GPs struggle with drug shortages as MIMS tracker shows over 100 products still out of stock

Ongoing drug shortages are leaving GPs unable to prescribe many first-choice medicines, according to polling by GPonline.

Drug shortages are driving up practice workload as patients are forced to request alternative prescriptions. | GETTY IMAGES
Drug shortages are driving up practice workload as patients are forced to request alternative prescriptions. | GETTY IMAGES

The total number of products listed on the MIMS drug shortage tracker has remained around the 100 mark for almost a year, with 15 products added to the list within the past month.

The tracker currently includes several combined contraceptives - the ethinylestradiol/drospirenone pills Eloine and Yiznell, and the ethinylestradiol/norethisterone pills Brevinor, Norimin and Synphase, as well as Akizza (ethinylestradiol/gestodene) and Zoely (estradiol/nomegestrol). The depot norethisterone injection Noristerat is also currently unavailable.

Shortages of commonly prescribed HRT preparations - first highlighted by MIMS over a year ago - persist, with the FemSeven range still listed on the tracker alongside Bedol (estradiol), Climanor (medroxyprogesterone), Clinorette (estradiol/norethisterone) and some Elleste preparations. However, the manufacturer Theramex confirmed in June that the full Evorel range is now back in stock.

There are also continuing supply issues with H2 antagonists, as a result of the ranitidine withdrawal last year over concerns of potential contamination.

Opinion polls by MIMS' sister website GPonline and the BMA have highlighted the impact of ongoing medicines shortages.

A poll by GPonline this spring found that more than nine out of 10 GPs had noticed an increase in medicines they prescribe being unavailable over the past 12 months - with 71% of the 400 GPs who took part reporting they had been forced to prescribe second choice drugs fairly or very often.

A BMA poll published in April found that one in three doctors said they experienced medicines shortages some or most of the time.

Vital medicines

BMA GP committee chair Dr Richard Vautrey warned earlier this year that with many doctors regularly experiencing supply issues the situation could not be allowed to deteriorate further.

'The government must ensure that the system reacts quickly to shortages and ensure distribution networks are in place to quickly move resources around the country so that vital medicines are available to doctors when and where they are needed,' the Leeds GP told GPonline.

Dr Vautrey warned last year that drug shortages caused 'no end of problems' for practices and patients. He said practice workload was being driven up by patients 'frequently' being forced to come back following appointments to request an alternative prescription.

'There is real uncertainty over whether common medicines are going to be available, and patients may have to return to their practice to get an alternative prescription, or go round lots of pharmacists looking for one that has a particular drug in stock,' Dr Vautrey said.

Government measures

The government says it has taken steps to preserve drug supplies, including stopping wholesalers exporting certain medications. The list of drugs banned from export has risen from fewer than 40 in early March to almost 200 now.

Last October the government implemented an emergency 'serious shortages protocol' (SSP) measure to allow pharmacists to supply an alternative strength or pharmaceutical form of a drug without first consulting with the original prescriber.

Two SSPs are currently in place, for fluoxetine 10mg and 40mg, and are set to remain in force until early September.

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