New report finds UK medicines shortages are ‘exacerbated’ by Brexit
Nuffield Trust report finds that while medicines shortages are now commonplace globally, they have become the ‘new normal’ in the UK, as organisations call on the government to conduct an urgent review into medicines supply chains.
The latest report in the Nuffield Trust’s Health and International Relations Monitor project, The future for health after Brexit, concludes that while Brexit has not caused UK medicine shortages, it has made it significantly more challenging to address them.
The report finds that over the last two years, shortages of medicines including life-saving antibiotics, epilepsy, and chemotherapy drugs, have become a ‘new normal’. As well as reducing patient access to medicines, the shortages are placing significant burdens on pharmacists and GPs.
The shortages have also resulted in the need for the government to reimburse pharmacies for buying drugs above their standard costs more often. Since 2022, the NHS has spent an estimated £220 million on price concessions, absorbing an increasing sum of NHS England’s prescribing budget.
The research is supported by the Health Foundation and explains that UK shortages are reflective of problems in the global medicines market, and not caused directly by Brexit. The UK, however, is experiencing these shortages more acutely that comparable countries.
Global shortages have occurred due to a combination of factors, including a thinner market caused by manufacturing dominance in India and China, post-pandemic inflation and the war in Ukraine.
The Nuffield Trust’s Brexit programme lead, Mark Dayan, said: “We know many of the problems are global and relate to fragile chains of imports from Asia, squeezed by Covid-19 shutdowns, inflation, and global instability.
“But 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.”
“The medicines supply chain is broken at every level”
The report explains there are unique factors affecting the UK’s shortage issue. A change to prescription patterns causing a squeeze in supply of certain medicines; HRT prescriptions increased by 40 per cent in 2021/22, while policy decisions around medicines pricing and financing, and Brexit, have all contributed.
Brexit has lowered the value of the sterling and removed the UK from EU supply chains. It has also meant the UK is left out of EU efforts to mitigate the shortages, such as initiatives like the Critical Medicines Alliance, as well as efforts to bring medicines manufacturing back to Europe.
Additional customs checks at the border and greater regulation faced by manufacturers have also led some companies to remove the UK from their supply chains.
Professor Tamara Hervey, of the City Law School, said: “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. It is the consequence of policy choices and those could be different.”
Although the report warns that rebuilding the EU-UK health relationship more formally is not a current a priority for EU institutions and representative bodies, it outlines steps the UK government could take to address the issue without requiring renegotiation with the EU. These include anticipating shortages in advance, transparency around them, and taking care to ensure sudden squeezes on cost do not drive instability.
A spokesperson for the Department of Health and Social Care said: “Our priority is to ensure patients continue to get the treatments they need. There are around 14,000 licensed medicines and the overwhelming majority are in good supply.”
The report additionally found the UK’s medicines regulator has been slower to approve new medicines compared to the EU. Between 2022 and 2023, four drugs authorised by the European Commission had been approved faster in UK than in the EU. However, 56 had been approved later and eight had not been approved at all as of March 2024.
Several organisations and individuals are calling on the government to carry out a review of the medicines supply chain.
Dr Leyla Hannbeck, Chief Executive of the Association of Independent Multiple Pharmacies (AIMp), said: “The medicines supply chain is broken at every level and unless the Department of Health and Social Care reviews its processes and procedures, we will never achieve the stability that will guarantee patients their prescription when they need it.”
Louise Ansari, Chief Executive at Healthwatch England, has also urged the government to carry out such a review to “ensure medicine safety and resilience.”
The Royal Pharmaceutical Society has launched a project to investigate the shortages by convening stakeholders from across the supply chain, with recommendations expected later this year.
The recently concluded pharmacy inquiry, conducted by the Health and Social Care Select Committee, also extensively discussed the shortage issue and is therefore likely to make recommendations to government in the near future.
Medicines shortages have placed a significant burden upon many healthcare professionals, but particularly the pharmacy profession. Public Policy Projects (PPP) is contributing to the debate by convening pharmacy professionals as part of a programme to document the challenges and their impact on the wider sector. If you would like further information about PPP’s Pharmacy and Medicines Programme, please contact Samantha Semmeling, samantha.semmeling@publicpolicyprojects.com.
