British cancer patients could be left without life-saving drugs as medicine prices skyrocket due to the war in Iran, experts have warned. The supply crisis has already begun to impact drugs used to treat cancer, as well as those taken to manage its symptoms and the side effects caused by treatments.
It comes amid industry body warnings that a range of medication shortages – including drugs used for blood pressure, steroids and painkillers – could affect millions of Britons in coming months. Existing NHS shortages have also been exacerbated by the conflict, due to disruption to air freight routes, as well as higher fuel and shipping costs.
Price Increases and Supply Disruptions
Research from 400 pharmacies across the UK by the National Pharmacy Association (NPA) showed all have experienced price increases in some of the most commonly prescribed medicines. Some drugs saw prices increase by as much as 11-fold since February, with the NHS struggling to cover the costs. Pharmacies surveyed said they were concerned that the war would worsen medicine shortages they were already experiencing. Others reported only receiving a quarter of their usual volumes of drugs due to the war driving up prices and tightening supply.
According to the NHS, there were already shortages of prescription drugs before the Iran conflict, but now the situation is even more concerning. Price concessions – temporary, higher reimbursement prices granted by the Department of Health and Social Care (DHSC) when community pharmacies are unable to source drugs at or below the standard price – have also surged to their highest level in years, NHS figures show. Some pharmacies reported already having lost large sums of money due to the health service reimbursing them far less than they were paying for medicines.
Cancer Treatments in Short Supply
A number of cancer treatments are already in short supply, and could become even scarcer as the conflict continues, experts warned. These include Creon – a medication used to treat pancreatic cancer – and Efudix – a topical chemotherapy cream used to destroy cancerous and precancerous cells on the skin. Intravenous cancer drugs Endoxan, Sendoxan and Genoxal, used widely across the UK and Europe to treat breast, lung and ovarian cancer, as well as lymphoma, leukaemia and myeloma, are already in short supply, according to regulators. The NHS has yet to put out a formal shortage notice for the drugs, however.
Olivier Picard, the chairman of the NPA, told the Telegraph: 'We are alarmed by reports from manufacturers that will be inevitable if this conflict in the Middle East and subsequent blockade is prolonged further.' Medication Oxybutynin, used to manage hot flushes in patients undergoing hormone therapy, is also already largely out of stock in the UK, and has seen its prices rise by more than threefold since the beginning of the year.
Supply Chain Under Pressure
The shortages and dramatic price increases seen since the conflict began reveal how precarious the supply chain has become, say experts. Pharmaceutical companies are under increasing pressure from the conflict, said Mark Samuels, chief executive of Medicines UK, which represents manufacturers who supply most NHS prescriptions – warning that disruption could hit Britons undergoing cancer treatment within weeks. 'Transport costs have surged – in some cases by up to 300 per cent – and these increases cannot be absorbed indefinitely, particularly for generic medicines because they are sold at extremely low prices,' he told the Telegraph. 'At the same time, some critical raw materials used in manufacturing rely on petrochemicals disrupted by the Strait of Hormuz's closure. Rising fossil fuel costs are also increasing manufacturing expenses. Off-patent medicines make up the vast majority of treatments used by NHS patients, and given the pressures on the supply chain it is increasingly likely that we will see shortages, price rises or both in the weeks ahead. Because these medicines underpin essential treatment areas – from cancer care and pain relief to antibiotics and mental health – any disruption will likely have a direct impact on patients across the NHS.'
Wider Medication Shortages
It comes just days after pharmacies warned of supply issues affecting a wide range of everyday medications – including a certain dosage of Ramipril, a common high blood pressure drug. The medication, which can be taken as tablets, capsules or as a liquid, works by widening the blood vessels and making it easier for the heart to pump blood around the body. A 'serious shortage protocol' notice has been issued for Ramipril 1.25mg capsules, which says patients can only get one month's worth of supplies at a time. Sir Jim Mackey, chief executive of NHS England, warned last month he is 'really worried' about a potential shortage of supplies. The National Pharmacy Association (NPA) said three million items of Ramipril are prescribed every month in England. NPA chairman Olivier Picard said: 'We are concerned by this recent shortage, with a number of pharmacies being unable to order some strengths of Ramipril as well as seeing the cost soar in recent weeks, in instances where stock can be found. Millions of patients rely on Ramipril and although there are alternative medicines available, supplies of these must be managed carefully by the Government to ensure subsequent demand can be met. The Government should allow pharmacists to make substitutions to Ramipril prescriptions to ensure patients do not have to go back to their GP to find an alternative. Whilst the medicine supply chain is extremely complex, the rising problem of shortages across a wide range of medication is extremely worrying for patients and heartbreaking for pharmacists who go to great lengths to ensure they don't turn them away.'
Sir Jim Mackey, the head of NHS England, admitted last month to being 'really worried' about a potential shortage of supplies such as syringes, masks and surgical instruments due to the ongoing conflict. Deliveries have been directly affected by Iran's blockade of the Strait of Hormuz and the wider disruption to global shipping. The blockade of the Strait has already pushed up oil prices and is expected to have a major knock-on effect on the rate of inflation. Sir Jim said the crisis could impact drugs and wider medical supplies, stressing: 'Honestly, everything. Everything is at risk.' The UK imports about three quarters of its drugs and many others made from materials that are shipped from the likes of China and India. So far this year, UK pharmacies have struggled to secure stocks of some painkillers, antidepressants, blood pressure drugs, and hormone replacement therapies. The Department of Health and NHS England were contacted for comment.
