatment choice, followed by remdesivir, with molnupiravir pushed down to a third-line option. But the limited supply, short treatment window and small number of patient groups eligible to receive antivirals gave rise to concerns about whether they could really turn the tide on the pandemic.
By the end of the year, draft guidance from the National Institute for Health and Care Excellence recommended Paxlovid but not molnupiravir or remdesivir as options for treating COVID-19 in adults on the grounds that they were not cost-effective.
The new guidance came on the back of a plethora of cardiovascular outcome trial data in recent years and meant that people with type 2 diabetes mellitus, who also have cardiovascular disease or are at high risk of developing it, were offered a SGLT2 inhibitor in addition to metformin earlier in their treatment.
In February, the Pharmaceutical Services Negotiating Committee appointed Janet Morrison as its new chief executive, who went on to negotiate the final two years of the community pharmacy contract in England. These negotiations led to the introduction of a national contraception management service and the expansion of the NHS Community Pharmacist Consultation Service to include referrals from emergency care, but the shelving of plans for an English version of ‘Pharmacy First’.
Andrew Lane, chair of the National Pharmacy Association, said that no comfort can be taken from the figures, since the trajectory is still downwards, and there will be more closures to come without a fresh injection of funds.
In March, NHS England appointed Tony Avery, a GP based in Nottingham, as its first national clinical director for prescribing. Avery’s focus is to ensure prescribing reflects the needs of the diverse population in England, improves health outcomes and protects the environment.
Pharmacists were given powers to limit dispensing of some types of HRT to three months to try to improve shortages. The news came following an exclusive story in The Pharmaceutical Journal, which revealed that shortages are being “exacerbated” by some patients being given prescriptions for a 12-month supply.
As part of the government’s response to HRT shortages, the health secretary appointed Madelaine McTernan, former director general of the COVID-19 vaccine taskforce, as ‘HRT tsar’ in April, with the promise of leaving “no stone unturned in our national mission to boost supply of HRT”.
Although HRT was perhaps the most widely reported medicines shortage in 2022, it was by no means the only one. Our reporting also covered shortages of alendronic acid, thrombolytic drugs, aripiprazole, paroxetine and Gaviscon and, in the summer, we reported results from our annual salary and job satisfaction survey, which showed that 54% of UK-based pharmacists said medicines shortages had put patients at risk in the past six months.
Later in the year, the four UK governments published a rapid policy statement, which said that hospitalised patients with PCR-confirmed mpox are eligible for antiviral treatment with tecovirimat if they have severe or complicated disease.
Also in May, NHS England set up an independent commission to review pharmacy professional leadership “to guide, support and enable the transformational change” that is ongoing for the sector, chaired by Nigel Clarke. In October, the RPS proposed a single leadership body to credential pharmacists and pharmacy technicians. The commission promised to report its recommendations by December 2022.
The debate was reignited later in the year, when scientists claimed to have found the first direct evidence that people with depression have a reduced capacity for releasing serotonin in the brain, in a small brain imaging study.
Steve Barclay was appointed health minister in July following the resignation of Sajid Javid, only to lose the job to Therese Coffey two months later in a cabinet reshuffle, when Liz Truss took over the role of prime minister from Boris Johnson. Barclay was then reappointed as health minister when Rishi Sunak became prime minister in October. There was also no less than four pharmacy ministers in 2022.
A Pharmaceutical Journal exclusive revealed that pathfinder sites will launch in every region of England from the beginning of 2023 — the first independent pharmacist prescribing service in community pharmacy to be fully funded by the NHS in England.
The development, described by David Webb, chief pharmaceutical officer for England, as a potentially “game-changing” expansion of the services the profession can provide on the NHS, aims to prepare for 2026, when all pharmacists will be able to independently prescribe at registration.
Nearly a third (31%) of the 100 most popular posts were actively promoting the use of diet pills for weight loss and, of those, more than a quarter (26%) were promoting a specific named prescription-only medicine.
September also saw the death of Queen Elizabeth II and a period of national mourning followed. Queen Elizabeth II was patron of the Royal Pharmaceutical Society and a long-time supporter of the profession.
The new pilots aim to test the practicalities of how pharmacogenomic panel testing can be embedded in the NHS. Initial findings from a large international study, reported in The Pharmaceutical Journal later in the year, showed that adverse drug reactions could be reduced by nearly a third by using a pharmacogenomic panel approach.
Community pharmacy funding came to the fore once again in October, following a government report that showed community pharmacies in England have seen a real-terms funding cut over the past five years.
Following reports from pharmacists of worsening supply problems for antibiotic oral suspensions, including penicillin, amoxicillin and azithromycin, NHS guidance advised clinicians to encourage children “to swallow oral solid dose forms” of antibiotics where possible, instead of using oral suspensions.
Speaking to the BBC’s Today programme on 9 December 2022, Kamila Hawthorne, chair of the Royal College of General Practitioners, called for community pharmacists to be able to dispense alternative formulations of antibiotics, or substitute them, if the prescribed form is unavailable.
Less than a week later, pharmacists were given emergency powers to supply alternatives for eight phenoxymethylpenicillin products under serious shortage protocols issued across the UK. The government also banned export or hoarding of four different antibiotics and the Competition and Markets Authority began investigating price increases for antibiotics used to treat strep A.
We hope you enjoyed our review of 2022. If you’d like to hear our predictions for 2023, listen to this month’s episode of the PJ Pod.
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