Survey reveals impact of drug shortages on GPs and patients

Responses to a recent survey suggest that drug shortages have a detrimental effect not only on GP workloads but also on patient wellbeing.

Eighty per cent of GPs said their workload had increased as a result of drug shortages. | GETTY IMAGES
Eighty per cent of GPs said their workload had increased as a result of drug shortages. | GETTY IMAGES

In a recent survey conducted by MIMS' sister website GPonline, 83.5% of those responding to questions regarding drug shortages (n=583) stated that they had been forced to prescribe a second-choice drug within the past year as a result of shortages.

Increased workload

Over 50% of GPs said they had experienced worsening problems with drug shortages over the past year while around 80% said that their workload had increased as a result.

These findings findings correlate with statistics gathered by the MIMS Drug Shortages tracker which has listed more than 100 out-of-stock products since its launch in early 2020, peaking at 142 items in November. The tracker provides back-in-stock dates for products where this information is available as well as possible alternatives if applicable.

One GP wrote: 'Leaving aside the panic over-ordering in March 2020 and to a lesser extent at the start of the second wave, which obviously resulted in shortages, I have experienced more requests from pharmacies for substitutions in the last year than ever before.' 

Abuse of practice staff

More than two thirds of respondents to the survey said that drug shortages had inconvenienced patients, sometimes resulting in altercations with practice staff. 

GPs reported patients blaming their GP practice when medicines were not available. One GP wrote: 'This has been going on for the past five years and results in duplication of work for the GP and angry frustrated patients who create more work for us.'

Another wrote: 'Patients get cross when we cannot give them the same meds. Pharmacies often no help as they don't tell us what we can get. Patients demand an immediate solution.'

Adverse effects on patients

Fourteen per cent of GPs said that patients had been adversely affected by drug shortages with one saying that a patient had 'nearly died'.

The survey responses also revealed other issues directly related to drug shortages, including the delaying or undermining of care where alternative treatments were not available and the undermining of control of long-term conditions. Increased risk of adverse events and inferior patient care were also cited as direct outcomes of drug shortages.

One GP stated: 'The medicines shortages are becoming chronic and they are limiting therapeutic options, significantly impacting patients.'

Another said: 'Limits prescribing options in some areas - especially HRT. Time consuming and frustrating when you don't know whether the drug you want to prescribe is back in stock or not - often easier to just avoid using these drugs altogether.'

Another GP said they had been forced to alter patients' management plans to work around available medication - while others reported delays to care or harm to patients forced to change medicines.

Onus on suppliers

Legislation that took effect in January 2019 requires suppliers to report on availability of medicines and anticipated shortages. The government guidance said: 'These requirements aimed to address the ongoing concerns about medicine supply issues and to ensure that DHSC have relevant information at the earliest point possible to help manage supply shortages and discontinuations and mitigate any potential impacts on patients.'

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