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BAPW backs international shortages prevention plan

It is "vitally important" that manufacturers communicate with regulators abut shortages, says BAPW CEO Martin Sawer

It is "of vital importance" that manufacturers communicate with regulatory bodies, says BAPW executive director Martin Sawer

Recommendations by an international trade body could reduce medicine shortages by improving communication between manufacturers and regulators, the British Association of Pharmaceutical Wholesalers (BAPW) has told C+D.

BAPW chief executive Martin Sawer branded a shortages prevention plan by the International Society for Pharmaceutical Engineering (ISPE) a "positive and important piece of work" that could help address the "global issue". 

In its plan, published on Tuesday (October 14), the ISPE urged manufacturers to communicate with regulators around the world to help identify when certain drugs were out of stock and provide a "rapid response" to address the impact on patients.

Mr Sawer told C+D it was "of vital importance" that manufacturers in the UK followed this recommendation for a "holistic approach" to shortages, which would help the government "get a grip" on the problem.

Wholesalers could find alternative sources for medicines if they knew about stock shortages in advance, he said, but it was a "challenge" to continue to supply pharmacies when shortages occurred without any warning. 

It was "particularly helpful" that the plan had been written by an independent body with the backing of regulators around the world, said Mr Sawer, who was hopeful it would put pressure on the European Medicines Agency (EMA) and national regulators such as the MHRA to ensure that manufacturers adhered to the ISPE's recommendations.

But Mr Sawer suggested that the ISPE's drug shortages team, which includes representatives from manufacturers such as Novartis and Johnson & Johnson, was not broad enough. The team should consider either expanding or designating separate teams to focus on different drug markets across the world, he said.

In its plan, which the ISPE published in response to a request from the EMA last year, the trade body recommended that manufacturers implement "robust" quality systems to ensure good practice and put in place measures to predict the likelihood of shortages. These measures could help address the "underlying root causes behind shortages", it said. 

The recommendations were limited to shortages caused by manufacturing and supply issues, but the ISPE stressed that there were other factors that could impact the availability of medicines, such as regional or economic causes.

In August, pharmacy minister Earl Howe told C+D that the government dealt with stock shortages "very effectively" and warned that their effect on patients should not be "exaggerated".

What else could manufacturers do to prevent shortages? 

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John Randell, Non Pharmacist Branch Manager

very effectively" and warned that their effect on patients should not be "exaggerated".

spoken by someone NOT on the front lines....he is not the one who has to tell the patient sorry your medicine is out of stock.....and face critisim from the patient..

Anton Sobala, Locum pharmacist

I don't really understand the current purpose of the BAPW. As the supposed representative body for mainline wholesalers in the UK, what did they do when the majority of their original members were excluded from DTP/RWM supply deals? The BAPW seem powerless.

What's the angle of the BAPW? Surely, all major manufacturers ought to be supplying all BAPW wholesalers? - a fair competitive market is essential. BAPW members are expected to follow the BAPW and GDP guidelines. If they do not, one would except the BAPW to cancel their membership. So why do manufacturers still choose to exclude?

BAPW full members now amount to a few wholesalers only, mostly large suppliers - eg. the 'big three' plus some smaller independent distributors such as Mawdsleys. I do not understand how supplying all of these companies would represent a major problem for manufacturers. I'm not suggesting that manufacturers should sell direct to anyone and everyone, but if they won't even supply the few remaining BAPW members, what's the point in the BAPW at all? How have these supply monopolies been allowed to happen? It might be permissible if the wholesalers involved in solus deals were entirely independent of pharmacy...... but giving exclusive distribution rights to Alliance (ie. Boots) and AAH (ie. LLoyds) is clearly anti-competitive. No wholesaler with such as huge associated pharmacy chain should be given exclusive rights to distribute any prescribable product. It is nothing more than corruption!

There are only two fair solutions....

1. Preferably, all major branded manufacturers should be legally required to use all BAPW members as distributors, plus any other wholesaler they wish to use.

2. If manufacturers insist on restricting sales to a limited number of wholesalers only, there must be a requirement for at least one national independent wholesaler (ie. one that does not own a large pharmacy chain) to be included in the deal. A good example is Mawdsleys. Unfortunately, most branded manufacturers have chosen to exclude the likes of Mawdsleys in favour of the huge vertically-integratated wholesalers (AAH, Alliance etc). This is always to the detriment of independent pharmacy. The result of these deals is always the same - reduced discounts for independents plus the loss of any power to negotiate. The inclusion of at least one independent wholesaler in all distribution deals would make the situation fairer, if not ideal. Whatever the failings of independent wholesalers, it's clear that they exist only for themselves and their customers. The largest vertically-integrated wholesalers also exist for themselves and their customers.. BUT with a strong emphasis on maintaining the profits of the many pharmacies they own... and pleasing their shareholders and off-shore owners.

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