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, as well as 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” financial pressures on pharmacy staff and businesses.

Government response to medicines shortages

The government has described medicines shortages as “an ongoing issue that the Department [of Health and Social Care] has been managing for many years”. 

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.

Appeals for reform centre on calls for pharmacists to be able to amend prescriptions to provide alternatives to patients when medicines are out of stock, and on changes to current medicines pricing systems.