Why are there increasing shortages of medicines?

ebmdatalab / prescribing-queries

Documentation about common queries against the prescribing dataset

GNU General Public License v3.0

3 stars 3 forks source link

Why are there increasing shortages of medicines? #78

Open sebbacon opened 5 years ago

sebbacon commented 5 years ago

Reasons touted:

More people use generics and the supply chain hasn't caught up
Market consolidation = fewer suppliers
Market manipulation

Discussion: https://twitter.com/ShinyBlackShoe/status/1081535983651147777

sebbacon commented 5 years ago

Another interesting twitter thread. Notes that a GP is refusing to prescribe on grounds of non-availability?!

Thread mentions:

Geography. If you live in Sheffield there is lots of prescribing (278 prescriptions). London & Newcastle virtually none. So it may be that the stock that does exist will be exhuasted pretty quickly
Planning: say production runs are 2 yearly - then unexpected increases in demand will not be met for low-level stuff where small margins mean you need larger production runs. Also for cheap generics, manufacturers unlikely to spend money on predicting demand
Brexit: suppliers have been asked to hold 6 weeks supply. Incentive may be to restrict supply now.

sebbacon commented 5 years ago

HRT now in the news

sebbacon commented 5 years ago

We circulated a memo about this at DHSC in June https://docs.google.com/document/d/1oTVUeeDqZsZtIXzsvKv-io8vJHTbI1Ln_DwRdNFVoho/edit

sebbacon commented 5 years ago

Good article about this relating to the burden of accessing contraception: https://www.stylist.co.uk/life/contraceptive-pill-coil-pharmacies-out-of-stock-inconvenience-viral-twitter-thread/278249

sebbacon commented 5 years ago

Anecdotally there are now shortages of common antibiotics and heart failure medicines. From a Facebook thread for someone with heart failure:

I've been struggling to get my prescriptions filled for the last 4 months. The chemist is having to fax copies of prescriptions to their suppliers to show they have an immediate need, and even then there are multi-day delays. I got my latest refill on the day the previous tablets ran out. The wholesalers are micro-managing my life sustaining medication to the day.

Pharmacies putting up posters like this:

sebbacon commented 5 years ago

Problems with shortages list

a) Dissemination of the current list is ludicrously restricted and been marked commercially sensitive despite nearly all the information being in the public domain b) The current update is a freetext PDF that is not compliant with nationally mandated dm+d standards.

sebbacon commented 5 years ago

On supply: the Economist has done a few good articles on this, e.g.

https://www.economist.com/international/2019/09/14/a-dire-scarcity-of-drugs-is-worsening-in-part-because-they-are-so-cheap

sebbacon commented 5 years ago

Illegal market sharing: https://www.gov.uk/government/news/drug-firms-accused-of-illegal-market-sharing-over-anti-nausea-tablets

sebbacon commented 5 years ago

Note the existence of the Medicines Shortage Response Group (MSRG) but its lack of footprint on the internet.