Patients hit by shortage of drugs as prices soar

….Mental illness and cancer sufferers forced to wait
Shortages of at least 100 drugs have forced NHS officials to approve temporary price rises Cancer patients and people with severe mental illness are going without essential medicines because of shortages that have cost the NHS £180m (about N66.6m) in six months.

At least 100 drugs have been affected by supply problems, forcing health officials to approve temporary price rises of up to 4,000 per cent to boost stocks.

The NHS is spending more than £50 million a month overpaying for the medicines but pharmacies are still running out for days at a time and turning patients away.

Paul Rogers of Times reports that Ministers are now investigating amid fears that the market is being manipulated to drive up prices.

Pharmacists have complained that there have been cases where a drug in severe shortage becomes available immediately when a higher price is granted.

Warwick Smith, director-general of the British Generic Manufacturers Association, said “something very unusual” was going on and suggested that wholesalers were artificially inflating prices.

Mr. Smith said that concessionary prices agreed by the government were on average two and a half times larger than manufacturers’ charges.

“It’s not in manufacturers’ interest to exaggerate their price increases,” he said. “It doesn’t make them any money, it just makes them less popular. Something is going on somewhere else in the supply chain.”

Prostate and breast cancer drugs taken by tens of thousands of people are among those affected as well as epilepsy treatments and several common anti-psychotic medicines used to treat schizophrenia and bipolar disorder.

Simon Wigglesworth, head of the charity Epilepsy Action, said that people were being forced to change drugs because of shortages.

“The impact of this should not be underestimated [People with epilepsy] may not be able to drive or work, and experience severe anxiety or depression as a result of switching medication,” he said.

Baroness Morgan of Drefelin, chief executive of Breast Cancer Now, said that shortages of the hormonal therapy anastrozole, taken for years after surgery to stop tumours returning, were incredibly worrying, adding: “Delays in receiving treatments can cause further uncertainty and anxiety at an already difficult time.

Crucially, if adherence to hormone therapy drops further, breast cancer recurrence rates could increase, ultimately costing women’s lives.”

Under rules to combat supply problems, a pharmacy industry body can ask the Department of Health to grant a month of higher prices, known as price concessions, for drugs that are difficult to obtain.

The cost to the health service of one drug, the anti-psychotic quetiapine, has risen from £1.62 to £65 and the total extra cost to the NHS of the concession price rises has increased from £2.5 million in April to £32.1 million in June and £53.4 million in September.

Overall the shortages have cost an extra £177.9 million between April and September, the most recent month for which data is available.
The cost is likely to be rising further as pharmacists report “unprecedented” shortages, with difficulties obtaining 97 drugs last month, up from 27 in April.

Mark Burdon, a member of the Pharmaceutical Services Negotiating Committee, which makes these formal requests, said that high street chemists were “scratching around” for crucial supplies.

“The most worrying ones are drugs for mental health. It’s terrifying for patients when they can’t get something they are stable on. Anti-cancer drugs too cause huge anxiety for patients,” he said.

“We have to spend a lot of time reassuring people — ‘Yes, we’ll definitely have it, but probably not today or tomorrow. Can you scratch by until Friday?’.

It does happen that we have to say to patients, ‘We can’t get this for love nor money’.” He said that pharmacists were having to beg GPs and hospitals for supplies.

Many of the shortages have occurred in drugs made by several companies that have been available for years without any supply problems.

At least two manufacturers have been forced by regulators to suspend some production this summer but the rise in shortages appears to have begun at least two months before these problems.

Martin Sawer, executive director of the Healthcare Distribution Association, representing large wholesalers, insisted that they were not manipulating the market but called for more scrutiny of smaller wholesale licence-holders.

“Our members do not sit on stock, they make generics available to customers as soon as they get them,” he said.

The Department of Health said: “Our priority is to ensure medicines used by the NHS are certified as safe and effective, even if this costs the NHS more money The generic drugs market is particularly volatile at present due to shortages of supply and other factors but we still have some of the cheapest prices in Europe.”

Case study
Dr Wayne Kampers, 53, a consultant psychiatrist in London, said his patients had suffered depression and suicidal thoughts as a result of medicine shortages (Billy Kenber writes).

“About 20 per cent have either not been able to get the medication that’s been prescribed or they’ve been given a different form of that medication and that has significantly affected their mental health,” he said.

Dr Kampers, who works at the Priory in southwest London as well as in Harley Street, said that one patient had been stable on an antipsychotic drug for many years but recently had to switch because it suddenly became unavailable. “They really struggled,” he said.

He described the problems suffered by another patient who was prescribed an antidepressant.

“He went to at least 12 different pharmacies around where he lived and worked and not a single one was able to dispense it and nor could they tell him when it was going to become available. The impact of the shortages has been far reaching.”

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