Healthcare Distribution Association (HDA UK)
Martin Sawer, executive director of the Healthcare Distribution Association (HDA), has said that there is a “confusing blur” between medicines shortages and the procurement of medicines.
Speaking at the HDA’s annual conference, held in central London on 23 January 2025, Sawer said he was concerned that “there’s a confusing blurring now between a real clinical shortage and what has become almost an economic shortage at times”.
”Patients and clinicians, including pharmacists and dispensing doctors, should not be directed to this confused debate,” he said.
“By economic shortage, I mean that the incentives in NHS medicines procurement are now sometimes… driving behaviours by stakeholders that prevent medicines being supplied as quickly as possible. The related reported shortage is then about the economics of procurement, not the result of a genuine pharmaceutical unavailability.”
Giving examples, Sawer asked: “Why would an independent community pharmacy or dispensing doctor… buy any more medicines than they usually require, when they know they’ve been dispensing some of these medicines at a loss for a long time and also have difficulty paying their wholesaler bills?
“Who can blame pharmacists for employing some real-time digital buying platforms to keep looking for the cheapest generic price on offer at the lowest price and perhaps not buying those where they will be dispensing at a loss?” he continued.
Sawer also argued that those involved in the supply chain need to share more about what is being done to maintain medicine supply to build trust with clinicians and patients.
“All sides [involved in medicines supply] — government, manufacturers and wholesalers — I think, need to be more open about the why, what and when, so we can all support clinicians and patients.
“Why don’t we explain better what we’re doing every day to maintain the supply of the vast majority of medicines, and I think this includes the NHS and Department of Health, as well as the stakeholders and supply chain. If we actually explain some of the mitigations that go on every day to make sure patients do get medicines that [they] never hear about, there’d be a lot more trust and respect.”
Also speaking at the conference, Simon Tottman, vice president of health consultancy firm IQVIA, said there had been a “slight reduction” in medicines shortages across Europe, owing to them being dealt with “more effectively”.
“We’re seeing a slight reduction in shortages across Europe. This is not because fewer shortages are being conveyed but more about them being potentially dealt with more effectively with some of the mechanisms that are being put in place,” he said.
Tottman added that antimicrobials — particularly pointing out coamoxiclav — which “have been at the top of the list for some time”, were not experiencing as much of a shortage issue, potentially because of a milder winter.
He added that there was a rise in shortages of mental health products, particularly for schizophrenia, which he attributed to a rise in demand rather than production issues.
He also said that practices to manage shortages in other countries will have an impact on the UK market.
Using Germany as an example, Tottman explained that the country has six-month stock requirements for certain products, “which has an impact on several central Eastern European countries, and it will have an impact on shortages in our [UK] market if such a large stockpile is being created by such a sizeable market as Germany”.
On 8 January 2025, the All-Party Parliamentary Group on Pharmacy announced an inquiry into the impact of medicines shortages in England, owing to growing concerns around shortages and their impact on patients.
In evidence submitted to the inquiry, the Royal Pharmaceutical Society (RPS) said that around 40% of pharmacists say medicines shortages have put patients at risk during the past year.
The RPS added that the effects of shortages of critical medicines can “heighten the risk of adverse events”, as well as cause “delays in patients receiving essential medications”.
NHS England was contacted for comment.
