Shortages of medicines are becoming an increasingly frequent issue that can hinder GP practices efforts to prescribe medicines and for patients to get their prescription dispensed in a timely manner.

Medicines supply issues can occur due to a number of unforeseen events and may be down to a combination of factors, which are outside of General Practices control.

Firstly, it is important to ascertain if the “currently” unavailable medicine will become available before the patient will actually need it. Due to the intermittent supply chain, many medicines availability can change throughout the week and in some circumstances daily. Community pharmacies are best placed to be able to provide any expected re-supply dates.

Patients should be encouraged to try several pharmacies (not of the same chain) to fulfil their prescription as different pharmacies use a range of wholesalers and distributors. The patient may wish to ring pharmacies in advance of attending to ascertain availability.

Some manufacturers of certain medicines (e.g. epilepsy, inhalers, adrenaline pens etc) advice patients that “if your pharmacy can’t get this medicine from their usual supplier, you can ask them to order direct from us, the manufacturer”. This should be checked as a viable option.

If it is determined a medicine is unavailable:

• The prescription containing the unavailable medicine should be asked to be returned to the GP practice so that the “item” (not necessarily entire script) can be cancelled. This will ensure the GP practice record is up-to-date and the pharmacy may re-download this prescription if there are other items to dispense
• Where possible an alternate drug from local guidelines should be used
• Where the alternative drug from local guidelines is not available (or there is no alternate drug) other options may be considered in discussion the practices Medicines Management Team support

We are aware that prescribers may also be asked to prescribe an alternative, recommended by the pharmacy, if there is a supply issue.  This will need to be considered on a case-by-case basis and in-line with local medicines guidelines. Despite the recommendation, it is the prescriber’s responsibility to ensure the recommended alternative meets local guidelines and is the most appropriate alternative for the patient.

The Medicines Management Team are available for advice and support for the practice.