Every single day I seem to be apologising to patients about not being able to supply their medicines. Every day it is another medicine that cannot be obtained; added to that what seems to be growing line of items that are currently “out of stock”. So Patient X can have a long term condition that has been very well maintained and has been on that medication for a number of years, and you’re telling them out of the blue they can’t have them. They obviously look bemused and a little disgruntled; understandably. You tell them not to worry, suggest an alternative if possible, and tell them to contact the GP to get an alternative script; if signposting to another pharmacy is not an option.
But this is the reality. Medicines are an integral part of the NHS, to ensure people remain healthy and have a good quality of life. Currently, Brexit is neither here nor there so systems have already been put into place in case of a ‘No Deal’. Stockpiling has been going on, and quota’s have been put into place. The vicious circle I have seen is that one item goes of of stock, no worries we’ll get everyone who needs Medicine A onto Medicine B, next thing you know Medicine A and Medicine B are out of stock and now we’re having to even switch more people onto Medicine C. Let me further define ‘out of stock’, the manufacturer may have stopped making it completely, the manufacturer may have stopped making it at that very moment in time with no date as to when it will be back in stock, it is unable to be sourced from the wholesaler and lastly it’s not viable to source the medication.
Let me go further into medicines not being viable to source. Pharmacies themselves are a business at the end of the day and they buy drugs in and get a fee back for dispensing them. Generally speaking, until now you could buy that particular medicine for example under £5 and most of the time the money paid for dispensing that drug would cover it or the difference would be negligible in the grand scheme of things. But with limited stock supply and the increased demand, the law of economics has caused the prices of certain drugs to rise drastically, from under £5 to over £50 (when they do actually become “available” again). I imagine larger multiples are able to withstand this financial burden much better than smaller independents, to a certain degree, and they have a larger profits to fund this. Yes our ethos is to make the patient our first concern. But in here lies the problem. Nobody knows how long this situation is going to last. So in theory we could keep providing these medicines to people but it would be unsustainable to the point some of the pharmacies themselves would have to shut down as they’re unable to cover their own costs – then where are the patients supposed to get their medicines from? Plus there have been cuts to community pharmacy so funding is stretched as it is and the demands are always sky high. This is the dilemma at the moment. So many people are affected by the drug shortages It is not realistic to be able to source every patients prescribed medication at the cost of the pharmacy, because it affects so many people. If we did so it would not only impact our own livelihoods, but the care of the residents in the local community. Where we can, we signpost other pharmacies but there is a strong likelihood they may be facing the same difficulties. I say signposting because it is an impossible task for us to find pharmacies that have a stock of the item required for multiple patients, as it would involve us calling multiple pharmacies and take up so much of our time all our other patients wouldn’t be cared for. Hence why getting a script for a replacement item is the best option in some scenarios, when it’s over a dozen patients in the same scenario, and you know you have the stock sitting there on your shelf and you can source it (for now).
I didn’t enter this profession to play god, as patients may sometimes feel, and withhold important medication. I came to make a difference by making sure people get the best out of their medications so they are able to live their best life. I am failing to meet my patients expectations through something that is completely out of my hands. I know that when I walk into the pharmacy tomorrow, I am going to have to apologise to a patient for not being able to get hold of their medication. What I don’t know is which medication is going to be affected next…
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