Medicines shortages

Pharmacies in the UK dispense millions of prescription items each year. Since 2021 there have been reports of increasing supply problems affecting medicines. Recent media coverage has highlighted shortages of medicines used to treat diabetes, attention deficit hyperactivity disorder (ADHD) and epilepsy, hormone replacement therapy (HRT) and others.

This briefing provides information on the causes and consequences of medicines shortages in the UK and internationally, and the UK Government’s approach to address supply problems.

Causes and consequences of medicines shortages

Supply chains for medicines are long and complex and shortages can be caused by multiple factors. These include manufacturing or distribution problems and increased demand for medicines. Commentators have also drawn attention to the effects of wider geopolitical factors, including the conflict in Ukraine, the covid-19 pandemic and Brexit.

Pharmacists and patient organisations have drawn attention to the impact of medicines shortages on patients, who may struggle to access medicines and sometimes have to switch to alternative drugs. Community Pharmacy England, which represents community pharmacies, has also reported that medicines supply and pricing issues are “severe” pressures on pharmacy staff and businesses.

Government response to medicines shortages

The government says that there are “a range of well-established processes and tools to manage [medicines supply problems] when they arise to mitigate risks to patients”. It also says that it is committed to improving supply chain resilience and improving the mitigation and management of shortages.

The Department of Health and Social Care and NHS England have published guidance on the management of medicines supply and shortages, which outlines the processes followed and options available to the government to address supply disruption. These include:

• issuing serious shortage protocols, which enable pharmacists to provide specific alternatives to scarce medicines
• taking regulatory action to approve new medicines or, in exceptional circumstances, extend medicine expiry dates
• restricting medicines exports
• offering pharmacies price concessions, to help pharmacies to cover the cost of NHS prescriptions.

Potential reforms to manage medicines shortages

Organisations representing pharmacists have called for reforms to the systems used to manage medicines shortages. Community Pharmacy England has called for “a strategic Government review of medicine supply and pricing” that focuses on supply chain functioning. In November 2024, the Royal Pharmaceutical Society published Medicines Shortages: Solutions for empty shelves. This report makes recommendations to strengthen medicines supply chains and improve information sharing about medicines shortages.

Community Pharmacy England and the Royal Pharmaceutical Society have also called on the government to update current regulations to allow pharmacists to amend prescriptions to provide alternative medicines to patients when medicines are out of stock, and to make changes to current medicines pricing systems.

The Health and Social Care Committee’s May 2024 report on Pharmacy highlighted the problem of medicines shortages. It made several recommendations, including calling for a review of medicines supply chains and allowing pharmacists to amend prescriptions. The government responded in January 2025. It said that it would consider commissioning an independent review, and that it was examining options for pharmacists to have the “flexibility” to supply alternative doses or formulations of medicines.   

In December 2024, the All Party Parliamentary Group on Pharmacy announced an inquiry into the impact of medicines shortages in England. The inquiry will consider the impact, contributing factors and potential solutions to the problem of medicines shortages.

International responses to medicines shortages

In November 2024, the British Medical Journal reported that the World Health Organization was aware of 300 reported shortages of essential medicines worldwide.

Recent research has identified a range of responses that governments take to address shortages, including requiring medicines manufacturers or wholesalers to keep reserves of important medicines in stock, imposing export bans, importing alternative medicines and working with manufacturers to resolve supply disruptions. 

In 2023, the European proposed a Critical Medicines Act. This new legislation would increase investment in EU medicines manufacturing capacity, incentivise supply chain resilience in public procurement of medicines and introduce collaborative procurement for medicines across the EU.