Medicine Shortages and Brexit

I just came across this misinformed piece of anti-Brexit hype on LinkedIn. That site only allows short comments, so I’ve written a fuller response here on the blog.

In brief … Remainers jump at any opportunity to blame any problem on Brexit. “We told you so”. This is certainly the case with medicine shortages. I show below that such shortages have been a growing problem for years, affecting many countries, and are clearly not the result of Brexit (which at the time of writing hasn’t even happened yet).

The Offending Post

The response

Medicine shortages are clearly a serious area of worry for people who need them. But no matter how much #brexit #brexitchaos #brexitshambles #brexitplanning hashtag hysteria you add, that doesn’t make shortages due to Brexit. In fact, such misdirection demeans a very real issue.

Here’s a more rational and less polemical take on Naproxen specifically from the National Ankylosing Spondylitis Society:

Shortages of drugs are commonplace and can be down to a number of factors:

– Increased global demand

– Cost of raw materials

– New regulatory requirements driving up costs

– Fluctuations in exchange rates

– Generic companies being unwilling to carry on selling unprofitable products.

At the moment it hasn’t been made clear exactly why naproxen shortages specifically are happening.

Is this related to Brexit?

No – it is more of a global problem than just a UK one.

https://nass.co.uk/news/current-supplies-of-naproxen-hit-by-shortages/ 

I know you began your post (incorrectly) with “Brexit fact”. But in case you believe the National Ankylosing Spondylitis Society is, for some reason shilling for Brexit, here’s another reference to help you with the truth:

Sandra Gidley from the Royal Pharmaceutical Society explained this has been an ongoing issue for nearly a decade and is not a direct side effect of Brexit.

https://inews.co.uk/news/drugs-shortage-uk-brexit-list/

Balanced and informed observers will point out that periodical shortages are a characteristic of the modern pharmaceutical market due to multiple factors, many of them structural, and are not a new thing although they have been getting more common in the last few years. They are also certainly not limited to the UK. Here’s an article on recurrent shortages in France in recent years – also clearly not related in any way to Brexit:
https://www.france24.com/en/20181127-focus-france-shortage-medication-prescription-cancer-neurological-patients-affected

One common characteristic is that many shortages relate to cheap generic versions of drugs. This is typically the result of manufacturers and suppliers managing production and distribution to try to optimise returns across different regulated national markets. In the case of the NHS, that means pharmacists and dispensaries have to choose between refusing to supply patients with the more expensive variants (which are usually in plentiful supply) or supplying them at a loss. This scenario appears to be precisely the one currently affecting Naproxen, which you mention.

The Department of Health is trying to make it easier to dispense alternative drugs/brands/forms/quantities where shortages are an issue. In some cases, it is possible to obtains a price dispensation so that pharmacies can supply a more expensive variant where a cheap generic has been prescribed and obtain full reimbursement instead of dispensing at a loss.

So please let’s avoid shroud waving and unfounded hysteria, and let’s not misuse this issue to attack Brexit.

 

Addendum: Handbags at dawn

As seems to be the Remainer Way, Phil was entirely unmoved by having his comments shown to be absolutely untrue. It predictably all got a bit handbags at dawn after that. Phil refused to acknowledge the unquestionable falseness of his claims or to correct them. He tried opening up a new line of attack (European worries about drugs FROM the UK, rather than the other way around, ‘proving’ that Brexit would cause shortages) . But that was also without any basis in fact and fell equally flat.  He finished off with another risible attempt at proving the Earth is flat and disappeared mumbling vague insults

 

Kevin. Many thanks for your comment, and blog. I welcome the challenge, the debate, and people should always look at both sides of the argument. However, I wonder if you have all your facts straight? Are you well informed?  How do you explain the following:  The Dutch Federation of Academic Hospitals claim that they “foresee great risks for our daily operations if Britain leaves the EU without a deal.This varies from medicines, tissues and medical supplies becoming unavailable, to problems with data storage and the registration of doctors. The safety of patients is at risk.”Germany’s drug safety regulator concluded this month that Brexit would not put its patients at risk of losing access to essential drugs, while Ireland has drawn up a list of 24 medicines whose supply would be most vulnerable if Britain fails to conclude a divorce deal. 

Forgot to mention.  Your clients are health and social care bodies. I think, maybe, you have a conflict of interest. 

All the more reason for responsible, informed honesty, Phil?

[1 of 4] Thanks for your concern Phil. Yes, I do take great care to have my facts straight, and I am fairly well informed. I’ve even read the same press releases from which you selectively copy and paste. Now that your “Brexit fact” about UK medicines shortages has been shown as utterly false – and evidenced as such by authorities – you appear to have shifted your anti-Brexit hype onto the new issue of supplies to other countries. Fair enough ….

[2 of 4] Clearly, (in the highly uncertain event of it actually happening) a farcically last-minute Brexit with no overall withdrawal agreement and a rush to make contingency arrangements in the last few weeks down to gross political mishandling of Brexit by May and the other remainers is less than optimal. It is certainly not what any leavers voted for. However, that is not a reason to attack or abandon Brexit per se, and all foreseeable risks can be handled calmly with new interim or permanent agreements/arrangements where the will exists. It’s not ideal but it is perfectly manageable. In fact – many such agreements are already quietly in place across many aspects of trade, transport, and regulation despite all the ‘no deal’ brouhaha and distraction.

[3 of 4] You pasted the press release quote from Germany’s drug regulator saying “Brexit would not put its patients at risk of losing access to essential drugs”. OK, good. You then pasted the bit about Ireland making a list of potentially vulnerable drugs, without mentioning from the same press release that the Irish Health Minister said “It is a really important message that I want to deliver to people in Ireland today, both to patients and pharmacists, that there is no need to stockpile medicines.” So that, again, is a question of sensible planning and arrangements already in place.

[4 of 4] You quoted – selectively again – from another Reuters press release, this time about the Dutch NFU’s concerns about medicines currently licensed by the UK not being recognised in the EU post-Brexit. In practice, this issue will clearly be addressed by the EU and/ or national governments simply agreeing that such certified medicines & devices continue to be recognised until alternative permanent arrangements are made. That press release in fact says exactly that that is what the NFU is seeking: “The NFU has called for an emergency law permitting the use of UK certified medical goods for at least the rest of the year.” Once again the hype does not stand scrutiny.

[5 of 4] Perhaps you would now, in the interests of accuracy correct the opening of your original article and remove the false and misleading phrase ‘Brexit fact’?

Kevin, unfortunately for you (and your healthcare clients) I won’t edit my post. It is a Brexit fact that ‘Oncologists can’t guarantee the supply of my friend’s son’s cancer treatment after Brexit.’ This is true. AND SO IS THIS. Yesterday afternoon, at a meeting of the integration joint board of NHS Shetland, Ralph Roberts, the Chief Executive of NHS Shetland, said that he cannot guarantee medicine supplies in the event of a no-deal Brexit. That was the answer he gave to a question from councillor Allison Duncan, who had pointed to concerns raised nationally around the supply of medicines such as insulin. “Are we in a serious position with supplies in the event of a no-deal Brexit?” Mr Duncan asked. Mr Roberts said: “The blunt answer to your question… [is] I can’t give you that assurance and I don’t think any health system in the country could give you that assurance.”  [Sources. NHS Shetland Press Office, The Scotsman, Shetland Times, Reuters, BBC Scotland.] PS – your last comment was [5 of 4?] I won’t reply to [6 of 4]. I’ve moved on to “The corruption of Amazon reviews..”  https://www.linkedin.com/feed/update/urn:li:activity:6494300853162242048  Take care. Blow hard. Laugh.

[6 of 4] To recap … we already established beyond doubt that the Naproxen shortage you wrote about is DEFINITELY NOT due to Brexit. So your ‘Brexit fact’ obviously is a false claim. You say you won’t correct it ‘unfortunately for me’. But it’s you rather than me insisting on keeping up a demonstrably false and misleading statement in order to push some political agenda. So maybe that’s a reputation issue for you rather than a problem for me?

I admire your willingness to flog a dead horse, regardless of embarrassment. But your Shetland example is just more of the same. We already established that medicine supply throughout Europe has been becoming more unreliable in recent years and that unpredictable shortages are increasingly common. Therefore, if you ask somebody whose job is about medicines to state whether they can “guarantee” supplies of all drugs over coming months, they would be incredibly foolish to say yes, regardless of Brexit. They cannot ensure supply today (hence your post about Naproxen et al) so how can they do so with regards to the future? It’s a sophism to pretend otherwise. Just as no doctor can guarantee I won’t drop dead next week – that ‘fact’ does not ‘prove’ that Brexit is life threatening. 

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