Menopause Matters Forum
Menopause Discussion => Other Health Discussion => Topic started by: Kathleen on December 26, 2018, 10:23:34 AM
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Hello ladies.
I've just been speaking to my neighbour who is having trouble sourcing her medication and thinks it may be due to people stockpiling because of Brexit. I said that I was worried about this as my Oestrogel is made in France but the drugs she uses are Naproxen for arthritis and Omeprazole for acid reflux. I thought I would mention this on the forum as I know many ladies rely on these drugs and may want to talk to their pharmacists about it.
Take care everyone.
K.
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It's the drug companies that are stockpiling, not patients, and they have been told to do so by the government. I don't know if this is resulting in less supplies being delivered to pharmacies, but it is a possibility.
Scaremongering or not, you decide, but it is a bloody mess and so unnecessary.
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Hello ladies.
My neighbour has learned from Twitter that many other people are having problems obtaining these drugs from their pharmacies.
Let's hope it will be resolved soon.
Take care everyone.
K.
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I've had trouble getting any epipens so am using a different brand x
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I had a week in Gran Canaria in early December - so I popped into a pharmacy there and bought a box of Vagifem ‘just in case'. I doubt the NHS will deem any form of HRT essential, so if there are any shortages we women will doubtless be at the bottom of the queue.
My sister is a prescribing nurse and she said that there are worries about things like asthma drugs!!!
Let's hope this whole Brexit thing gets sorted soon. DG x
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I had a week in Gran Canaria in early December - so I popped into a pharmacy there and bought a box of Vagifem ‘just in case'. I doubt the NHS will deem any form of HRT essential, so if there are any shortages we women will doubtless be at the bottom of the queue.
My sister is a prescribing nurse and she said that there are worries about things like asthma drugs!!!
Let's hope this whole Brexit thing gets sorted soon. DG x
That's worrying, I'm struggling to recover from bronchitis from 3 weeks ago and my asthma pump has been a lifeline (as are my epipens) x
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In which case ALL patients should be informed by letter from the Government Health Minister! Our Surgery won't prescribe extra unless I'm going on holiday and I keep a careful eye on which meds I request.
Most of what we read about Brexit is scare mongering. We haven't been there. No one can possibly know what will happen let alone what might occur. We should be more worried about HS2 :'(
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Is NHS already finding it hard to get medicines?
Hugh Pym
Health editor
@BBCHughPym on Twitter
18 December 2018
Supply shortages and rising prices for some medicines are being reported by pharmacists and GPs. The possibility of a no-deal Brexit is being blamed.
So what is going on in the pharmaceutical world and what might it mean for patients?
There is nothing new about occasional shortages of certain types of medicine.
But there are reports of more acute problems than usual and some are citing a market reaction to the risk of the UK leaving the European Union without a deal.
Public may have to stockpile drugs in no-deal Brexit
Six key questions Brexit poses for the NHS
Brexit: NHS managers warn about impact of no deal
The organisation that negotiates drug pricing on behalf of pharmacies told BBC Radio 5 Live's Wake up to Money that Brexit is already affecting the supply and price of some key generic drugs.
The programme was contacted by a patient unable to obtain the usual anti-inflammatory for her arthritis who was told she had to have a substitute because of shortages.
Simon Dukes, chief executive of the Pharmaceutical Services Negotiating Committee (PSNC), said there were supply shortages for a number of reasons and that "concerns around a no-deal Brexit are likely to exacerbate those ongoing issues".
In a letter to the Health Select Committee he referred to recent price rises, saying: "The surge may be due to a combination of factors including Brexit planning and contingency."
Generic medicines
The medicines market is complex. The big pharma companies market their own-brand drugs and the overall cost to the NHS is capped each year.
Once a patent expires, drugs become "generic" which means that any manufacturer and distributor can make and sell them.
The prices of these generic medicines rise and fall in a market which can be opaque.
Pharmacists have to pay the going rate and claim back from the NHS according to an agreed tariff but sometimes that tariff doesn't keep up with market moves and that leaves pharmacies out of pocket.
It is the price and supply of these generics which have caused concern amongst pharmacies.
Their cash flow comes under severe pressure if the extra costs of the generic drugs are not covered quickly by the NHS.
Sometimes wholesalers cannot immediately replenish supplies at pharmacies and that means disappointment for GPs and patients.
Stockpiling is a vexed issue.
The government has told manufacturers of both branded and generic drugs to ensure that six weeks' worth of supplies have been built up to ensure continuity in the event of a no-deal Brexit.
This exercise has been largely successful.
Hospitals and patients have been told not to build up their own private supplies.
Unofficial stockpiling
But the PSNC suspects that there is unofficial stockpiling of generic drugs somewhere in the medicines supply chain.
A combination of that and distributors possibly raising prices in anticipation of there being no deal are factors in the recent market moves.
Image copyrightGETTY IMAGES
Image caption
Pharmacists report difficulties obtaining some drugs
In response to the BBC Radio 5 Live story, there have been tweets from GPs, pharmacists and patients pointing to difficulties obtaining certain drugs.
There is clearly a feeling that these problems go beyond the occasional supply issues seen in the system.
The Department of Health and Social Care told the BBC: "Our number one priority is to ensure the continued supply of medicines and we work closely with industry and partners in the health system to help prevent disruption.
"The department has well-established processes to manage and mitigate the small number of supply problems that may arise at any one time due to manufacturing or distribution issues."
The British Generic Manufacturers Association denied there had been a "surge" in prices and said global market forces as well as Brexit were at play.
The association added: "We are working with the government, in the same forums as the PSNC, to ensure that patients can continue to receive their medicines in the case of a no-deal Brexit.
"If all in the supply chain are following the government's advice and not hoarding supplies of medicines, this should have no impact on current prices."
The government's line is that contingency plans for a no-deal Brexit are in place, including chartering aircraft to bring in drugs with a short shelf-life.
But there are concerns in the health world as the UK's departure from the EU draws nearer.
Some question whether a six-week official stockpile is enough. Others point to the recent price rises of generic drugs as a pointer to what might happen in the event of a disorderly Brexit.
https://www.bbc.co.uk/news/health-46597425
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:thankyou:
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My husband uses naproxen for arthritis. Our usual pharmacy was telling everyone they hadn't been able to get any for weeks. I took the prescription to Boots and they filled it no problem. The same thing happened with my HRT and again Boots ordered it for me next day. After Brexit we'll still be able to source drugs from around the world just as other non EU countries do, if for some unlikely reason our French 'friends' decide they don't want to sell to us. If our government truly can't prepare for any potential changes in drug suppliers then they really are useless. Does anyone remember the real shortages of the 70's? My grandma had about a ton of sugar hidden under her bed. Goodness knows what she needed it for. Did anyone have a millennium cupboard ready for when computers crashed world wide?
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The expected 'Millennium crash didn't happen because teams of people did their utmost to avoid it. I recently read comments from someone who was closely involved
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Thanks for that Shadyglade
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Did anyone have a millennium cupboard ready for when computers crashed world wide?
Ah - yes - I remember being advised about that. It will be a cold day in hell when I stockpile tins of potatoes :sunny:
I have been reading on twitter that there are various problems around getting naproxen at the moment, and that pharmacies (wholesale/warehouses?) are supposed to be holding a six week supply, which has to come from somewhere since the manufacturers are not manufacturing more for them to do this.
Trying to order my supplies in plenty of time - I have had various problems with getting vagifem over the years due to some bureaucratic supply problem, so always get that as soon as the computer allows (within reason).
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Did anyone have a millennium cupboard ready for when computers crashed world wide?
Ah - yes - I remember being advised about that. It will be a cold day in hell when I stockpile tins of potatoes :sunny:
I have been reading on twitter that there are various problems around getting naproxen at the moment, and that pharmacies (wholesale/warehouses?) are supposed to be holding a six week supply, which has to come from somewhere since the manufacturers are not manufacturing more for them to do this.
Trying to order my supplies in plenty of time - I have had various problems with getting vagifem over the years due to some bureaucratic supply problem, so always get that as soon as the computer allows (within reason).
If the computer says 'NO' isn't that just a GP refusing to issue a new prescription because he/she thinks you had one too recently? :( I didn't hoard anything for the Millennium bug threat.
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It automatically sets a time for the next prescription which will be the same if you order straight away or in two weeks - so I order as soon as it is time - if I do that each time, then I am well in hand and that irons out any problems with the chemists or bank holidays/xmas. If I kept doing it, I would end up with a small stock ::)
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Hello ladies,
Citation: The Pharmaceutical Journal, December 2018, Vol 301, No 7920, online DOI: 10.1211/PJ.2018.20205864
Pharmacy should take Brexit lead
As discussions continue over the relationship the UK will have with the EU, pharmacy bodies must do what they can to protect the interests of patients, whichever form of Brexit emerges. At the time of writing, members of parliament are debating the UK's future relationship with the EU. As the nation is poised to find out whether the prime minister Theresa May's deal will pass through the House of Commons, these discussions will doubtlessly continue.
Out in the real world — whether ‘Brexiteer' or ‘Remainer' — pharmacists could be forgiven for a sense of ennui over the whole enterprise. But that would be a mistake. May's favourite phrase may be the spectacularly vacuous “Brexit means Brexitâ€, but parliamentary decisions now will have consequences for medicines supply and drug development in the UK for years to come.
Of course, stockpiling and the potential role of pharmacists in substituting drugs to manage shortages of medicines after a ‘no deal' departure is the worst-case scenario and this has received the most attention thus far. But even the softest of Brexits could mean significant changes to the provision of healthcare in the UK. Indeed, it started happening some time ago, with the European Medicines Agency (EMA) headquarters moving from London to Amsterdam following the Brexit vote. The EMA has already rolled back its day-to-day work to enable the relocation, and the UK's Medicines and Healthcare products Regulatory Agency has had its evaluation work for new drugs shifted to other EU countries.
May did promise earlier in 2018 that the UK would be prepared to pay for access to the EMA and similar EU bodies, but the deal on which the House of Commons will vote says simply that “cooperation will be exploredâ€. And it's not just regulatory bodies that will be affected. As the Brexit debate rumbles on, it has become increasingly apparent how intertwined healthcare provision in the UK is with the rest of the continent — from clinical trials to mutual recognition of qualifications; from healthcare staff, including pharmacists, to ‘just-in-time' delivery mechanisms for medicines. The Association of the British Pharmaceutical Industry points out that 37 million packs of medicines are imported into the UK from the EU each month, and 45 million packs move the other way. Regulatory divergence could add £45,000 to the cost of each new medicine released in the UK, potentially making it an unattractive market for specialised medicines, according to the House of Commons business, energy and industrial strategy committee.
The risks to health could be so grave that the British Medical Association (BMA) and the Royal College of Nursing have both backed calls for a second referendum, following the government's proposed Brexit deal. In pharmacy, the Royal Pharmaceutical Society (RPS) has chosen not to back this particular call, but its president has been front and centre on news bulletins, talking about the risks that Brexit could pose to patients.
The Pharmaceutical Services Negotiating Committee has created a Brexit Forum, which includes the RPS, the Company Chemists' Association, the National Pharmacy Association, the Pharmacists' Defence Association and others. However, it only held its first meeting in September 2018, less than six months before Brexit is due to happen.
It is essential that pharmacy's voice is heard in these discussions. Perhaps taking a position similar to the BMA's would be too political, but it is also abundantly clear that the profession must continue to speak out about the effect that Brexit could have. It is extremely difficult to cut through the din surrounding Brexit, but scrutiny and campaigning from pharmacists, pharmacy bodies and their colleagues across healthcare in the UK is needed if the most vital group of people — patients — are to be placed as centrally as possible in considerations of the UK's future relationship with the EU.
Conolly X
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It automatically sets a time for the next prescription which will be the same if you order straight away or in two weeks - so I order as soon as it is time - if I do that each time, then I am well in hand and that irons out any problems with the chemists or bank holidays/xmas. If I kept doing it, I would end up with a small stock ::)
You say that you would end up with a small stock if you kept doing it. I think my practice would postpone issue of the prescription until a GP allowed it. I could test this by trying to order more Vagifem now. i suspect that no prescription would be sent. My last box says use daily for 4 weeks and then twice a week for 3 months. I only got that because the hospital doctor authorised it.
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Hello ladies.
Thank you for such an informative post Conolly.
Naturally everyone is concerned about scare mongering but saying it will be alright is no comfort when we can see the shambles unfolding before us.
I'm pleased that some ladies have been able to get the medicines they need and I genuinely hope that continues however any pharmacies that are out of stock will simply send their patients to the ones that do have a supply and what happens when their stock runs out? Obviously I hope we don't have any problems but from where I'm sitting hope is all I have!
Take care everyone.
K.
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Hello Kathleen,
I agree. It's a monumental task involving many actors and extensive resources. The repercussions will be felt for years as specific deals are going to take time to settle.
Conolly X
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Your right, it is a mess.
I have just been reading about the company the government has hired, and paid millions, to proved extra freight ferries after Brexit. Apparently they have no previous experience in this area. A 13.8 million contract, no ships and no trading history.
You couldn't make it up. ::)
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Hello Kathleen,
I agree. It's a monumental task involving many actors and extensive resources. The repercussions will be felt for years as specific deals are going to take time to settle.
Conolly X
Yes and I would be pretty unhappy if my epilepsy were to return after over 35 years of being seizure free simply because of a sudden lack of medication. Plenty of others would be in a similar situation.
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Your right, it is a mess.
I have just been reading about the company the government has hired, and paid millions, to proved extra freight ferries after Brexit. Apparently they have no previous experience in this area. A 13.8 million contract, no ships and no trading history.
You couldn't make it up. ::)
Yes I heard about that too. If that company cocks it up......!
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Hello Katejo,
I expect that first priority drugs won't be an issue as any shortages would impose a great burden on patients and the NHS.
Conolly X
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Type 1 diabetics not able to access their usual meds in some areas already. Its a very frightening possibily life threatening situation for them. It's not clear yet if it's due to brexit however we've never had this situation before in relation to these meds and medical devices so we strongly suspect it is
I note that Mrs May is a type 1 diabetic, and doubt she has any problems accessing her usual meds.....
JP x
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It's not just drugs we have to worry about. One in twenty NHS staff is an EU national. If they go home or are in anyway diswaded from staying, all NHS services will be affected.
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Hi Katejo. Our daughter was advised to get a double prescription of her epilepsy medicine when she went for her repeat prescription at the surgery pharmacy
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If post Brexit there is a shortage of drugs the UK ordinarily import from the EU, there will be GLUT of those drugs IN the EU!
Will they want to be stuck with them.......I doubt it. Will EU countries want to be unable to obtain the drugs WE export to them.....I doubt it.
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It's not really about wanting or not wanting to import /export. It's about customs delays caused by a no deal Brexit.
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https://www.sps.nhs.uk/category/shortages-discontinuations-and-expiries/ Pages such as these are easy to find (this one mentions the Epipen shortage of 2018).
Some of it is down to patent expiry NOT Brexit stockpiling, but it's far, far too easy for staunch 'remainers' to cast blame in that direction.
I know of one manufacturers of a certain 'often used' drug that has switched supplier for a particular ingredient & must go through the whole licensing process again, hence it will be unavailable for several months. Brexit, no, not at all.
Germany is one of the biggest manufacturers of drugs in the world, I can assure you they DO NOT only supply to EU member states, they transport worldwide & post Brexit the UK will be one of their worldwide customers, there was life before the channel tunnel you know!
Don't be a victim (of scaremongering), be a survivor. Check back over drug shortage sites for a few years, this is not peculiar to a Brexit vote.
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Don't be a victim (of scaremongering), be a survivor. Check back over drug shortage sites for a few years, this is not peculiar to a Brexit vote.
I don't know who you are but you are extremely cheeky, if not down right rude.
There are rules on this forum. I suggest you read them.
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https://www.sps.nhs.uk/category/shortages-discontinuations-and-expiries/ Pages such as these are easy to find (this one mentions the Epipen shortage of 2018).
Some of it is down to patent expiry NOT Brexit stockpiling, but it's far, far too easy for staunch 'remainers' to cast blame in that direction.
I know of one manufacturers of a certain 'often used' drug that has switched supplier for a particular ingredient & must go through the whole licensing process again, hence it will be unavailable for several months. Brexit, no, not at all.
Germany is one of the biggest manufacturers of drugs in the world, I can assure you they DO NOT only supply to EU member states, they transport worldwide & post Brexit the UK will be one of their worldwide customers, there was life before the channel tunnel you know!
Don't be a victim (of scaremongering), be a survivor. Check back over drug shortage sites for a few years, this is not peculiar to a Brexit vote
No no no! Remainers are NOT attributing ALL drug shortages to Brexit. However, by March 29th, it is highly likely that there will be severe shortages due to customs delays/ lorries unable to proceed with deliveries. I am genuinely concerned about it. It is not scaremongering.
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https://www.bbc.co.uk/news/uk-england-kent-46775722
If you read this article you will see, not only how a no-deal Brexit will affect my county, but also how it will affect imports including drugs.
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https://www.bbc.co.uk/news/uk-england-kent-46775722
If you read this article you will see, not only how a no-deal Brexit will affect my county, but also how it will affect imports including drugs.
According to the ES the whole exercise was a farce due to a lack of drivers and lorries.
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There is a good article in the Guardian, Saturday. Have read it twice and still don't understand much of it ::)