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Medicine shortages are putting patients in “distressing situations”, with nearly 70% of pharmacists warning that shortages have put patients at risk in the past six months, a survey of more than 1,200 UK pharmacists has revealed.
The survey, carried out by The Pharmaceutical Journal in April 2024, found that 861 out of 1,265 (68%) UK-based pharmacists working in all sectors answered ‘Yes’ when asked if medicines shortages have put patients at risk “in the past six months”.
This is a 14 percentage point increase on The Pharmaceutical Journal’s 2022 survey, which found that 54% of pharmacists answered ‘Yes’ to the same question.
The results showed that 122 (10%) pharmacists answered ‘No’ to the question, while 282 (22%) responded with ‘I don’t know’.
Pharmacists responding to the survey highlighted particularly concerning shortages of ADHD medicines, antiepileptics, the pancreatic enzyme replacement therapy Creon (pancreatin; Mylan) and medicine to treat diabetes, including insulin and glucagon-like peptide-1 receptor agonists (GLP-1 RAs).
There have been persistent shortages of ADHD medicines in the UK since 2022, owing to increased global demand and manufacturing issues.
One hospital pharmacist in England who responded to the survey said: “The lack of availability of ADHD medicines has led to some distressing situations in which desperate parents have resorted to unsafe measures to try to help their children,.”
Another hospital pharmacist who responded to the survey added that the ADHD medicine shortages meant “patients were forced to access alternatives online, which are not considered safe”.
In September 2023, the Department of Health and Social Care (DHSC) issued a national patient safety alert in response to shortages of methylphenidate prolonged-release capsules and tablets, lisdexamfetamine capsules, and guanfacine prolonged-release tablets.
Commenting on the survey results, Henry Shelford, chief executive of ADHD UK, said: “Since September [2023], individuals with ADHD have had a monthly lottery on whether or not they are going to get medication, with many lives turned upside down for those that don’t.
“The medication crisis for ADHD continues unabated, but the DHSC has withdrawn its support to pharmacists on ADHD. ADHD medication stock updates used to be updated weekly but were last updated in May 2024… We’re failed by the NHS and bureaucratically abandoned by the DHSC.”
Responses to The Pharmaceutical Journal survey also warned about the risk to patients with diabetes posed by shortages of GLP-1 RAs, such as semaglutide.
One GP pharmacist in England said that that GLP-1 RA shortage for diabetes is “putting a whole cohort of patients at risk of poor control [which] therefore could lead to micro and macro vascular complications”.
The same pharmacist said the shortage of Creon, used to treat exocrine pancreatic insufficiency, is “potentially causing deterioration in [the] condition when not available”.
The government declared a national shortage of GLP-1 RAs in June 2023 owing to an increase in demand for licensed and off-label indications, with the shortage expected to continue for all of 2024.
Pharmacists have previously described “unmanageable shortages” of GLP-1 RAs, owing to private online prescribing for weight loss that “is not wholly controlled”.
One GP pharmacist based in Scotland, who prescribes for diabetes patients, said in their survey response that the increased demand for GLP-1 RAs has meant their patients “have had to go without for long periods, switching to alternative gliptin or increasing [the] dose of other meds, has often resulted in significant adverse effects”.
Janet Morrison, chief executive of Community Pharmacy England (CPE), described the survey results as “worrying”, adding that pharmacists “urgently need more to be done to protect patients and community pharmacies from ongoing supply chain disruptions”.
“We want to see a full review of the medicines supply market to protect access to medicines and address issues such as under-funding and price concessions.”
In May 2024, a survey carried out by CPE found that 99% of pharmacies were affected by medicines supply problems at least weekly, with 94% of pharmacy owners saying their teams were spending more time sourcing medicines in 2024 compared to 2023.
Commenting on the survey results, James Davies, director for England at the Royal Pharmaceutical Society (RPS), said: “Delays in receiving medicines mean pharmacists spend hours tracking down supplies when their time and expertise could be spent advising and treating patients.”
He added that the Society would “like to see manufacturers, wholesalers and the new government work together to improve the medicine supply chain and make it more robust” and wants to “see a change in the law in England to allow pharmacists to make minor amendments to a prescription”.
The RPS has launched an advisory group, led by Bruce Warner, former deputy chief pharmaceutical officer for England, to scope out the reasons behind shortages and steps to reduce their impact.
Rachel Power, chief executive of the Patients Association, commented: “We are concerned about reports from pharmacists that medicines shortages are putting patients at risk. No patient should be unable to get prescribed medicines, but shortages are becoming increasingly common, and this is a real worry.”
A spokesperson for the DHSC commented: “Medicine supply chains are complex, global and highly regulated. Supply disruption is an issue which affects the UK, as well as other countries around the world.
“Our priority is to ensure patients continue to get the treatments they need. Where there are supply issues, we work with industry, the NHS and others to ensure patients continue to have access to an alternative treatment until their usual product is back in stock.”
