Without decisive government action, reported medicine shortages in hospitals in England will only be the tip of the iceberg, according to Amanda Cole, director of the Office of Health Economics.
Complex supply chains and Brexit impact
Medicine supply chains are complex and global, with multiple points of potential failure that are especially sensitive to geopolitical shocks. Brexit has made the UK even more vulnerable, as there is no longer access to EU medicine reserves, and cross-border logistics are further complicated.
Generic markets under pressure
Research shows that shortages tend to be concentrated in off-patent generic and biosimilar markets. Low prices for off-patent medicines are important in driving health system savings and promoting affordability. The problem is that when prices are driven unsustainably low, manufacturers exit, leaving markets with too few suppliers and dangerously exposed to any supply disruption or demand spike.
Costs to the NHS and patients
The NHS bears the cost when a shortage occurs, in the form of higher prices, expensive substitutes and a heavy staff burden in managing emergency procurement and, sometimes, rationing. Patients pay the highest price in delayed treatment and worse outcomes.
The government needs to weigh pricing controls against the costly damage that a drug shortage can cause. The answer lies in using regulatory, pricing and approval decisions to encourage competition and nurture supplier resilience. There is a critical balance between affordability and medicine security that needs to be struck.
