Drug shortages are endangering lives and wasting NHS time

This article was taken from: https://www.theguardian.com/society/2019/jun/11/drug-shortages-endangering-patients-lives-wasting-nhs-time

By Zara Aziz

I shouldn’t have to spend large chunks of my day tracking down certain medicines or researching alternatives

As a GP, managing patients’ medicine requests has until now been a seamless process of writing prescriptions to send to nominated pharmacies to dispense. But drug shortages mean that many common medications are often “out of stock” so I have to identify and prescribe alternatives. Yet, it is not always apparent which alternatives are in stock and whether a problem is limited to a few pharmacies (with different wholesalers) or is a universal shortage.

All this takes lots of staff and patient time, and scarce resources, away from healthcare. If a shortage occurs during a busy on-call surgery or just before a holiday break, out-of-stock queries pile up.

I recently saw a patient in acute distress from arthritis pain when Naproxen (a commonly used anti-inflammatory) went out of stock. She was unable to take many of the alternatives and we tried multiple pharmacies, until finally we found a distant one with a small stock that she used sparingly. For significant medication swaps or patients with complex health issues or allergies, I need to have further consultations with the patient until a solution is found. This week, I spent an hour trying to find an alternative for a patient’s usual HRT medication and discussing this with her.

At the moment, the most common shortages in Bristol are EpiPen (for allergic reactions), where users are now told to use their old one up to four months after the expiry date, some tablets for high blood pressure, certain contraceptives and hormone-replacement therapies, and a formulation of morphine used in palliative care. This poses safety issues as patients risk running out of medication, suffering adverse reactions or not taking medicines properly for fear of running out. It adds to their stress and generates workload through more GP and pharmacist consultations.

Although there are also problems in the rest of Europe, it is worse in the UK, where 60% of hospital pharmacists report shortages

These shortages are caused by a combination of factors including stockpiling of medications by some unethical wholesalers to push prices up; manufacturers of certain generic drugs prioritising more profitable markets abroad; and new regulations slowing down the manufacturing process. And, of course, Brexit fears are another issue.

Drug shortages are hurting patients. I shouldn’t have to spend large chunks of my day tracking down certain medicines or researching alternatives. The government has to take action now before more patients are harmed, or even die.

• Zara Aziz is a GP partner in inner-city Bristol