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New asthma inhaler batches released to ease ‘dramatic’ demand surge

New MHRA-approved Clenil 100mcg on the left. Picture credit: Chiesi Limited
New MHRA-approved Clenil 100mcg on the left. Picture credit: Chiesi Limited

Manufacturer Chiesi has announced it is releasing additional batches of Clenil 100mcg into the UK supply chain as demand for inhalers has rocketed during the COVID-19 outbreak.

The first seven batches – whose batch-specific variation has been approved by the Medicines and Healthcare products Regulatory Agency – are expected to arrive in the UK on May 11 and will undergo a safety check before they are released to wholesalers, Chiesi told C+D yesterday (May 6). 

“Further batches of the batch-specific variation” will be “released into the supply chain over the coming months”, Chiesi added in a statement issued earlier this week (May 5).

A “larger number of prescriptions being filled than usual and a dramatic increase in inhaler demand” has resulted in “Chiesi’s wholesaler partners experiencing out-of-stock situations related to Clenil 100mcg”, the manufacturer said. 

The company added that it hopes the additional batches of the product will help it “rapidly manage this current increased demand of inhalers”. 

Different appearance

The new batches contain the same medication, beclomethasone, as Clenil 100mcg’s regular batches, meaning no change is needed to the way prescriptions are written, Chiesi said.

However, the new batches feature different colours (see image above) that are “very similar” to Clenil 50mcg. For this reason, the manufacturer advises healthcare professionals to check “the dosage of the Clenil 100mcg inhaler written on the labelling on the packaging prior to dispensing as the Clenil 100mcg”.

Managing director of Chiesi UK Tom Delahoyde said “continued stock deliveries are also expected over the coming weeks and months, with good stock levels confirmed on all Chiesi products”.

GSK and Novartis

GlaxoSmithKline (GSK) told C+D earlier this week that as of May 5, “all our inhalers continue to be available across the UK” but said it “understand(s) this is a regularly evolving situation, so we are monitoring on a daily basis our stocks and safety stocks”. 

Novartis also told C+D yesterday that it does “not have any supply issues on any stock keeping units for inhalers”.

Stock from AAH and Alliance Healthcare

A spokesperson from AAH told C+D earlier this week (May 5) that demand for “all variants of inhalers has significantly increased” during the COVID-19 pandemic, but “overall demand has now stabilised”.

However, the spokesperson added that, at present, the demand for some inhalers still “exceeds our manufacturers’ ability to supply the wholesale distribution network”.

AAH has introduced a cap on the number of inhalers each pharmacy can purchase, to “enable as many pharmacies as possible to access some stock”. However, the wholesaler said tha,t subject to availability, it is able to offer extra stock to pharmacies –where there “remains an unfulfilled patient need” – even if the pharmacy has reached its cap.

Alliance Healthcare has also experienced a “significant increase” in demand for some asthma inhalers over the last six weeks, a spokesperson told C+D yesterday.

“While this has caused a few challenges, we continue to work closely with manufacturers as normal to procure sufficient stock to meet this demand and maintain consistent distribution of products and ensure patient safety wherever possible,” they added.

A 150% increase on Christmas figures

Demand for some inhalers was up by “400% from usual business”, the British Thoracic Society said in an update last month (April 20).  

Sadik Al-Hassan, manager of the Well Pharmacy in Kingswood, Bristol told C+D yesterday that in March, his pharmacy saw a “spike in inhalers prescriptions”. His branch registered a 158% increase in demand for Clenil 100mcg compared to Christmas figures. Demand for inhalers slightly decreased in April, he added. 

“Working with our surgery, we made sure [prescriptions of asthma inhalers] were appropriate. The surgery received a lot of reliever requests that were not appropriate during those first few weeks but in the pharmacy, we definitely saw a surge in preventer inhalers,” Mr Al-Hassan told C+D.

Uday Thakrar, pharmacy contractor and owner of Jai Chemist in King's Lynn, Norfolk told C+D yesterday that demand for inhalers is “easing off”. 

How can you advise patients with severe asthma and a suspected or confirmed COVID-19 infection? Read our CPD module to find out more.

Have you recorded an increased number of Rx for asthma inhalers?

Industry Pharmacist, Head/Senior Manager

Amazing how CCGs and prescribers continue to ignore NICE recommendation to issue DPI, in line with what most of the more forwarding-thinking European countries do. I wonder why...

A.S. Singh, Community pharmacist

Make the CCG's criminally liable for this change as they were keen to push branded generic prescribing. There would be no issue had the prescriptions been written generically.

I personally have a CCG pharmacist in the area who has a personal agenda against community pharmacists. She is an absolute loathesome person professionally and a disgrace to the profession. Would love to see someone like that take a hit from branded prescribing

I agree completely on branded generics, it is seen as a short term money saving scheme that actually will cost CCGs in the long run.

However, many inhalers are not bioequivalent or are the same device so for safety reasons are prescribed by brand. So in this case I don't think the reason is solely a financial one for branded prescribing.

John Cleese, Production & Technical

Correct. Clenil Modulite should never be prescribed generically, because it then opens up the possibility of giving Qvar, which is twice as strong. Your argument A.S. does not work with this product - however I do agree with you for other branded generics.

John Cleese, Production & Technical

One mitigation for the risk of the Clenil 100's looking like the Clenil 50's is that... Clenil 50's are now as rare as rocking horse poo!

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