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Fluoxetine shortages powers bring ‘new way of working’ for pharmacy

Pharmacists have been granted the power to supply different strengths or forms of fluoxetine
Pharmacists have been granted the power to supply different strengths or forms of fluoxetine

Granting pharmacists the ability to supply alternative strengths of fluoxetine without contacting the patient’s GP will mean a “new way of working” for the sector, PSNC has said.

The Department of Health and Social Care (DH) today (October 3) granted pharmacists the ability to supply an alternative strength or form of fluoxetine 10mg, 30mg and 40mg capsules, in an effort to cope with shortages.

As there are sufficient supplies of 20mg capsules, as well as tablets and oral solutions, pharmacists can currently switch to these strengths or forms.

This is the first time pharmacists can dispense an alternative to a medicine suffering a shortage, rather than the prescription and without contacting a GP, under three “serious shortage protocols” (SSPs).

Pharmaceutical Services Negotiating Committee (PSNC) director of operations Gordon Hockey said the SSPs mean a “new way of working for pharmacies”.

“We see this as a positive step in giving the sector more freedom to make minor changes to the treatment provided, without needing to await the individual doctor’s approval.

“The SSPs should allow some patients to obtain their prescribed medicines in a quicker timeframe than might otherwise have been possible,” he added.

“Frustrating” fluoxetine shortages

The Association of Independent Multiple Pharmacies (AIMp) said activating the shortages powers for fluoxetine was a “welcome decision”, as the supply issues surrounding the antidepressant has been “very frustrating for pharmacists and their patients”.

“Having [the protocols] in place will allow pharmacists to act in the best interest of their patients and provide them with their medicines in a timely manner,” it added.

Empowering pharmacists

Royal Pharmaceutical Society (RPS) English board chair Claire Anderson said the use of SSPs “enable and empower pharmacists to help patients access appropriate medicines”.

“Pharmacists are experts in medicines and work hard every day dealing with medicine shortages,” she said

The SSPs “will support patients’ health, reduce time spent going back to their GP for a new prescription and save pharmacists time spent finding alternative suppliers”, Ms Anderson added.

The Company Chemists Association (CCA) said it had been working closely with the DH to “work through the practicalities of applying SSPs”.

Through the application of the protocols, “community pharmacists will be able to support their GP colleagues by preventing the need for large numbers of prescriptions to be re-written”.

HRT restrictions

In a separate statement today, the DH has also announced efforts to tackle other shortages, by restricting wholesalers from exporting drugs out of the country, including 19 hormone replacement therapy (HRT) products, adrenaline auto-injectors and hepatitis B vaccines.

National Pharmacy Association head of advice and support services Jasmine Shah said the exporting restrictions on HRT products “could help resolve what has become a stubborn shortage of medicines that are important to many women in this country”.

“We hope too that the measures to maintain availability of auto-injectors and hepatitis B vaccines are effective. A shortage of adrenaline products can have life-threatening consequences,” it added.

C+D is exploring the impact of medicine shortages on community pharmacy staff all week. Read the coverage so far and join the conversation by tweeting #MedicineShortagesWeek

6 Comments
Question: 
What do you think of the SSPs and export bans?

Frustrated Pharmacist, Community pharmacist

Barmy... We do this in Ireland all the time. So this is a 'new way of working'? We need five years training to work out 10+10=20? Crazy...

SIMON MEDLEY, Community pharmacist

so if 30mg is out of stock, you can substitute 20mg  and 10mg ( which is also short )- am i missing something

N O, Pharmaceutical Adviser

10mg Tablets available as per the SSP !!!

Career Miss Take, Locum pharmacist

Do we need to complete a Declaration of competence to confirm that we are clear that 20+20=40

Kevin Western, Community pharmacist

the first people who knew about this were the press. The last were pharmacists. In between that,  people with nothing better to do will have been hoovering up fluoxetine liquid and any other strengths they can get hold of. 

watch out for more "stock shortages" and price increases.

The procedure for claiming is, once again arcane and time consuming.  but at least the price for doing so is reasonable

Oliver Elshof, Locum pharmacist

I could see the price at least rising by £5.35 which is the ssp fee. In the same way when you order a special some (main wholesalers) will charge a £20 handling fee because they know we are paid that when endorsing SP. 

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