A few months ago East Anglia Bylines reported on the problems in locating open pharmacies and fulfilling prescriptions. Medicine shortages, depleted shelves and closed pharmacies are causing serious concerns. And when you are unwell, these extra worries make life very hard.
Pharmacies are battling a shortage of pharmacists. The Home Office has listed the profession on its Shortage Occupation List. The three major chains, LloydsPharmacy, Boots and +Well have a programme of pharmacy closures. Online prescription delivery services are not without their challenges. Global supply issues have impacted some medicines. But Brexit has worsened our resilience and our ability to source.
The Brexit Effect
The Nuffield Trust has published their “Future of health after Brexit” report examining the health landscape post-Brexit. The Trust finds that global supply problems and a shortage of ingredients have caused a “shock rise” in shortages of life-saving drugs like antibiotics and epilepsy medication. What is most alarming is that the current situation is being described as the ‘New Normal’.
In the past two years there has been growing medicines shortages in the UK. Drug companies issued more than 1,600 shortage notices last year. This is compared to 648 in 2020. Patients are not only being told that a medication is not available, but that it may not be available soon, nor available anywhere nearby.
“The rise in shortages of vital medicines from rare to commonplace has been a shocking development that few would have expected a decade ago,” said Mark Dayan, Brexit Programme Lead for the Nuffield Trust. “Exiting the EU has left the UK with several additional problems – products no longer flow as smoothly across the borders with the EU, and in the long term our struggles to approve as many medicines might mean we have fewer alternatives available.”
Medicine shortages come at a cost to the patient and also to the taxpayer. In mitigation, the shortage is forcing the NHS to spend hundreds of extra millions buying more drugs above their normal cost. The report estimates the NHS paid an extra £220 million more in one year than the same products would have at their previous costs.
The divergence problem
Now no longer part of the EU economic bloc with its purchasing power, the UK’s position is significantly weakened. Being outside European supply chains and the EU’s collective efforts to respond to shortages, such as the Critical Medicines Alliance and Voluntary Solidarity Mechanism, will hamper the UK’s mitigation efforts. The EU plans to shift medicines between member states as shortages arise and buy products jointly. There is also a move to bring drug manufacturing back to Europe.
A further issue is that the UK’s life science and medicine regulation now often lags behind the EU. The EU’s new law on artificial intelligence (AI) opens up a significant point of divergence from the UK. The result is running the risk of dividing the market for medical devices. In Northern Ireland, which has to align with EU rules, medical devices with AI could be available – but not on mainland Britain. And vice versa.
The government needs to act
Only with a more co-operative and proactive approach to EU/UK relations than is currently in place, will matters improve. However the Trust’s research suggests that rebuilding the EU–UK health relationship at a formal level is not currently a priority for EU institutions. Not least after experiencing ‘exhausting and at times bitter negotiation process with London’.
The Trust argues that there are actions which the UK government could undertake and which do not require renegotiating with the EU. These include improved anticipation of medicine shortages, more openness about shortages, planning the stockpiling of drugs and being watchful on costs.
“There is nothing inevitable about this ‘new normal’ where Great Britain is isolated in efforts to manage fragilities in global supply of the products, and people we need to run the NHS,” said Professor Tamara Hervey, of the City Law School. “It is the consequence of policy choices and those could be different.”
