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Health: Prescription Drugs

Volume 718: debated on Wednesday 17 March 2010


Asked by

To ask Her Majesty’s Government what plans they have to ensure that the supply of prescription drugs to patients is maintained.

My Lords, medicine supply problems can occur for a number of reasons, including manufacturing, regulatory problems and parallel trading. The Government work with drug companies, wholesalers and pharmacies on an ongoing basis to minimise the risks to patients.

My Lords, over the past 12 months, 48 different medicines have been reported to be in short supply so that patients cannot get access to them. Some of these medicines are critical. A parallel market has developed, practised by pharmacies, wholesalers, dispensing doctors and even NHS hospitals. Eighteen hundred licence holders are allowed to export medicines out of the UK. What urgent plans do the Government have to stop this parallel market? We know that existing regulations do not seem to work, while regulations in some EU countries forbid some of the practices that exist in the UK.

The noble Lord will know that parallel trading is a legitimate activity, but we take a very dim view of any NHS organisations indulging in it. We are concerned about whether it is having the effect on the supply of medicines that the noble Lord mentions. I am pleased to report that my right honourable friend Andy Burnham and the Minister, Mike O’Brien, held a summit with UK pharmaceutical supply-chain stakeholders to discuss concerns about the supply of medicines and agreed a package of urgent actions to address this issue to ensure that our patients continue to get the care that they need when they need it.

I believe, from when I chaired the Intergovernmental Organisations Select Committee on pandemics, that we in the UK stockpile drugs, so am I right in saying that we always have significant amounts of drugs available? We have an impressive reputation around the world for our drugs supply, but we have to keep stockpiles as well as meeting domestic needs.

My noble friend is right that there are stockpiles—the expression is “buffer stocks”—of essential medicines that we are building up for use in the event of pandemics or other major disruptions. The problem, as I am sure noble Lords will appreciate, is that feeding them back into the supply chain at the moment could have the opposite effect from what was intended, as it might encourage greater exporting. We are concerned not to increase the problem of parallel trading.

My Lords, the Minister has just told us that the Government take a dim view of this practice and the shortage of drugs. What does a “dim view” mean in reality? Who is held to account?

We think that it is unacceptable and contrary to acceptable professional behaviour for any hospital to be taking part in this. We were aware of some anecdotal reports that hospitals were trading in medicines, so the Chief Pharmaceutical Officer wrote to all chief hospital pharmacists in July 2009 and to the NHS chief executive and Monitor in February. Hospitals and NHS organisations are in absolutely no doubt that we regard this practice as unacceptable.

My Lords, does my noble friend accept that this is a particular problem for doctors’ practices in rural areas, where they do their own dispensing and where often no other source of treatment is available for patients? Will she take an urgent and close look at this aspect of the problem?

My noble friend raises an important point. This matter was discussed at the summit that I referred to and is being addressed by the stakeholders and partners that took part. He is quite right. I will undertake to ensure that we are taking action on rural pharmacies and I will write to my noble friend about it.

Will the noble Baroness explain how the outcomes of the summit will ensure that the supply chain of medicines in this country, which requires pharmacists to be able to receive medicines within 24 to 48 hours, will be resolved and restored?

The participants in the summit were the Association of the British Pharmaceutical Industry, the British Association of Pharmaceutical Wholesalers, the National Pharmacy Association, the Pharmaceutical Services Negotiating Committee and the Medicines and Healthcare Products Regulatory Agency, or MHRA. They agreed with my right honourable friend the Minister a more explicit duty on manufacturers and wholesalers to ensure the supply, a series of targeted inspections by the MHRA, tougher standards for the issuing of licences for medical wholesalers and the development of a best practice guide on how supply difficulties should be dealt with by doctors, pharmacies, wholesalers and manufacturers.

My Lords, according to the Minister, we were first worried about this in July 2009. The summit was held 15 days ago. Has there been any marked improvement over the last 15 days, as this is obviously an urgent problem?

As I said in my original Answer, the supply of medicines has to be dealt with all the time and interruptions in supply can be for a variety of reasons. It has become apparent only over the last period that parallel trading, which is to do with the relationship of the pound and the euro, has become a particular issue that we particularly need to address. It is too soon to say what the effect of the summit will be, because it was only a few weeks ago, but I will certainly let the noble Baroness know.

Is there a link between the department’s early warning systems and the specialist medical groups so that alternative guidance can be enacted quickly, such as happened when diamorphine supplies ran out at very short notice and the specialist society rapidly produced alternative guidance? No patient complaints were received then because no patient was left in pain through a lack of diamorphine supplies.

The noble Baroness points to a good example of how the system can work in different ways. We have officials who spend almost all their day making sure that the supplies of medicines are in the right place at the right time for the patients.

My Lords, had some of the drugs that were sold on to other countries—these drugs may be for people with rheumatoid arthritis and cancer—already been bought by the National Health Service before being sold on?

I am not absolutely certain about the answer to that question. Certainly, there is a list of 40 medicines, but that is 40 medicines out of tens of thousands of licensed medicines and out of millions of prescriptions. They include drugs for some of the conditions that the noble Baroness mentioned. I am not absolutely certain whether these were sold on by the wholesalers or the manufacturers direct. I will undertake to ask that question.