Drugs: Supply and Availability

Lord Evans of Rainow Excerpts

Wednesday 14th June 2023 Lords Chamber

[Baroness Rawlings]

To ask His Majesty’s Government what steps they are taking to ensure the continued supply and availability of (1) prescription, and (2) non-prescription, drugs.

[Lord Evans of Rainow (Con)]

My Lords, the department is focused on helping to ensure continuity of supply of medicines to the NHS. We have a well-established process to manage and mitigate medicine supply issues, working closely with the Medicines and Healthcare products Regulatory Agency, the pharmaceutical industry, NHS England, devolved Governments and others operating in the supply chain to help prevent shortages and ensure that risks to patients are minimised when they arise.

[Baroness Rawlings (Con)]

I thank the Minister for his Answer. Despite what the Government are doing, would he agree that, even though there are pharmaceutical shortages worldwide, aspects of this in the UK have been exacerbated by Brexit? As of April 2023, there are 301 drugs in shortage—100 more than in the same time five years ago. I know the Government have kept a close eye on shortages and supplies, but what are HMG doing to prepare for the forecast shortages of sunblock creams—a vital skin cancer preventive—just in case we have a good and sunny summer?

--- Later in debate ---

[Lord Evans of Rainow (Con)]

My Lords, it looks like we have a good and sunny summer so far. The department recognises the important role that sunscreen creams play in preventing skin cancers by providing vital UVA and UVB protection. Suncreams are cosmetic products rather than medicines. The supply of cosmetic products is commercially driven and there is an extensive range of these products, with wide availability on the open market. Sunscreen creams may also be prescribed by clinicians if clinically appropriate, taking into account any NHS England guidance. I am not aware that there is a shortage of suncreams at the moment.

[Lord Hunt of Kings Heath (Lab)]

My Lords, the noble Lord says that he has a well-ordered system. Will he confirm that the number of price concessions—in other words, price increases—agreed to by his department when medicines are in short supply has shot up in recent months and that community pharmacies have to pay the gap between the set price and the newly agreed price? It then takes a long time for those community pharmacies to be compensated. Will he look at speeding up the compensation for community pharmacies?

[Lord Evans of Rainow (Con)]

Community pharmacies play a vital role in our communities. I will certainly take on board what the noble Lord has said and look into that.

[Lord Patel (CB)]

My Lords, all of us want the UK to be the best place in the world for excellent, new and innovative medicines. However, the pharma industry has complained about uncompetitive rebate rates for both voluntary and statutory schemes. Added to that, it has found it difficult to launch new medicines in the UK, and there is a great variation of availability to patients of medicines appraised by NICE of as much as 51%. What are the Government doing to address all these problems with solutions, so that patients can get the medicines they need?

[Lord Evans of Rainow (Con)]

The Government work closely with NICE on a multitude of new medicines and do a very good job of bringing them to the patients of need. If the noble Lord has any specific issues about any particular drugs, I can certainly look into that on his behalf.

[Baroness Walmsley (LD)]

My Lords, when a drug is in short supply and being replaced by an alternative, can the Minister say what guidance is given to GPs and pharmacists on how to ensure that the patient understands how to use the new product? This may be particularly important in the case of medical devices, such as those to control diabetes. I am thinking of pre-filled inulin pens, which all work in different ways and have different dosages. It is particularly important that the patient understands how to deliver it, when to deliver it and what the dosage should be.

[Lord Evans of Rainow (Con)]

The noble Baroness raises a very important point regarding medication for diabetes. She is absolutely right: when a patient is used to a medication, or indeed a device, it can be distressing and frustrating. We are aware of that. We want to assure noble Lords that the DHSC has well-established processes to manage supply issues, working with the supplier to resolve these issues as soon as possible. Where there is perhaps a shortage, it is very important that the patient gets training on the alternative device and that we get them back on to the device that they are familiar with.

[Baroness Manzoor (Con)]

My Lords, to follow on from the comments of the noble Lord, Lord Patel, Ozempic, a drug approved by NICE, is to be made available to diabetics. The accessibility to this particular drug is poor, and yet it has been made available to non-diabetic patients, such as celebrities. My concerns are twofold. First, what is the access available for diabetic patients to this new and life-changing drug? Secondly, how are the Government ensuring that young girls in particular are not following celebrities in using this drug just to bring down their weight?

[Lord Evans of Rainow (Con)]

My noble friend raises a very important point. Social media has a detrimental effect on the health and well-being of young girls—celebrities latch on to these things and it goes viral. The prescribers, whether NHS or private, are accountable for their prescribing decisions. They are expected to take account of appropriate national guidance. It is for the responsible clinician to work with their patient and decide on the course of treatment, with the provision of the most clinically appropriate care for the individual always the primary consideration. We will always work with clinicians to ensure that these drugs are prescribed as safely as possible, alongside specialist weight-management services.

[Baroness Merron (Lab)]

My Lords, a recent survey by the Pharmaceutical Journal listed serious shortages over the last year in the availability of treatments for common conditions, including menopause symptoms, high cholesterol, high blood pressure and osteoporosis, such that pharmacists were unable to provide the necessary medication. What assessment has been made of the effect of medicine shortages on people with those conditions? Does the Minister share my concern about the associated impact of these shortages on the NHS, in pressures as well as increased costs?

[Lord Evans of Rainow (Con)]

I share the concerns of the noble Baroness. Medicine supply problems can occur for a number of reasons, and occasionally the NHS experiences shortages of specific medicines, which may be temporary and localised. We want to assure people that the department has well-established processes to prevent, manage and mitigate medicine shortages. The noble Baroness mentioned HRT. There are 70 hormone replacement therapy products, and the vast majority are in good supply. There have been issues with the supply of a limited numbers of HRT products, primarily due to a very sharp increase in demand, but the supply position for the majority of HRT products has improved considerably over the last year.

[Lord Kakkar (CB)]

My Lords, I draw the attention of the House to my registered interests. What assessment have His Majesty’s Government made of the importance of securing an effective environment for clinical research, in ensuring that major developers of innovative therapies continue to provide those therapies to the citizens of our country?

[Lord Evans of Rainow (Con)]

The noble Lord raises a very important point. The Government are always keen to engage with the development community on a case-by-case basis. As we have discussed from this Dispatch Box in the past, there are moneys available. It is very important that we all work closely together to make sure that those medicines of the future are made available for the population.

[Lord Sandhurst (Con)]

My Lords, do the Government intend to take steps in response to the January report by the Medicines Manufacturing Industry Partnership to address the decline in medicines manufacturing and employment in the United Kingdom?

[Lord Evans of Rainow (Con)]

The Government recognise the valuable role that medicines manufacturing plays in the UK economy. It enables us to capitalise on our world-class research and development, create jobs and, significantly, create growth. Life science pharmaceutical manufacturing was responsible for more than £20 billion of exports in 2021. Our Life Sciences Vision set out the Government’s ambition to create a globally competitive environment for manufacturing investment. Last March, we launched the £60 million life sciences innovative manufacturing fund to encourage manufacturing investment in the UK. We will announce the fund’s winners later this year.

[Lord Allan of Hallam (LD)]

My Lords, for people to be able to access the drugs they need it is essential that there is a well-staffed network of local community pharmacies. Can the Minister confirm that there will be increased training of pharmacists in the Government’s long-awaited NHS workforce plan? When can we expect to see it?

[Lord Evans of Rainow (Con)]

I thank the noble Lord for that question. I assure him that, earlier this morning, before I came to this Dispatch Box, I asked for an update on the workforce plan. It is going to be released shortly—

[Noble Lords]

Oh!

[Lord Evans of Rainow (Con)]

That was my choice of words. I look forward to sharing the plan with noble Lords. The noble Lord raises an important point about community pharmacies. We all rely on them. Some 80% of the population can get to a pharmacy within 20 minutes, so there is a good distribution of community pharmacies in this country. With regard to training, my understanding is that it is rolled out, and pharmacists do an outstanding service for the country.