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Demand and packaging issues behind MMR jab and misoprostol export ban

DH: Export ban aims to tackle ongoing shortages and minimise the impact on patients

Global demand and packaging issues are among a raft of reasons why MMR vaccines, alogliptin with metformin and misoprostol cannot leave the UK, the DH has told C+D.

Measles, mumps and rubella (MMR) vaccines, pneumococcal polysaccharide vaccines (PPVs), alogliptin with metformin and misoprostol were added to the Department of Health and Social Care’s (DH) list of products that cannot be exported from the UK on Tuesday (November 5).

The DH has been alerted to issues with branded versions of the latest products to be added to the list. However, the export bans apply to all medicines containing the active ingredients, whether generic or branded, it explained to C+D.

PPVs not available until January

As is the case with the MMR vaccine, the PPV vaccine, which protects against 23 strains of pneumococcal bacteria (PPV23), is facing an “increase in global demand”, the DH told C+D.

This has prompted it to add all PPVs – typically given to patients at higher risk due to long-term health conditions, such as those over 65 years – to its list, the DH explained.

There will be “limited supplies” of both the PPV23 vials and Pneumovax 23 pre-filled syringes until the next delivery, which is “expected in January 2020”, it added.

As with MMR vaccines, although the PPV is available on the national programme, it is also often given to private patients and those who are not eligible for the national programme, the DH explained.

Manufacturing and packaging issues

The DH added diabetes tablet alogliptin with metformin to its export ban list after manufacturer Takeda alerted them to “manufacturing issues” with its branded version Vipdomet.

This has caused “global supply issues” and Vipdomet is not expected to be available again until “mid-November”, the DH said.

Meanwhile, Pfizer, manufacturer of the branded version of misoprostol, Cytotec, told the DH it is experiencing “supply issues due to packaging delays”.

Its original resupply date was expected to be the first week of December, but this has been brought forward to “early November”, the DH said.

Ongoing shortages

The latest four products join ranitidine and norethisterone, 19 hormone replacement therapies, adrenaline auto-injectors, emergency hormonal contraception levonorgestrel and hepatitis B vaccines in a growing list of medicines now subject to exporting restrictions.

The products that cannot leave the UK are at “high risk of parallel export”, due to their prices increasing in EU countries, the DH said.

By restricting wholesalers from exporting these products, the DH hopes “to tackle ongoing shortages and minimise the impact on patients”, it added.

Fluoxetine SSP extended

The news comes as the Department of Health and Social Care (DH) announced it is extending its serious shortage protocol (SSP) for fluoxetine 40mg capsules by another week.

The SSP for fluoxetine 40mg capsules will now expire on November 20, the Pharmaceutical Services Negotiating Committee announced this afternoon (November 8).

SSPs for the both the 30mg and 40mg strengths were originally due to end on October 31, but the DH extended their end dates to November 20 and 11 respectively, “due to ongoing supply issues”.

The DH withdrew its SSP for fluoxetine 10mg capsules on October 25, after enough stocks of the 10mg strength were found to be “available to meet normal demand”.

More information and supporting guidance on SSPs can be found on the NHS Business Services Authority’s website.

Pharmacy staff have experienced shortages in every major category of medicine, a C+D investigation exclusively revealed last month, with certain medicines, such as HRT, proving particularly difficult to source.

1 Comments
Question: 
Have you experienced shortages of these four medicines?

Leon The Apothecary, Student

Out of curiosity, what would happen if we simply didn't parallel export?

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