Pharmacy teams are no strangers to medicine shortages, having weathered pandemic-borne supply issues and panic over hormone replacement therapy (HRT) products.

Pressure on medicine supply chains seems to have risen over recent months, with some pharmacists reporting shortages have never been worse.

C+D asked pharmacy teams which products they are struggling to get hold of.

 

Merseyside GPs not issuing alternative medicines

 

For Merseyside-based community pharmacist and contractor Waqas Ahmad, “the list [of out-of-stock medicines] goes on and on”.

Aside from HRT products – which pharmacies have struggled to keep in stock for a few years – it has been a challenge to acquire aripiprazole, citalopram 20mg, Buscopan, alendronic acid tablets, capsaicin cream, all Butec pain relief patches and MST pain relief products.

While “there have been fairly constant issues over the last few years”, medicine shortages have “been worse than I can ever remember over the last three months”, Mr Ahmad stated.

And sourcing product alternatives can be “complex”, he explained.

When there is a “straightforward alternative” to an out-of-stock medicine that the pharmacy has available, the team will contact the patient’s GP to switch their prescription to it.

However, “we find that the increased demand on [an alternative] product tends to affect the supply on that one”, Mr Ahmad noted.

To add to the complexity of the situation, “some GP practices are now not issuing suggested alternatives”, he claimed.

GP practices in Merseyside are “instead are asking the patients to ring around a number of pharmacies to see if any have the item before they will consider changing it”, he added.

C+D has approached the Liverpool local medical committee (LMC) for comment.

So, how are patients responding to these medicine shortages?

Mr Ahmad said that while the “minority are understanding”, most “get annoyed and frustrated, especially if they are close to, or have run out of, that particular medicine”.

“It can be very stressful for them, and for the pharmacy teams,” he stated.

 

Harkin’s Healthcare: “Exhausting” to keep medicines in stock

  

Things are no different for Harkin’s Healthcare, a two-branch pharmacy business based in Maghera, Northern Ireland.

One of its owners, Nuala Harkin, said the business is dealing with “a considerable increase in out-of-stock [medicines] across the board on a daily basis”.

As a result, the team was wasting an increasing amount of time in “trying to source medicines”, she told C+D.

Some of those included painkillers such as Solpadeine Plus and Nurofen Plus tablets and the oral suspension version of ibuprofen.

Ms Harkin also listed Robitussin cough relief medicine, Feroglobin iron supplements, Gaviscon, laxatives Senokot and Dulcolax, Cystocalm, Dioralyte and “any rehydration sachets”.

“It’s very hand to mouth to keep some medications in stock”, Ms Harkin added, calling the process “exhausting”.

Read more: 12 SSPs for HRT products extended as supply woes continue

 

Evergreen Pharmacy: Shortages confusing for patients

 

For Rifat Asghar-Hussain, superintendent pharmacist at Evergreen Pharmacy and Green Cross Pharmacy in Birmingham, dealing with medicine shortages has been “so crazy”.

She told C+D the pharmacy was having a “massive issue” stocking aripiprazole in both tablet and liquid form.

Ms Asghar-Hussain has found that clonidine, Hibiscrub skin cleanser, and lacidipine tablets have also been hard to come by.

Though patients have found the shortages “frustrating”, Ms Asghar-Hussain said they have mostly been “very understanding”, probably because Evergreen is “a small village pharmacy”.

Similarly to Mr Ahmad, she claimed that some GP surgeries in the area “are refusing” to issue patients with an alternative prescription if their medicine is unavailable at their usual pharmacy, instead asking them to “try at least four or five other pharmacies first”.

C+D has approached the Birmingham LMC for comment.

 

JWW: “Distressed” patients

 

JWW Allison in Cockermouth, Cumbria, is “at present” struggling to get hold of “quite a few” medicines, its director Nat Mitchell told C+D, including Buscopan, Asacol tablets, HRT gel Sandrena, Dioralyte, hydrocortisone ampoules and the rabies vaccine.

Shortages for these products have been particularly pronounced in recent months, Mr Mitchell said.

Though patients tend to be understanding if the pharmacy cannot get hold of their medication, “some do get distressed about it”, he added.

“It doesn’t always correlate with the importance of the medication.”

 

Heath Pharmacy: Situation “not sustainable”

 

Meanwhile, Amanda Smith – manager at Halifax-based Heath Pharmacy – said the team “have been able to get hold of most products”, though aripiprazole 10mg and promethazine were proving difficult to find.

“We are trying to keep the bare minimum in stock when prices are above drug tariff,” Ms Smith said. She noted that “some of the differences in price are eye watering”.

She added that Heath Pharmacy was spending an unsustainable amount of time “shopping around for products and reporting prices to the Pharmaceutical Services Negotiating Committee”.