NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Medicine shortages – where to find info

Our NEW Medicine Supply Problems StaffNet Page contains links to any memos that have been distributed and provides an update regarding specific supply problems affecting acute or primary care.

Medicine shortages- why do they occur?

National Services Scotland, National Procurement Team provide some insights into why medicine shortages occur.  ‘The production of medicines is complex and highly regulated; difficulties can arise at any step in the process, from malfunctioning equipment on the production line to a shortage of a raw material.  Globalisation has increased the fragility of the supply chain. Medicines are often now manufactured in just one or two sites worldwide, production schedules are planned months in advance and this along with the move to ‘just in time manufacture’ and minimising stockholdings throughout the supply chain, means that there is little flexibility when problems do arise.’

Medicine shortages have the potential to significantly impact on the quality and safety of patient care. They also create significant financial and workload pressures, not only due to the use of more expensive alternatives, but also in terms of the cost of the additional workload for healthcare professionals involved in the prescribing, dispensing and administration of medicines.

Medicine shortages - recent examples affecting NHSGGC

Currently shortages of over 70 different drugs/ preparations are being monitored in primary care in NHSGGC.

Over recent months, several key antimicrobials have been in short supply within the Acute sector. A shortage of one medicine can create a domino effect; numerous antibiotics have been in short supply recently as historic demand for piperacillin-tazobactam (pip/taz) shifted to alternatives

  • An explosion at a key manufacturing site in China was behind the recent pip/taz shortage.
  • Aztreonam IV has regularly been in short supply in recent years. Multiple active ingredients are used to manufacture the product; delays in sourcing any one of these impacts on release of the finished product.

Shortages can also arise from an imbalance between supply and demand, for example inaccuracies in forecast usage. Sanofi have indicated that the current Clexane® shortage was due to greater than anticipated global demand for Clexane®; with long manufacturing lead times, it was not possible for Sanofi to respond quickly enough to avoid a stock-out.

Medicine shortages – how does NHSGGC deal with them?

Medicine shortages are closely monitored by pharmacy teams across NHSGGC.  The Central Prescribing Team in Primary Care, the Pharmacy Distribution Centre (PDC) and Medicines Information team take a lead role. Once a shortage is confirmed, the pharmacy team link with the relevant specialists teams (for example, the antimicrobial team if the shortage involves an antimicrobial agent) to identify alternatives, agree contingency plans and finalise communication material for healthcare professionals.

Every supply problem brings a different challenge.  The key aim is to ensure patient care is not compromised due to a problem with the supply chain.  A significant challenge is to ensure any risk associated with an alternative agent is minimised and a risk assessment is always undertaken. 

Once action plans have been agreed, alternative agents are procured and the message is communicated across NHSGGC.  Any memos that have been distributed are stored in the NEW Medicine Supply Problems StaffNet Page

 

Published 20/02/18