Pharmacy teams told to ‘urgently’ order unlicensed imports of chemotherapy drugs in shortage warning

Exclusive: A ‘Tier 3 — high impact’ alert has been issued for the platinum-based chemotherapy agents cisplatin, carboplatin and oxaliplatin.
chemotherapy intravenous drip in patient's hand

NHS pharmacy procurement teams have been told to “urgently” place orders for unlicensed imports of platinum-based chemotherapy agents.

On 31 July 2023, the Department of Health and Social Care (DHSC) and NHS England declared a ‘Tier 3 — high impact’ medicine supply issue for the platinum-based chemotherapy agents cisplatin, carboplatin and oxaliplatin.

In the alert, seen by The Pharmaceutical Journal, the DHSC and NHS England warned that all strengths of cisplatin are in “very limited” supply and will be unable to meet full UK demand until at least early October 2023, with a resupply date yet to be confirmed.

They also reported limited supplies of carboplatin at all strengths — particularly the 600mg/60mL solution for infusion vials, which is expected to be significantly impacted.

Oxaliplatin remains available but the medicine supply notice advised that extra supplies of the drug will not be available to meet any uplift in demand. It also said that supplies from independent aseptic compounders will remain available, but that they would also not be able to increase capacity or accept new customers.

The announcement included a list of specialist importers, which have said they would be able to supply unlicensed imports of cisplatin and carboplatin.

The supply notice said that for cisplatin and carboplatin: “NHS provider pharmacy procurement teams in all regions should: urgently place orders for unlicensed imports to meet the needs of patients during this period; work with the aseptic and quality assurance leads in trusts to be ready to use unlicensed imports in aseptic units on receipt; and work with their pharmacy aseptic lead to ensure appropriate mitigations are put in place to minimise the risk of product confusion and dosing errors in the event that trusts have multiple unlicensed products in use within the organisation at the same time.”

Commenting on the supply notice, Emma Foreman, vice chair of the British Oncology Pharmacy Association, said that the supply issue has not yet had “much of an impact” but highlighted the need for contingency planning.

“If it [the stock issue] continues, it will have a significant impact on our ability to provide treatments because these drugs form the sort of backbone of a significant number of chemotherapy regimens, including some potentially curative regimens,” she said.

“I imagine oncology pharmacy services across the country are going to need to do some contingency planning to perhaps reserve those drugs for the treatments that are going to have the greatest impact.”

Damian Child, director of pharmacy at the Christie NHS Foundation Trust, said: “Whilst still having some concerns about the robustness of future supply arrangements, the current message in the MSN [medicines supply notice] is that stock is available but we can’t increase capacity of these products.”

Last updated
The Pharmaceutical Journal, PJ, August 2023, Vol 311, No 7976;311(7976)::DOI:10.1211/PJ.2023.1.193451

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