Government consults on giving pharmacists powers to substitute drugs during shortages

The introduction of a “strict protocol” could allow pharmacists to dispense an alternative medicine if the one prescribed is unavailable.

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Pharmacists could be given new powers to switch patients’ prescriptions without consulting a doctor in the event of a national medicines shortage.

The Department of Health and Social Care (DHSC) has launched a consultation on the introduction of a “strict protocol” to allow pharmacists to dispense an alternative medicine if the prescribed drug is unavailable.

The DHSC has said that a protocol would be issued in case of a serious national shortage and allow pharmacists to dispense in accordance with the protocol, rather than the prescription, without having to contact the patients’ GP.

The government added that the protocol would clearly indicate which alternative medicines can be dispensed and to which patients.

The protocol may allow pharmacists to respond to a shortage in four ways, including dispensing a reduced quantity, a therapeutic equivalent, a generic equivalent or an alternative dosage form.

A DHSC spokesperson said: “In the unlikely event of a shortage of any medicine it’s vital that patients continue to receive the high level of treatment they expect.

“We are consulting on the introduction of a strict protocol, which would be developed in collaboration with doctors, to allow our highly-trained pharmacists to provide an appropriate alternative should there be a shortage of certain types of medicines.

“This is a sensible approach that should reduce the time taken for alternatives to be provided to patients.”

In a statement, the Royal Pharmaceutical Society said: ”This ‘serious shortage protocol’ will enable community pharmacists to dispense in accordance a protocol rather than contacting the GP. We support pharmacists using their professional judgement to decide on what medicine to dispense. Pharmacists will work with doctors to make sure any communication about changes to medicines is clear.”

The Pharmaceutical Services Negotiating Committee has already proposed that community pharmacists should be able to automatically substitute an alternative medicine if they cannot dispense the prescribed item, to help deal with any possible drugs shortages after Brexit.

This followed on from a similar suggestion from Sibby Buckle, vice chair of the Royal Pharmaceutical Society (RPS) English pharmacy board and chair of the RPS pharmacy digital forum.

The government’s protocol would introduce a new regulation into the Human Medicines Regulation 2012 enabling ministers to issue a “serious shortage protocol”.

Last updated
The Pharmaceutical Journal, PJ, December 2018, Vol 301, No 7920;301(7920):DOI:10.1211/PJ.2018.20205873

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