Friday 23 August 2019

Patient care being hit by drug shortages, pharmacist warns

Gap in supply of medicines goes beyond panic hoarding over Brexit

'Patients who cannot get hold of their prescribed drug may have to be put on a second-choice medicine or told to ration their supply by their doctor' (stock photo)
'Patients who cannot get hold of their prescribed drug may have to be put on a second-choice medicine or told to ration their supply by their doctor' (stock photo)
Eilish O'Regan

Eilish O'Regan

Drug shortages are affecting patients' ability to manage their illness and leaving pharmacists scrambling for essential supplies, it emerged yesterday.

Kerry pharmacist Jack Shanahan warned that drug shortages are seriously hampering pharmacies' ability to function as normal.

"They are also having noticeable effects on patients where optimal treatments are being degraded by erratic supply," he said. He revealed he placed a bulk order with a well-known generic drug maker recently and of "the hundred odd lines I ordered, over 20 were in short supply".

Medicines which are affected include blood-pressure pills and anti-inflammatory drugs to treat conditions like arthritis. Patients who cannot get hold of their prescribed drug may have to be put on a second-choice medicine or told to ration their supply by their doctor.

Mr Shanahan, who is editor of the 'IPU Review', the journal for pharmacists, said he believed the problems go deeper than hoarding of drugs because of fears they will be low in stock after Brexit.

One of the reasons for fluctuations is the way some pharmaceutical plants now produce one kind of medicine before going on to a batch of another drug.

If any issue is found the next medicine will not be released but they can run out of "buffer stocks", creating a gap in delivery of the product.

Supplies are also being slowed down by the Falsified Medicines Directive which aims to increase the security of the manufacturing and delivery of medicines in Europe.

The management of drugs shortages is the responsibility of the Health Products Regulatory Authority (HPRA), the medicines' watchdog.

However, Dr Shanahan said the list of HPRA drugs shortages only reflects a small portion of gaps in supply at any one time.

"Drug rationing is a fact of life for us all, under the guise of 'allocations'. We spend countless hours pleading with various functionaries to release stocks for patients in urgent need of essential medicines."

In response, a spokeswoman for the HPRA said medicine shortages have become increasingly prevalent worldwide over the past decade.

The causes are multi-factorial, including shortages of raw materials, manufacturing difficulties, product recalls due to potential quality defects, industry consolidations and the parallel trade of medicines to other markets.

Medicine shortages can originate at any point in the supply chain and involve and affect many different stakeholders.

They require a multi-faceted, multi-stakeholder response to ensure patient safety, continuity of care and protection of public health. The HPRA has a co-ordinating function in Ireland's response to the management of medicine shortages. She said: "Information relating to shortages on the HPRA website is dynamic and changes depending on the current information to hand, including removal from the list when a shortage has been resolved."

It is not aware of any case where a patient was without treatment as a result of a shortage. In some cases where the medicine originally prescribed is unavailable, patients may be switched to a suitable therapeutic alternative following appropriate consultation with a healthcare professional.

Irish Independent

Editor's Choice

Also in Irish News