Management of Stock Shortages

Management of stock shortages

Stock shortages will occur periodically due to outside factors and can cause anxiety and may impact on patient care.

Please note the guidance ‘A guide to managing medicines supply and shortages¹’ from the Department of Health and Social Care with NHS England and NHS Improvement for both primary and secondary care. This document outlines the national, regional and local management and communication routes for medicines supply issues to ensure continuity of supply and ensure that patients receive the treatment and medication required. These are followed in BNSSG.

In summary, when a medicine is unavailable:

• Where possible an alternate drug from the formulary should be used.

• Where there is no alternate drug on the formulary a non-formulary option may be considered in discussion between primary and secondary care.

• Once the stock shortage has resolved the formulary drug should be reinstated.

 The Specialist Pharmacy Service has developed a new Medicines Supply Tool, which can be accessed via the website here. Please note a log in is required to access this tool.

A Serious Shortage Protocol (SSP) may be issued if the Department of Health and Social Care (DHSC) decide there is a serious shortage of a specific medicine or appliance. SSP updates are available via the NHS Business Services Authority website here.

The Royal Pharmaceutical Society (RPS) published a report  in November 24 'Medicines Shortages: Solutions for Empty Shelves' which calls on the UK Government to create a national strategy to both prevent and manage medicine shortages that would streamline efforts across the NHS, reduce inefficiencies caused by duplication of effort and ensure information and guidance for professionals and patients is available as soon as shortages occur.

References:

1. Document Title: A Guide to Managing Medicines Supply and Shortages. Publishing approval number: 000920. November 2019

Supply Shortage of GLP-1 RA Injections

There is an ongoing national shortage of glucagon like peptide-1 receptor agonists (GLP-1 RAs) used in the management of Type 2 Diabetes (T2DM). This situation is not expected to resolve until into late 2024. Supplies of some GLP-1 RA preparations may be intermittent or exhausted within this time. An updated MSN has been issued (click here to view) advising that there are now products available which can be used for new initiations and conversions for people with type 2 diabetes unable to obtain their original GLP-1 RA medication. Please refer to the Guidance from the Primary Care Diabetes Society (PCDS) and Association of British Clinical Diabetologists (ABCD) for information about management of patients who may be affected by this supply issue.

Supply disruptions of medicines used in the treatment of attention deficit hyperactivity disorder (ADHD)

There are supply disruptions affecting a wide range of medicines used in the treatment of attention deficit hyperactivity disorder (ADHD).

The medicines supply notification is available here.

Please see Managing ADHD Medicines Shortages and BNSSG Patient Information Leaflet about methylphenidate

Shortage of salbutamol 2.5mg/2.5ml and 5mg/2.5ml nebuliser liquid unit dose vials

Please see Adult and Paediatric Primary and Community Care Guidance for Shortage of Salbutamol Nebuliser Liquid Units

Intermittent Shortages of Creon 10,000 and 25,000 gastro-resistant capsules

There are currently intermittent shortages of Creon 10,000 and 25,000 gastro-resistant capsules across the UK. These shortages are also having an impact on supplies of other dosages and brands of pancreatic enzyme replacement therapy (PERT) as demand for these alternative products grows. In response to this situation, a group of specialist pancreatic cancer dietitians and cystic fibrosis dietitians have developed a Position Statement: Pancreatic enzyme replacement therapy (PERT) shortage – advice for the management of adults with pancreatic exocrine insufficiency which provides advice for prescribers and dietitians on what to do if a patient is running low or cannot get PERT.

Please see Specialist Pharmacy Services website for stock updates.

The two main suppliers of PERT in the UK have set up customer support lines to help identify areas with recent deliveries. However, it is possible these deliveries may have already been allocated to specific patients.
• Viatris (Creon®) 0800 8086410 (for patients and pharmacists)
• Zentiva (Nutrizym®): 08448 793188 (for pharmacists) and 08000 902408 (for patients)

Update for Primary Care

Please see the Neonatal & Paediatric Pharmacy Group position statement on the Shortage of Pancreatic Enzyme Replacement Therapy (PERT) in neonates and children for information only. This has been written in response to National Patient Safety Alert.

Medicine Supply Notification: Pabrinex® (Vitamins B and C) Intravenous and Intramuscular High Potency solution for injection ampoules

Department of Health and Social Care (DHSC) has issued a medicine supply notification for Pabrinex® (Vitamins B and C) Intravenous and Intramuscular High Potency solution for injection ampoules.

• Pabrinex® Intravenous (IV) injection will be out of stock from August 2024 with a resupply date to be confirmed.
• Pabrinex® Intramuscular (IM) injection is being discontinued, with stock exhaustion expected from December 2024.

Please see the SPS website for more information on this stock shortage.

Shortage of Disopyramide 250mg (Rythmodan Retard) modified-release tablets and disopyramide (Rythmodan) 100mg capsules

There are intermittent shortages of Disopyramide 250mg (Rythmodan Retard) modified release tablets and Disopyramide (Rythmodan) 100mg capsules across the UK. 

Please see the Specialist Pharmacy Services (SPS) website for stock updates.