Government medicines security response ‘fails’ to address main supply chain challenges

The government’s response to a report on medicines security ‘fails to address the main challenge facing the supply chain, a leading pharmacy association has warned.

Responding to a House of Lords report that called for medicines security to be treated as a national security issue, the government said it had ‘robust’ processes’ in place to source alternatives or additional supplies.

But the Company Chemist Association’s (CCA’s) chief executive Malcolm Harrison said that the government's response, published last week, did not address how to build long-term resilience.

Mr Harrison added: ‘Unfortunately, the response fails to address the main challenge facing the supply of over one billion NHS prescribed medicines in primary care - the medicines people are prescribed by their GP and collect from their pharmacy.

‘The response does provide some solutions for dealing with shortages in primary care once they have occurred, however, it does not address how to build longer term resilience in the supply chain, to prevent shortages in the first place.’

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Mr Harrison said that the low prices the government sets for generic medicines have left many pharmacies supplying NHS prescriptions at a loss.

‘Over 1,500 pharmacy closures in the past decade stand as testimony to this uncomfortable truth,’ he added.

‘To ensure the security of medicines supply in the UK the government must make additional and sustained investment across the whole of the UK’s medicines supply chain.

‘This includes funding to stabilise the community pharmacy network and investment in generic medicines pricing.’

The House of Lords Public Services Committee’s report on medicines security, published in February, said the government was not proactive in protecting the UK from fragile supply chains and only acted once shortages had already occurred.

It also found that the government did not effectively communicate shortages, or solutions, to frontline staff such as community pharmacists and GPs.

Baroness Morris of Yardley, who chaired the committee during the inquiry, said the issue was of ‘great importance’ because of the risk to people’s health and wellbeing from medicine shortages.

She said the Department of Health and Social Care (DHSC) was not ‘particularly proactive’ in tackling the issue, and highlighted a lack of oversight and leadership to address current ‘shortcomings’ across the medicines supply and manufacturing process.

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In its response the government said it had ‘robust’ processes in place to source alternative or additional supplies when medicine supply is unable to meet demand.

It added that the current system is designed to support healthcare professionals and ensure that ‘negative impact on patients and healthcare workers are kept to a minimum’.

The government also noted the need for improved real-time visibility of stock levels and said the DHSC was already progressing a range of measures to understand supply chain pressures.

Manufacturers are legally required to report potential supply issues six months in advance where possible and the DHSC is reviewing enforcement mechanisms to improve compliance, the response said.

It also said the government was developing ‘digital pathways’ to enable GP prescribing systems to flag shortages at the point of prescribing and it would also consult on the type and use of 2D barcodes that might be needed on medicines packaging.

‘More broadly, the department continues to work with Community Pharmacy England (CPE) to improve data flows and consider how to increase appropriate stock information sharing while recognising the burden and commercial sensitivities of real‑time inventory reporting,’ the government response said.

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It rejected the committee’s claim that the government does not see the UK as a competitive place for generics manufacture, and that the Medicines and Healthcare products Regulatory Agency (MHRA) is slower than comparable regulators in other countries.

The response also said it would not be compiling a critical medicines list – as recommended by the Lords committee – because the government’s focus is on ‘having the best possible understanding of our supply chains’ which ‘does not require a list to be made public’.

Last week health minister Dr Zubir Ahmed told a parliamentary reception hosted by the CCA that the UK does not take a ‘passive approach’ to medicines shortages.