Having the right medicine at the right time and administered in the right way can be the difference between that patient continuing their treatment or being transferred to an alternative option.
Unfortunately, one of the biggest issues facing those of us working in pharmacy is the unavailability of medicines caused by supply chain issues. This results in anxiety, additional workload and cost for all involved.
Explaining to patients that you cannot supply their medicine is frequently met with dismay, disbelief and anger. We do all we can to source the appropriate medicine, either from the wholesaler, direct from the manufacturer or by phoning around local pharmacies, but sometimes the patient is left without treatment.
In many situations, we have no alternative but to ask the GP to prescribe an alternative; not good for the patient or a manufacturer. When we part-dispense with stock held in the pharmacy, we ask the patient to return for the remainder, resulting in touching a prescription more than once.
All of this takes time and resource, and at £1.29 per item, it’s not something we are reimbursed for. Pharmacies are very busy places dispensing hundreds of items per day, and anything that interferes with the dispensing process can result in delays and increased risk of errors as we multi-task to keep the flow.
When I ask pharmacist colleagues what causes the biggest frustration in their working day, supply chain and medicine cost issues are most commonly cited.
Stock shortages can also have an adverse financial impact on pharmacies, including sourcing from an alternative wholesaler at a reduced discount. It’s not uncommon for a pharmacy to make a loss on a product in short supply when the reimbursement price is lower than the acquisition cost. Yet pharmacies will put the patient interest first.
The generics market is particularly volatile and we are seeing high-value medicines affected including those for serious conditions including cancer, epilepsy and mental health.
Cause of shortage
The supply chain can be impacted by a sudden or fluctuating demand, small stock sizes, globalisation, exchange rates, long delivery time and or complex production chains. It does seem, however, that something else is going on.
The Government is promising to get to the bottom of shortages amid fears that the market is being manipulated to drive up prices. Until the situation is solved, patients will continue to suffer, and we will see lives lost.
From our perspective as pharmacists, when we’re trying to source a medicine for a worried patient, we just want it sorted. Government, industry and those in the supply chain must take responsibility for rectifying the situation. Continuing as we are simply isn’t good enough.
Deborah Evans is Managing Director of Pharmacy Complete, a specialist consultancy and training company working with pharmacy. Go to pharmacycomplete.org or email firstname.lastname@example.org