Drug shortages affected 111 products in the UK this year, but the outlook for 2024 could be better

Over the past year there have been ongoing drug supply problems in the UK and internationally. Recent figures show that over 111 products have been affected in the UK alone. This is more than double compared to 2022.

These delivery problems have led to shortages of many products. While the global shortage of Ozempic and Wegovy has received much attention, many other drugs have been in short supply in the UK, including drugs used to treat type 2 diabetes, ADHD and menopausal symptoms.

These shortages have affected millions of people around the world and in the UK, with many finding it harder to get regular prescriptions over the past year.

This may lead many to wonder why 2023 has been the year of drug shortages for so many and if the situation will be the same in 2024.

The reasons for the shortage

There are four main reasons for the current global drug shortage.

Manufacturing problems are the most commonly cited reason for drug shortages. According to the 2022 report, 60 percent of the world’s drug shortages were due to manufacturing problems. This will likely have been the same in 2023.

Medicines are manufactured in accordance with strictly controlled quality requirements. As such, developing, expanding and transferring production are difficult processes. Material shortages and suspension of drug production to solve quality problems and technical defects can also cause shortages.

This year’s shortage of medicines is also connected to the increase in patient demand. This has been cited as the primary reason for the lack of hormone replacement therapy (HRT), ADHD drugs, Ozempic (used to treat diabetes) and Wegovy (which contains the same active ingredient as Ozempic but is licensed for weight loss) this year. Ozempic is a particularly good example of how rapid demand growth can have serious consequences for supply chains.

Ozempic is only licensed for the treatment of type 2 diabetes. But it became popular through social media because it was used to help with weight loss. The increased use, licensed and unlicensed (off-label), affected the supply so significantly that in many countries doctors were advised not to start new patients on the drug.

This also meant that patients who needed Ozempic could not use it. It even led to black market sales and counterfeit products with questionable safety.

Overwhelming demand for Ozempic led to a shortage of the type 2 diabetes drug.

The growth in demand for some products has also been accelerated by seasonal factors. The strep A epidemic of recent years increased antibiotic prescriptions. The resulting shortage has continued throughout this year.

Although protocols were put in place to authorize pharmacists to use alternative products when necessary, sometimes these measures were not enough. This led to the NHS issuing guidance on crushing tablets and opening capsules to help children take medicines when liquid versions were not available.

Although it is difficult to correlate the current drug shortage with Brexit, changes to trade agreements between the UK and the EU have led to additional red tape, costs, supplier switching and delays.

In the UK, we rely on just one manufacturer for many medicines, which can be a risky strategy. For example, Alteplase is the only medicine licensed in the UK for the treatment of acute ischemic stroke, and it is made by just one manufacturer. However, supplies are running very low, which could seriously affect patients.

There are concerns that government agreements on pricing and supplier taxation (via the Voluntary Pricing, Access and Growth Scheme) may discourage suppliers from doing business with the UK. This could lead to fewer suppliers and products in the UK system.

Globally, it is challenging to set affordable prices in multiple markets and also provide manufacturers with an acceptable return on investment.

Some of the supply problems in the UK are also due to global spikes in demand, either due to increased prescribing of certain drugs or seasonal spikes in infections.

Outlook for 2024

Measures are being taken to control drug disorders in Great Britain and Europe. The European Commission has implemented several initiatives to reduce shortages in the EU, such as requiring suppliers to report shortages earlier, increasing transparency and sharing stocks between countries, and joint procurement strategies. It is not clear whether this will benefit the UK, but strong supply chains across Europe should be positive for the global drug supply.

Some of the supply disruptions that affected UK medicines in 2023 will be resolved in 2024. For example, the pharmaceutical company Besins, which manufactures hormone replacement therapy products, has increased its production capacity after opening a new factory in Spain.

The UK government is also working with manufacturers to ensure continued access to ADHD medicines for patients. Its expected ADHD drugs should be more readily available starting in April 2024.

Another measure that can help reduce drug shortages is issuing advisory notices about who should and should not be prescribed certain drugs. For example, a national directive was introduced advising that patients should not be prescribed Ozempic for weight loss. Wegovy’s approval for weight loss (which contains the same active ingredient as Ozempic) will also help improve stock levels of Ozempic, ensuring that patients with type 2 diabetes can use this product.

Establishing strategic stockpiles of important medicines also helps mitigate potential shortages and reduce supply disruptions. The European Union has already adopted this approach. This approach is particularly useful for drugs that may experience seasonal increases in demand, such as liquid antibiotics used to treat strep A.

We can all also help reduce the drug shortage and its effects on our treatment. Order prescriptions sensibly (so don’t order more than you need at one time), take medications as prescribed, and don’t buy from unregulated sources if your regular prescription isn’t available. Hopefully, this means less shortages in 2024 with the measures already taken by the government and suppliers.

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