Type 2 Diabetes: Availability of Drugs

Ian Lavery Excerpts

Tuesday 30th January 2024 Westminster Hall

[Christine Jardine]

I thank the hon. Member for that intervention, because that point is at the heart of the matter. We have to ensure that the supply of drugs, which is short at the moment, is prioritised for those who need them for important health reasons.

A healthy weight, as the hon. Member said, and keeping active make it easier for someone’s body to manage their blood sugar levels and help prevent insulin resistance, which can lead to type 2 diabetes. Research has shown that, for some people, a combination of lifestyle changes can reduce the risk of type 2 diabetes by about 50%, but sufferers may also need to take diabetes medication such as metformin and insulin, as well as making changes to their lifestyle.

In the UK, 4.6 million people have type 2 diabetes and around 13.6 million are at risk of developing it. People often need help, such as intervention and medicines. Last year, I called on the UK Government to take action on the shortage of medicines for type 2 diabetes patients, after a constituent came to me concerned that her treatment and her health would be impacted by a shortage of the diabetes drugs she needed. They are known as GLP-1 RAs—glucagon-like peptide-1 receptor agonists—and include one of the most common drugs, semaglutide.

As for many other manufactured drugs, there is currently a supply problem with semaglutide. In this case, the problem has been made worse, as the hon. Member for Strangford (Jim Shannon) said, by the fact that the same drugs are effective for weight loss. The very thing that semaglutide does to help diabetes patients is making it difficult for them to access it.

I wrote to the Scottish Government, who told me they did not expect the supply to return to normal until mid-way through this year. I appreciate that that is not the most helpful response, but in some ways it is understandable, because medicine supply and licensing is a reserved matter. That is why I am raising it with the UK Government. We have seen issues with drug shortages beyond diabetes, and that is why I am so concerned at the slow response to the lack of medication.

Patients find themselves stuck between the proverbial rock and a hard place. In Scotland, they have the Scottish Government unable to act, and they perceive the UK Government to be very slow to act. It seems that neither Government have realised how potentially serious this situation could be for patients who use these drugs daily. For a patient to be in a position where they do not know whether they can get what they need to help them get well and keep them healthy is simply not acceptable. I have heard from people in my constituency and beyond about the impact that the situation is having on their lives.

[Ian Lavery (Wansbeck) (Lab)]

Does the hon. Lady recognise that this is not just about access to drugs for type 2 diabetics, but about access to medical equipment, such as the LibreView glucose monitoring sensors that have changed people’s lives? Does she agree that, because the incidence of type 2 diabetes is closely related to areas of social deprivation, where the finance is not available, the NHS should look to give those sensors to as many people living with type 2 diabetes as possible? That would save a fortune in the future, and it would reduce harm to lots of people who are currently suffering greatly because of diabetes.

[Christine Jardine]

The hon. Gentleman makes an excellent point, and I completely agree.

Type 2 diabetes is a problem in itself, with the lack of medication, but it is also an illustration of a major problem that our health services are facing with growing costs. We should be looking at how we prevent the problem in the first place, both in areas of social deprivation and in society generally. We should be looking at how we help people to avoid the problems that come with conditions such as type 2 diabetes. If we fail in that, people will fall into the situation where they are living with diabetes—a condition that requires 24/7 self-management to stay healthy. I invite Members to imagine living with a condition that they have to manage every day—a condition that has the power to affect them at any moment, disrupting what they are doing and altering their day to day life—when they have done all they can to stop that happening. Now consider how the lack of a medication that we have organisations and administrations responsible for providing makes that situation worse.

A couple of years ago, as part of a campaign by Diabetes UK, I tried to live life as if I had diabetes, and I have to say that I failed dismally. I realised just how difficult it is, and I realised that people living with diabetes —type 1 or type 2—deserve much better than they are getting at the moment. To be turned away at the GP surgery or pharmacy through no fault of the practitioner and to be told, “You might have to wait 18 months for what has been helping you get on top of the condition”, is simply unacceptable.

I know some people who have been left waiting since 2023. Shortages have been linked to those without diabetes using the drugs, as the hon. Member for Strangford mentioned, simply for weight-loss purposes. Drugs such as Ozempic are being sold online for nearly £200—a 1,765% increase on the cost of what they would be on an NHS prescription.

The Association of Independent Multiple Pharmacies has talked of the shortage of medication to treat the likes of epilepsy and attention deficit hyperactivity disorder as well as diabetes, all of them potentially life-changing and life-ending conditions. That is true also of some cancer drugs and hormone replacement therapy. The consequences do not lie just at the door of patients but, as we have heard, at that of the NHS and community pharmacy teams, which are under increased strain.

A national patient safety alert has been issued by NHS England and the Department of Health and Social Care to address supply, but I ask those with the power to consider standing in the shoes of those going through this. People who should have been started on GLP-1s are facing delay or are being put on to less effective options. Let us imagine being told that we had to take less effective medicine for a life-changing condition. If the supply is interrupted, a person potentially has to go through the side effects again and again when being restarted. People have been contacting Diabetes UK regularly since the start of the shortage in early 2023. This is not just about equality or ease of access. For all those affected, it is about quality of life.

--- Later in debate ---

[Andrew Stephenson]

It is an injectable medicine for adults with type 2 diabetes. It was recently approved by the MHRA. To put a little bit of extra information out there, the National Institute for Health and Care Excellence recommended Mounjaro, the same drug, for the treatment of patients with type 2 diabetes who meet specific criteria. The NHS in England is therefore now legally required, in line with NICE recommendations, to fund its use for eligible patients. The availability of that new medicine in Scotland is, however, a matter for the devolved Administration. The Scottish Medicines Consortium, which makes decisions on the use of medicines in Scotland, has not yet published guidance on Mounjaro. It will be a matter for the SMC as to whether that becomes an option in Scotland.

As I was saying, Mr Pritchard, unfortunately we expect supply chain issues to continue for the rest of the year. Throughout the management of this issue, our guidance has been supported by additional advice issued in Scotland, Wales and Northern Ireland, which has, critically, reinforced the messaging provided by the national patient safety alerts.

[Ian Lavery]

Does the Minister understand and recognise the benefits of glucose monitoring centres? It is not a supply chain issue, but an access issue. They can and do change people’s lives, but they are not widely accessible. People are very much unaware that they actually exist. If they did and understood that the centres were available from the NHS, it would save the NHS millions if not billions of pounds. It would change the lives of many people, mainly in deprived areas. Can the Minister give a commitment to look at that and see how we can allow more people to access glucose monitoring systems?

[Andrew Stephenson]

I hear what the hon. Gentleman says and I am more than happy to look at the issue. However, I believe—I may be mistaken—that he is suggesting something that we would routinely advise for type 1 diabetics to be provided to type 2 diabetics. As far as I am aware, the clinical advice does not suggest that we do that, but I am more than happy to look at the issue, because I want to ensure that we support people living with diabetes as much as we can.

Finally, I emphasise that our guidance remains clear that medicines licensed for the treatment of type 2 diabetes should be used only for that purpose. All prescribers, whether employed privately or by the NHS, are expected to take into account the appropriate national guidance. Unfortunately, the supply disruption is a common issue for the UK and other countries around the world, which is both frustrating and distressing for patients. We cannot always prevent supply issues from occurring, but where they do arise, the Department has a range of well-established processes and tools to manage them and to help mitigate the risk to patients. Addressing issues with GLP-1 RAs continues to be a priority for the Department. We will continue to work hard with industry to resolve the issues as quickly as possible. Once again, I am grateful to the hon. Member for Edinburgh West for raising such an important issue.

Question put and agree to.