The medicines in dangerously short supply in the UK

09/05/2024

Patients’ health is being put at risk by medicine shortages that have become a daily occurrence in pharmacies across England, according to a new report.

Community Pharmacy England has warned medicine supply issues have become “beyond critical”.

In its 2024 Pressures Survey report, which is based on the views of over 6,100 pharmacy owners and 2,000 pharmacy team members, nearly all (97 per cent) of staff report patients being inconvenienced as a result of medicine supply issues, while 79 per cent say patient health is being put at risk as a result.

Community Pharmacy England said medicines across a range of clinical and therapeutic areas are being affected by supply disruptions at different times, with issues this year affecting in particular medicines used for the treatment of diabetes, ADHD, and epilepsy.

Janet Morrison, chief executive of Community Pharmacy England, said: “Patients with a wide range of clinical and therapeutic needs are being affected on a daily basis and this is going far beyond inconvenience, leading to frustration, anxiety and affecting their health. For some patients, not having access to the medicines they need could lead to very serious consequences, even leaving them needing to visit A&E.”

Pharmacists have reported that more than a hundred medicines used in the UK are currently affected by shortages. In November, supply issues reached record levels, with 111 products affected, more than double since the start of 2022, according to the British Generic Manufacturers Association.

Here, i takes a look at key medicines in short supply and how these issues are putting those who rely on them at risk of harm.

Insulin

Around 400,000 people with type 1 diabetes are at risk of being affected by supply issues with insulin, which is the result of a global manufacturing challenges.

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Insulin is a life-saving medication for people with type 1 diabetes who cannot naturally make insulin which helps the body manage blood sugar levels. Dangerously high blood sugar levels caused due to a lack of insulin can lead to diabetic ketoacidosis, a life-threatening condition, in people with type 1 diabetes.

The availability of Humalog and Humulin vials has been affected by supply issues, and some insulin medicines are not expected to be readily available until next year.

There are also ongoing supply issues with glucagon-like peptide receptor agonists, a range of drugs used for managing blood glucose levels in people with type 2 diabetes.

In part, the global shortages have been caused by the soaring demand for off-label prescriptions of the drug semaglutide – marketed under brand names such as Ozempic and Wegovy – being issued for weight loss.

Supply issues are expected to last into 2025 and affected patients are advised to contact their healthcare team to change to a different medication.

Salbutamol

In February the NHS issued a national patient safety alert for liquid forms of salbutamol, a medicine used to relieve symptoms of asthma and chronic obstructive pulmonary disease (COPD) such as coughing, wheezing and feeling breathless.

The shortage of salbutamol 2.5mg/2.5ml and 5mg/2.5ml nebuliser liquid unit dose vials is ongoing and no date has been given for when the issue will be resolved.

The forms of salbutamol affected by shortages are given to patients via a machine called a nebuliser that delivers the medicine as a mist inhaled through a face mask. The drug can be life-saving for patients who are unable to breathe unaided.

A combination of manufacturing issues resulting in increased demand on other suppliers has caused the supply issues, the NHS said.

A number of alternative medications used to alleviate asthma and COPD symptoms are available but these cannot support the increased demand.

Epilepsy medication

Various medicines used to control epilepsy symptoms have been hit by supply issues over recent months.

Carbamazepine, phenytoin and lamotrigine are among the key medicines that remain affected by supply issues, Community Pharmacy England said.

Earlier this year, epilepsy patients who take lamotrigine told i they lived in fear of fatal seizures amid the shortages and uncertainty over whether they would be able to get hold of their particular epilepsy drugs.

Mark Devlin, Young Epilepsy CEO, said: “Anti-seizure medications are life-saving drugs, without a consistent supply those that rely on them are left open to serious injury or even death.”

ADHD medicines

People with ADHD have been experiencing ongoing difficulties obtaining the medications they need to manage their symptoms. The shortages have been linked to a combination of manufacturing issues and a surge in global demand.

Medications currently affected include various types of Methylphenidate, Lisdexamfetamine, Guanfacine and Atomoxetine.

ADHD experts say a lack of access to treatment for the condition can be life-threatening for some patients.

Henry Shelford, CEO of ADHD UK, told i: “ADHD is a very difficult condition to live with, and much more difficult than most people without it know. We know most brutally, through the figures on suicide, that one in 10 men or boys with ADHD will at some point try and take their own life. And it’s one in four women or girls with ADHD will at some point try and take their own life.”

Pancreatic enzymes

Supply issues have made it difficult for patients to get hold of pancreatic enzyme replacement therapy (PERT), sold under the brandnames Creon, Nutrizym and Pancrex.

Also known as pancreatin, PERT supports digestion in patients with pancreatic exocrine insufficiency, a condition which prevents the pancreas from producing enough enzymes to digest food properly. It most commonly affects people with pancreatic cancer, pancreatitis and cystic fibrosis.

Student Amber Gibb, who takes Creon and has struggled getting hold of her usual prescription, told The Sunday Times: “It was really upsetting. I can’t live without Creon.

“It is a medicine that is my life support. Otherwise, I can’t eat.”