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Pharmaceutical Services Negotiating Committee

Supply Issues

In this section you will find information on medicines shortages and the recent distribution changes by leading UK medicine suppliers.

Distribution of Medicines

There have been a number of recent distribution changes by leading UK medicine suppliers.  More information on new arrangements can be found by clicking here.

Medicine Shortages

Generic Medicines & the NCSO Concession: When stock of a product in Part VIII of the Drug Tariff has gone short in the market or the product has been discontinued by the manufacturer, and there is a more expensive alternative product available in the market, it is possible to apply to the Department of Health to grant the NCSO ('No Cheaper Stock Obtainable') concession which will allow contractors to dispense a more expensive alternative product, and be paid on their endorsement. To see more details on the NCSO concession, and to see what products have currently been granted NCSO, click here.
Contractors are reminded that NCSO/price concessions agreed with the Department of Health only lasts for the month in which it is granted.  PSNC understands that where products being granted an NCSO/price concession late in the month can cause confusion as to which month it is intended to be applied to.  However as stock situations are dynamic and constantly changing PSNC cannot guarantee that the granting of a concession in one month will be agreed in subsequent months.  Contractors are advised to procure as economically as is possible for their individual businesses.

Branded Medicine Shortages: Over the past year there has been a significant increase in the number of problems contractors are reporting experiencing in obtaining branded medicines. More information including the contact details to order emergency stock from manufacturers can be found here.  

What is the Impact of Stock Shortages?

stock shortagesFrom a patient perspective, stock shortages can lead to delays in patient care and can result in increased visits to pharmacies to collect supplies of medicines when the full prescribed order is not initially available. Evidence from the US shows that stock shortages can also lead to increased adverse reactions, for example when alternatives are prescribed and can cause confusion and decreased compliance.

From the NHS perspective, shortages can also be very costly. As well as the increased costs of sourcing alternatives, the unavailability of a key medicine or decreasing a patient's compliance with their medication regimen can lead to the exacerbation of a patient's medical condition, increasing hospital admissions and treatment costs.

Although the impact of stock shortages on patient care is widely acknowledged, when a medicine goes into short supply, it can also have a major impact on community pharmacists. For example, shortages inevitably lead to increased time spent in sourcing products, discussing alternatives with prescribers and counselling patients. Shortages can mean ‘double dispensing', for example if patients have to return to the pharmacy at a later date with an owing note and it can increase conflict between the patient and the pharmacist and the pharmacist and the prescriber, for example if there are misconceptions that the problem is due to the pharmacy's stock management rather than a genuine supply problem. Evidence from the US also suggests that the risk of medication errors increase when alternatives are prescribed, for example if the prescriber and pharmacist are less familiar with the alternative.

Stock shortages can also have an adverse financial impact on pharmacies, as well as increased costs caused by the increased burden on pharmacists, there may also be increased costs in procuring medicines which are not always reimbursable.

Stock Shortage Notification Schemes

The Department of Health, the Association of the British Pharmaceutical Industry and the British Generics Manufacturers Association developed guidelines on the notification and management of stock shortages. These were launched in January 2007. PSNC has welcomed this guidance and believes that it is a positive step in improving the monitoring of potential supply problems. Click on the links below for more information:

Department of Health and ABPI guidance

Department of Health and BGMA Guidance  

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