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Editor's view: Supply strain

Is the current spate of GLP-1 RA shortages a sign of worrying things to come?

Despite the progress being made to put community pharmacy on a more services-led path, the sector is still overwhelmingly reliant on medicines dispensing as its core business. And it’s still what patients expect: timely, reliable turnaround of their prescriptions (whether they appreciate the time and work needed to dispense safely is sometimes another matter). This is a big part of why reports of an increasingly fragile medicines supply chain are so worrying.

Issues have arisen on a number of fronts. In 2022, there was widespread coverage of logistical factors like shipping delays and labour shortages causing a ‘supply chain crisis’ affecting far more than just medicines. Things appear to be running more smoothly now, but the crisis exposed just how susceptible to sudden shocks our globalised system can be.

At the moment, manufacturers are locked in fierce battle with the Government over its branded medicine pricing clawback proposals, with some already pulling biosimilar products from the UK market over what they see as punitive and anti-business measures that will stifle innovation in the life sciences market.

Then there are sudden demand spikes, which are difficult to predict and almost impossible to resolve as quickly as patients would wish. Some have cited the ‘Davina McCall effect’ as having exacerbated long-running HRT shortages, and while it’s not as big a story for the nationals as it was last year, there are still two active Serious Shortage Protocols for HRT products at the time of writing. We saw this again last winter as pharmacists were shocked to find that staple antibiotics were all but impossible to source due to Strep A panic among understandably worried parents. 

Perhaps most egregious are the current issues around GLP-1 receptor agonists. In July, the MHRA put out an urgent bulletin to healthcare providers warning that diabetes drugs like Saxenda will be out of supply until mid-2024.

The cause of these shortages? Off-label use for obesity, the MHRA explains. News outlets have laid the blame on Tik Tok trends and the apparently commonplace use of Ozempic by actors and influencers. Some GLP-1 RA drugs appear to be readily available online from private providers at the same time as GPs are told to stop prescribing them. 

There are serious, wide-ranging conversations to be had about the UK supply chain. Perhaps, as some claim, pharmacists have been just too successful at driving down prices on behalf of the NHS, making it a less attractive market for pharma companies; efforts they justifiably feel they get little thanks for. 

It may be just as vital to get our heads around how these seemingly random demand spikes can be managed; no easy task in an age of social media, but one that will be necessary to ensure that drugs get to the people who need them most.

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