The lives cut short by medicine shortages

With pharmaceutical companies sending an average of four medicine shortage warnings to the government each day, the issue of drug supply has a tight grip over the NHS and its patients. June 2026 saw a record number of price concessions, which can indicate shortages, issued by the government at 254 — breaching the 250 mark for the first time. In addition, a House of Lords committee report, published in February 2026, labelled medicines shortages a “national security issue”, stating that ministers should take a more proactive, coordinated approach to tackling shortages.

However, this issue has been ongoing for many years. Between 2021 and 2023, reports from manufacturers to the government on potential supply problems grew by almost 70%, while analysis published in October 2025 by the National Pharmacy Association found 7,426 separate warnings of likely shortages had been made to the government since October 2020 — an average of around four per day.

The impact on pharmacists was noted in a March 2026 progress report by the Royal College of Pharmacy (RCPharm), which was published one year after the College called for solutions for medicines shortages. The progress report also found that the burden on community pharmacies, general practice and hospitals to manage medicines shortages was still “unsustainably high”.

Patients have always been at the sharpest end of medicines supply issues. In June 2023, The Pharmaceutical Journal‘s salary and job satisfaction survey revealed that 57% of pharmacists said medicines shortages had put patients at risk in the preceding six months.

This has further played out in warnings from coroners issued as prevention of future deaths (PFD) reports. PFDs are written by coroners when they have concerns that circumstances relating to a person’s death may potentially also cause future deaths.

They are sent to organisations, such as GP surgeries, hospital trusts and the government, who could change practice or policy to address issues identified by the coroner.

An analysis of PFDs by The Pharmaceutical Journal has found that between 2023 and 2025, coroners warned public bodies six times about the threat of medicine supply issues to patients.

Epilepsy medicines shortages

Of the six reports, three were linked to the supply of anti-epileptics.

Shortages of this class of medicines, including carbamazepine, clobazam and topiramate, began to ramp up in 2023, with research showing 7 in 10 people with epilepsy had struggled to obtain their medication in 2024.

Patient David Crompton from Leeds, West Yorkshire, died from a fall at home, aged 44 years, in December 2024 during a seizure, after being unable to obtain Tegretol (Carbamazepine; Novartis) in both April 2024 and December 2024.

The coroner raised concerns over the “lengthy periods” that the patient had been left without medication, adding that hospital specialists said the absence of Tegretol for around ten days “will likely have contributed” to the seizure activity.

Another patient, Paul Nash, died at his home in Luton, Bedfordshire, aged 58 years, in October 2025 from a seizure, after running out of carbamazepine and missing three doses.

The coroner wrote to the health secretary and Department of Health and Social Care (DHSC) that Nash’s consultant neurologist had indicated patients with epilepsy across the country were experiencing difficulties in obtaining enough supply of their medication to ensure they could access this when running low or when “there are delays in the pharmacy processing a prescription”.

In another case, university student Charlie Marriage, aged 32 years, died at his flat in Camberwell, south London, from sudden unexpected death in epilepsy (SUDEP) after he was left without Fycompa (Perampanel; Eisai) for two days. Marriage had tried to get his medication from a local pharmacy, but it was out of stock.

“The lack of Fycompa likely increased the prospect of a severe seizure and contributed to his death. The growing risk of him suffering SUDEP over the 48 hours since his last dose had not been recognised or resulted in appropriate prioritisation, safety-netting or an emergency supply,” the coroner wrote in the PFD report.

While there are currently shortages of epilepsy medication, such as sodium valproate and phenobarbital, Alison Fuller, director of health improvement and influencing at charity Epilepsy Action, tells The Pharmaceutical Journal that the charity has not seen an increase in reports of medicines shortages over recent months.

“We are aware that medication shortages have been an issue for people with epilepsy in the past, and we know that this can be very concerning and anxiety inducing,” she says.

“Any shortages can pose a risk to patients, as any missed dose of epilepsy medication puts someone at an increased risk of a breakthrough seizure. This is why we consistently monitor the supply and keep our community up to date with any changes.”

ADHD medicines shortages

Similarly, filling prescriptions for ADHD medicines at the moment can be challenging but not impossible. “Currently, we hear from people having some limited issues getting their prescription filled (including me), but fortunately we’ve not recently seen any widespread stock outages,” says Henry Shelford, chief executive of ADHD UK.

However, the results of a survey conducted by ADHD UK in November 2023 revealed that more than one-quarter of ADHD patients in the UK had not received their medication, following a September 2023 patient safety alert warning on ADHD drug shortages.

Around that time, Oliver Winson, aged 33 years, died from a drug overdose while on a waiting list for an ADHD service in June 2024.

In the PFD report, the coroner wrote of their concern for patients on “lengthy waiting lists” who were at risk of “harmful behaviour and death” as a result of undiagnosed or untreated ADHD, noting a shortage of medication for patients who have been diagnosed.

At the time, Shelford said the charity had “called out for prioritisation of people at risk of suicide during the ADHD medication shortages but to no avail”.

Substituting medicines during shortages

Another of the PFD reports focuses on Hannah Jacobs, aged 13 years, who died at Newham University Hospital in east London, after her prescribed Epi-pen strength was out of stock, following national shortages in 2023.

Jacobs had begun having an allergic reaction after being incorrectly served a dairy hot chocolate. She was without an Epi-pen and so went with her mother to get treatment in a local pharmacy.

Her mother “asked for an Epi-pen, but due to a national shortage, there was only one in stock, a 150 micrograms rather than the 500 [micrograms] Hannah had been prescribed”.

“This was given but sadly Hannah went into cardiac arrest and could not be resuscitated,” the coroner wrote.

In another case, Ava Hodgkinson, aged two years, died at Ormskirk District General Hospital, Lancashire, after a pharmacy did not have the correct strength of amoxicillin in stock in 2022.

A rise in strep A cases during the winter of 2022 led to several shortages of antibiotics, with the Specialist Pharmacy Service advising clinicians to encourage children to take solid-dose forms, following severe shortages of antibiotic oral suspensions for children, including penicillin, amoxicillin and azithromycin.

Hodgkinson had been prescribed amoxicillin 250mg/ 5ml, but the pharmacy only had 125mg / 5ml in stock. The coroner highlighted that, owing to restrictions, the pharmacist was not able to issue the alternative strength, “even where the medication can be provided to enable the same dose to be administered (here Ava’s parents could have been instructed to provide 10ml enabling the same dose of antibiotics to be provided)”.

The government later launched a consultation on enabling pharmacist flexibilities in prescribing alternative doses in 2025, but the outcome is still awaited. In the meantime, serious shortage protocols (SSP), introduced in 2019, do allow pharmacists to substitute products or quantities of a drug in shortage, but only once the SSP has been issued by the government.

Commenting on the six PFDs, a spokesperson for the DHSC said: “Our deepest sympathies are with the families of those people who have died.

“There are around 14,000 medicines licensed in the UK, and the overwhelming majority are in good supply. We have invested in UK medicine manufacturing to manage supply disruptions and have well-established processes in place to mitigate shortage risks, including using alternative medicines when available, actively engaging with partner countries to bolster supply chains, and supporting pharmacies with medicine costs.”

However, Shelford calls the government’s response to ADHD medication shortages “woeful”.

“It doesn’t have an effective strategy for when an ADHD medicine is out of stock. There is no process to help change the prescription to what is available,” he adds.

Shelford notes that, instead, “the problem is passed to already overwhelmed ADHD specialists”.

“In the last major shortages, I looked to change my prescription and was told it would be two years before I could speak to someone. I needed it that week. If anything, the current situation is likely even worse, with waiting lists even longer to see NHS ADHD specialists,” he continues.

“Medicines shortages can have serious, and sometimes devastating, consequences for patient safety,” says Tase Oputu, president of RCPharm. “These tragic cases highlight the urgent need for action to prevent shortages from contributing to patient harm.”

She adds that the College has “long called for a more resilient medicines supply chain”, including emergency protocols for life-critical medicines and greater flexibility for community pharmacists when supplies are disrupted.

“Pharmacists and their teams work tirelessly to protect patients from the impact of shortages, but the wider system must now do more to support them and prevent further harm.”