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Drug shortages may impact patient care

WHILE there has been concern in recent months over problems with drug supplies with the possibility of hoarding in the lead-up to Brexit the indications are that pharmacists are already under pressure to secure essential supplies for their patients for other reasons.
In a report in the Irish Independent a Kerry pharmacist, Jack Shanahan, revealed that patients’ optimal treatments are being degraded by erratic supply. He revealed he placed a bulk order with a well-known generic drug maker recently and of "the hundred odd lines I ordered, over 20 were in short supply".
Apparently the most common medicines which are affected include blood-pressure pills and anti-inflammatory drugs to treat conditions like arthritis. The only alternative for patients who cannot get hold of their prescribed drug may be a second-choice medicine or, in some cases ration their supply.
Mr Shanahan, who is editor of the 'IPU Review', the journal for pharmacists, said he believed the problems go deeper than hoarding of drugs because of fears they will be low in stock after Brexit. One of the reasons for fluctuations is the way some pharmaceutical plants now produce one kind of medicine before going on to a batch of another drug.
If any issue is found the next medicine will not be released but they can run out of "buffer stocks", creating a gap in delivery of the product.
Supplies are also being slowed down by the Falsified Medicines Directive which aims to increase the security of the manufacturing and delivery of medicines in Europe.
While the management of drugs shortages is the responsibility of the Health Products Regulatory Authority (HPRA), the medicines’ watchdog, Mr. Shanahan says the list of HPRA drugs shortages only reflects a small portion of the gaps in supply at a given time.
"Drug rationing is a fact of life for us all, under the guise of 'allocations'. We spend countless hours pleading with various functionaries to release stocks for patients in urgent need of essential medicines."
In response, a spokeswoman for the HPRA said medicine shortages have become increasingly prevalent worldwide over the past decade. The causes are multi-factorial, including shortages of raw materials, manufacturing difficulties, product recalls due to potential quality defects, industry consolidations and the parallel trade of medicines to other markets.
She said: "Information relating to shortages on the HPRA website is dynamic and changes depending on the current information to hand, including removal from the list when a shortage has been resolved."
It is not aware of any case where a patient was without treatment as a result of a shortage. In some cases where the medicine originally prescribed is unavailable, patients may be switched to a suitable therapeutic alternative following appropriate consultation with a healthcare professional.