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Just say no to drug (shortage)s

Copperfield 

So, just to clarify. At roughly the same moment a nationwide shortage of HRT is declared, we GPs are told that women on this treatment should hear about the latest research on HRT and breast cancer risks at their next routine appointment.

That’s right. We’re encouraged to talk about the pros and cons of HRT, ask them if they want to continue which, obviously, they always do, and finally break it to them that, actually, they can’t, because there isn’t any.

If that’s not enough irony for you, throw into the mix that, simultaneously, we hear there are ongoing contraceptive pill shortages. Hilarious. We have one set of women unable to suppress their hormonal cycle and another thwarted in their attempts to resurrect theirs, a situation clearly begging for an innovator/entrepreneur to set up some sort of oestrogen exchange programme.

In the meantime, we wait for these sodding ‘medication shortages’ to sort themselves out. Younger readers will find this hard to believe, but I actually recall a time when medication shortages didn’t exist, and it wasn’t all that many years ago.

Just like CQC and revalidation, medication shortages have simply become another familiar and steeply uphill part of the GP landscape which we just have to endure

Then, one day, rather like the CQC and revalidation, they were just there. Everyone agreed that, like the CQC and revalidation, they were a complete pain in the arse which no one understood and which made our difficult jobs harder still. And now, just like CQC and revalidation, they have simply become another familiar and steeply uphill part of the GP landscape which we just have to endure.

Frankly, it’s a sign of our oppression and demoralisation that we put up with this drug shortage crap. It’s ridiculous. We spend years refining our history taking, examination skills and investigation techniques with a view to producing precise diagnoses, only to have to spend days fannying around in some prescription lottery because the preferred treatment is mysteriously ‘unavailable’.

It’s getting so bad that maybe we should be told at the beginning of each week what drugs are available, so we can mould our diagnoses accordingly. Failing that, I’d simply ask for someone, somewhere, to tell us GPs what is going on, because I have yet to hear a consistent, rational and reasonable explanation for the drug shortage phenomenon.

Better still, explain it to the patients, preferably as an information leaflet. No, they probably won’t read it. But they could use it as a fan.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield or follow him on Twitter @doccopperfield

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Readers' comments (12)

  • Any chance of a patient shortage?

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  • Spot on. We are like developing countries now with drug shortages.
    The only thing we are not short of though are indecision on all fronts and BS oh and more guidelines and standards and quangos to "help" the situation.

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  • Pure profiteering only is the answer I suspect
    hang on to the medications in the warehouse and claim distribution issues .... shortage occurs on the street price goes up.... sell them to the highest bidder
    immoral certainly illegal..... well who knows
    or maybe I'm just an old cynic ??

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  • A PIL used as a fan for hot flushes is the best social prescribing I’ve seen.

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  • What is very bizarre is that there has been no rational explanation for why there are shortages. And no one seemingly authoritative enough to ask and find out the answer.

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  • I heard that the shortage is financial: the NHS plays hardball due to its sheer volume in the market and three outcomes are related to this:
    1: there is more money to be made by uk manufacturers by selling to those paying a better price.
    2: wholesalers are under no professional or contractual reason to promise a supply to the NHS
    3. Some faithful meds are no longer profitable to make: some have been designed to be expensive to manufacture to keep the generics houses at bay when the patents expire.

    As usual, led by donkeys.

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  • Seems like a gap in the market for someone uk based to fill?

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  • Visiting a hospital in another corner of the world there was in the doctor's office a drawer filled with pills. All the colours of the rainbow, old new, certainly not stored in optimum conditions. These could be searched through to find one suitable for the current patient.

    I don't know that the available pill informed the diagnosis, 'this week we will have epilepsy as we have antiepilleptics'; 'This week we are seeing a lot of hayfever as we have antihistamines'.

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  • 1. Anti-trust law should apply, i.e companies can't legally or openly corroborate and withhold stock to drive prices up. hopefully that limits profiteering.

    2. |The cavalry isn't coming | Hospital Doctor|04 Sep 2019 2:32pm
    What is very bizarre is that there has been no rational explanation for why there are shortages. And no one seemingly authoritative enough to ask and find out the answer.

    - What do you expect when the 'procurer' is not spending their own money but taxpayers....

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  • In Canada I write - "please provide most cost effective PPI" or "whichever similar COCP is in stock" and the pharmacists help the patients. Like professionals. It's mad.

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  • NHS declines to pay market price, supply dwindles; drugs and staff.

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  • look on the bright side - less breast cancer and strokes to deal with but potentially more pregnancies. apparently there is an issue with the glue used in the patches, its made in china and there is a shortage of the basic ingredients, added with a export profit making exchange rate selling abroad compared to the NHS makes more money. its a no brainer. I tell patients they get their drugs really cheap in the UK as its a block buying market. Elsewhere people pay full cost, plus warehouse costs plus pharmacy mark up costs - a popular inhaler in the Uk will cost £54 on the NHS, in north america if will cost you £150 plus. unless you have the right insurance of course.its called capitalism with a free trade market. You restrict the pharmacy companies - they will just move abroad taking UK jobs with them, which is already happening. the public gets what it voted for.

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