Title page
Contents
Summary 5
1. Medicines shortages in the UK 7
1.1. What causes medicines shortages? 8
Medicines pricing 9
Regulatory delays 10
1.2. The impact of medicines shortages 12
Reduced patient safety and access to medicines 12
Increased pressures on pharmacies 13
2. UK Government response to medicines shortages 15
2.1. The DHSC Medicines Supply Team 15
2.2. Identifying medicines supply problems 16
2.3. Classification of medicines supply problems 17
2.4. National management of medicines supply problems 17
Serious shortage protocols (SSPs) 18
Regulatory actions for supply disruptions 19
Restrictions on exporting and hoarding medicines 19
The National Supply Disruption Response 20
Local actions to address shortages 21
Price concessions 21
2.5. Communication about medicines supply problems 23
Low and medium impact (tiers 1 and 2) 23
High impact and critical (tiers 3 and 4) 23
2.6. The Critical Imports and Supply Chains Strategy 25
2.7. Scotland, Wales and Northern Ireland 25
Scotland 25
Wales 26
Northern Ireland 26
3. Calls for reform of medicines shortages management 28
3.1. Pharmacists' prescribing decisions 28
3.2. Medicines pricing and price concessions 29