East Sussex Local Pharmaceutical Committee
“To promote, represent, develop and support NHS Community Pharmacy in East Sussex in the interest of contractors
and service users.”
50 Rockington Way, Crowborough, East Sussex TN6 2NL
01892-665565
Darren Grayson 5th June 2009
Chief Executive NHS Brighton and Hove City
Prestamex House
171-173 Preston Road
Brighton BN1 6AG
Dear Darren
Community Pharmacy medicines supply chain problems
Over the past year, there has been a substantial increase in the number of problems that contractors are experiencing in obtaining certain branded medicines. At the heart of the problem are changes in the European import and export market. A weak pound and strong Euro have reduced the benefits from using parallel imported products; increasing the demand for UK medicines both from UK pharmacies and internationally.
Contractors in East Sussex are concerned that the situation is damaging the reputation of community pharmacy with our healthcare professional colleagues, the public and our patients. It is also a concern that in certain cases we may be putting patients lives at risk and nor meeting our contractual obligations.
This is a complex issue - there is no easy solution. Some manufacturers have introduced quotas to better manage the supply of UK medicines to ensure patient access, however where stock hasn't been allocated correctly by the manufacturer or managed appropriately by the wholesaler, problems arise. Quotas also need to be effectively managed by wholesalers. The reports PSNC (pharmaceutical services negotiating committee – our national negotiating body) has received indicate that different wholesalers manage the stock they have been allocated in different ways and with markedly different levels of success.
An alternative option is, as Pfizer have done, monitor and restrict purchases at an individual pharmacy level rather than through wholesaler quotas. However, contractors have also reported problems with this arrangement.
Typically, when a wholesaler's quota has been exceeded, pharmacies need to obtain the product directly from the manufacturer or through alternative contingency arrangements. This increases workload in pharmacies and has an adverse financial impact on both pharmacies and the NHS.
PSNC has argued that to protect the timely and efficient supply of medicines to NHS patients, the Department of Health should impose information requirements on branded medicines manufacturers to support the ongoing monitoring of supply problems and should institute a review in conjunction with manufacturers, distributors and community pharmacy to consider what measures can be put in place to address supply issues.
PSNC is seeking to work constructively with manufacturers and wholesalers to find solutions to the current problems that could be introduced to help meet the needs of UK patients more efficiently. PSNC and BAPW (British Association of Pharmaceutical Wholesalers) have recently written to all affected manufacturers proposing that a buffer of “ring-fenced”emergency stock is kept by pharmaceutical wholesalers, to be distributed at the request of manufacturers as part of their contingency supply arrangements. Under the proposal, once quotas have been exceeded, the manufacturer would authorise the wholesaler to deliver contingency stock on a “next day delivery” basis using established logistical processes. At present each manufacturer has different arrangements in place with different delivery companies being used to deliver contingency stock – in varying amounts of time.
As an LPC we are charged with looking after the interests of contractors and we would be failing in our duty if we did not alert our PCTs to the supply problem nationally. We would also like to illicit your support in trying to minimise disruption to the supply to patients of certain branded medicines in East Sussex. We look forward to hearing from you with your thoughts regarding this issue and ways we could communicate the problem to our professional colleagues and patients in East Sussex.
Yours Sincerely
Craig Mc Ewan MRPharmS
LPC Chair
cc. Jane Moffat, Head of Prescribing
Dr Russell Brown, Chair East Sussex LMC
Chairman – Craig McEwan, BPharm. MRPharmS. Tel 07771 696890
Professional Executive Officer – Vanessa Taylor MRPharmS. Tel 07770 430186
Treasurer - Paul Antenen MRPharmS Tel 07968 535970
Secretary – Flick Johnston MRPharmS Tel 01892-665565