Access to medicines in Britain is at its most fragile point in years, leaving patients at risk of stroke, heart attack and seizures unable to get the medications they need.
Experts say global supply chains are to blame, with overcomplicated funding processes in the UK costing patients’ lives.
The NHS pays pharmacies a fixed price for each drug it dispenses, which pharmacies are then expected to match when sourcing the drug.
But with some 230 medications on price concession – when the price of a drug rises above what the NHS pays – pharmacies are struggling to afford enough stock.
As a result, patients are facing serious delays and sudden shortages.
The price of some key medicines taken by millions of Britons have also soared since the conflict in Iran began – including drugs used to treat cancer – due to disruption to air freight routes as well as higher shipping costs.
Pharmacists are concerned that existing blood pressure, epilepsy and cancer drug shortages – to name just a few – could worsen because of the war.
In April, the number of drugs on concession reached a record high as hundreds of pharmacies experienced price hikes of some of the most commonly prescribed drugs.
The struggle to get hold of medication in England is set to get worse
According to the National Pharmacy Association, some have seen prices rise ten times since February, and the NHS is struggling to cover the additional cost.
This means pharmacies are operating at a loss, because the NHS is reimbursing them far less than they paid for the drugs.
Whilst the association does not publish which medicines specifically are in short supply to avoid panicked enquiries, Dr Leyla Hannbeck, chief executive at the Independent Pharmacies Association, says ‘the list goes on.’
‘Medicines for thinning the blood, some allergy medications, epilepsy medicines, and cancer drugs are in short supply, and the list goes on,’ she said.
She added that some ADHD drugs are also being affected by the supply chain breakdown, meaning patients are struggling to go to work.
Others are suffering otherwise-preventable seizures which could cost them their lives.
And when hundreds of everyday drugs are in short supply, it suggests the problem is systemic.
Olivier Picard, chairman of the NPA, told the Pharmacy Magazine that the gap between supply and demand has now become so wide that they are sending patients to other pharmacies, often miles away, for their medicine ‘to protect the bottom line.’
‘We are in a position now where we cannot afford to dispense at a loss. The system is simply not working.’
He added that whilst there are no immediate shortages directly as a result of the conflict in the Middle East, manufacturers say supply breakdown is ‘inevitable’.
‘Even if medicines are available, the conflict in the Middle East is pushing production and transportation costs of drug manufacturing to such a level that the price the NHS is willing to pay for the drugs simply doesn’t cover the cost of manufacturing them.’
‘It’s more a pricing issue than a supply issue and I expect this to continue to increase in the coming months as the situation in the Middle East develops,’ he concluded.
Ingredients sourced from the region are also in short supply ‘affecting the availability of petroleum based solvents used in many pharmaceutical products’, Hannbeck added, with transportation costs significantly higher than before the conflict.
Other drugs taken by millions of patients are already under severe pressure.
These include apixaban – a drug taken to prevent blood clots from forming and conditions like DVT and stroke- blood pressure drugs like bisoprolol and carvedilol, a heart medication.
Cancer drugs currently thought to be affected by the break down in supply include Creon for pancreatic cancer and Efudix – a topical chemotherapy cream used to kill cancerous cells on the skin – Hannbeck says.
Oxybutynin, a drug used to manage symptoms of the menopause in those on hormone replacement therapy (HRT) is also largely out of stock.
Last month, the Department of Health also issued a “serious shortage protocol” for ramipril – one of the most widely prescribed blood pressure medications, with three million prescriptions issued monthly.
The protocol will see patients limited to one month’s supply of pills at a time, but many pharmacists are already struggling to meet this.
The UK imports around 75 per cent of its drugs, and even those that come from Europe are often made from ingredients that shipped from China, India, or the Middle East.
The Government also spends less of its health budget on medicine per patient than many EU countries like France and Germany, making them a less attractive buyer.
In response, a spokesperson from the DoH said: ‘The vast majority of the UK’s licensed medicines are in good supply, and we are working hard to keep it that way.
‘We have established processes to respond to sudden market price increases of medicines. This includes adjusting reimbursement prices based on current market conditions, which helps ensure that pharmacies can continue to obtain medicines for their patients.’
