Supply chain and shortages
Supply chain and shortages
The impact of stock shortages can have a substantial effect on a patients, community pharmacies and the NHS as a whole.
Patients– 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 also shows that stock shortages can lead to an increase in adverse reactions, for example when an alternative medicine is prescribed, this can cause confusion for patients and ultimately lead to decreased compliance.
NHS– shortages can be very costly to the NHS. 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. Evidence from the US also suggests that there is an increased risk of medication errors when alternatives are prescribed, for example if the prescriber and pharmacist are less familiar with the alternative and this can also lead to additional treatment costs.
Community Pharmacies– 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. Shortages inevitably lead to increased time spent in sourcing products, discussing alternatives with prescribers and counselling patients. ‘Double dispensing’ can also occur, where patients have to return to the pharmacy at a later date with an owing note for a second dispensing of their prescription. These factors have a major impact on increasing contractors’ workloads. 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.
Shortages can also have an impact on key pharmacy relationships as they can increase conflict between the patient and the pharmacist and the pharmacist and the prescriber. For example there could be misconceptions from both patients and prescribers that the problem is due to the pharmacy’s stock management rather than a genuine supply issue.
The Department of Health and Social Care, the Association of the British Pharmaceutical Industry and the British Generics Manufacturers Association developed guidelines on the notification and management of stock shortages. These have been in effect since 2007 to improve the monitoring of potential supply problems. The links below provide further guidance: