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UK must curb exports if drug shortages are to be resolved

All-Party Pharmaceutical Group report says shortages are diverting attention from patient care

Exports of medicines intended for use in the UK are the primary reason for the shortages that have plagued the country's NHS in the last four years, according to a report by the All-Party Pharmaceutical Group (APPG).

The MP's report - which marks the culmination of a six-month investigation into the issue - notes that "patients are suffering and … pharmacists' time and resources is being diverted away from patient care" into sourcing of medicines in shortage.

The source of the problem are groups that take advantage of exchange rates and differential pricing to sell UK medicines at a profit overseas. The UK was a net importer of so-called parallel traded medicines for years, but a few years of low prices have reversed the trend.

The APPG accuses those involved in the medicines supply chain of an "air of resignation" about the problem, which they say has been dismissed as "either inevitable, or as having been inherited from the previous government".

A number of vulnerable patient groups have been affected by the scarcity, including those with mental health problems, epilepsy, diabetes and pregnant women in need of drugs to stabilise their pregnancy.

Industry-initiated measures such as quotas and other supply chain control mechanisms have proved ineffective and often aggravated the problem. Meanwhile, the Department of Health (DH) has been similarly unsuccessful in its efforts to resolve it, which included the setting up of a Supply Chain Forum in 2010.

The parallel trade sector operates entirely legally within the EU under free trade legislation, but there are measures available to exempt certain goods if public health is threatened. The APPG wants the UK to follow France's lead in curtailing the export of some medicines.

"The government must examine the public health exemption in UK law with a view to protecting the interests of UK patients," says the report.

Other recommendations include sanctions for non-adherence to guidance for supply chain participants, levied by the DH or the Medicines and Healthcare products Regulatory Agency (MHRA) in the case of wholesalers.

The MHRA also came in for criticism, with report describing it as being constrained by a lack of market data, and that it has taken few steps to acquire data that would make it more effective in carrying out its duties.

It is also "poorly positioned to enforce obligations and duties, and unable to ensure that wholesale dealer license holders are taking their responsibilities to patients seriously ".

The publication of the report was welcomed by the Association of the British Pharmaceutical Industry (ABPI), which said however that the measures proposed by the APPG do not go far enough.

"Without the legal separation of pharmacy wholesaling and dispensing activities, industry is unable to prioritise pharmacists whose primary concern is UK patients, over those who are selling medicines abroad for a profit and causing the problems in the supply chain," said ABPI chief executive Stephen Whitehead.

16th May 2012

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