News

Media And Political Bulletin – 30 July 2018

Media and Political Bulletin

30 July 2018

Media Summary

Stockpiling medicines threatens cash flow headache for local pharmacies

The Telegraph, Helen Chandler-Wilde, 29 July 2018

The Daily Telegraph quotes HDA’s Chief Executive, Martin Sawer, in an article which claims that independent chemists face a cash flow crisis if they are required to stockpile medicines for a no-deal Brexit.

The article includes a statement from Martin Sawer where he states that ‘the UK exports more packs than it imports – there is trade both ways, so it’s important that there is alignment in the market…Companies are putting extra medicines into the UK already in buffer stocks. The essential medicines, the Government buys and stores them, but that’s not the case here. The supply chain would have to sort it out. Pharmacies need to be told about the plans as soon as possible.’

Drug wholesalers discuss contingency plans with government to prepare for ‘no-deal’ Brexit

The Pharmaceutical Journal, Debbie Andalo, 26 July 2018

The Pharmaceutical Journal reports on its discussion with HDA’s Chief Executive, Martin Sawer. It states that the HDA has already met with the Department of Health and Social Care to discuss contingency measures in the event of a ‘no-deal’ Brexit.

The article extensively quotes Martin Sawer, who says that ‘we are talking to the government to try and assess what the preparedness state is at the moment [in the event of a no deal]…. It’s about understanding the capacity of the UK market and building up a buffer stock should there be a no-deal scenario. Communication is going to be key.’

Sawer said that the current discussions and moves being suggested mirror those which would traditionally happen in anticipation of a pandemic flu outbreak, or the steps that were taken across the sector around potential medicine demand before the Olympic Games in London in 2012.

He said it is likely that wholesalers will request extra stock from their pre-wholesaler suppliers from January 2019 until March 2019, when the UK is scheduled to depart the EU.

Doctors warn border delays could ruin medicines amid fears No-deal Brexit ‘will put cancer patients at risk’

The Daily Mail, Stephen Adams, 29 July 2018

The Daily Mail reports that doctors have warned that the treatment of thousands of cancer patients could be dangerously delayed in the event of a no-deal Brexit.

The article states that critical supplies of radioactive medicines used to treat a range of tumours are at risk of being held up if the UK crashes out of the European Union.

Some of the treatments only work for a matter of days after being created, meaning any delay in transporting them can diminish their effectiveness.

Cancer specialists fear there will be hold-ups when the UK exits the Euratom agreement, which allows ‘medical isotopes’ to be whisked across borders.

Dr Jeanette Dickson, vice president of clinical oncology at the Royal College of Radiologists, said: ‘These medicines are like a burning fuse. They start off with a certain amount of radioactivity and you have a set time to get them to hospital when they are still effective. If you delay them for a few hours, you begin to lose activity.’

Army ‘on standby to deliver food and medicine’ if no Brexit deal is reached

The Evening Standard, Fiona Simpson, 28 July 2018

The Evening Standard reports that the army could be drafted in to deliver emergency food, fuel and medicine if Britain exits the EU without a Brexit deal.

Ministers have said that the military would be called in if blockages at ports after Britain leaves the EU led to shortages in supplies.

Helicopters and army trucks could be used to carry medicine to vulnerable people outside the south-east.

An ounce of prevention: UK drugmakers start stockpiling

Pharmacy Business, Kiran Paul, 28 July 2018

Pharmacy Business reports that the UK’s drugs industry said on Friday that it is stockpiling medicines to guard against a chaotic Brexit, but urged the EU to do more to protect patient lives on both sides of the Channel.

The action by the Association of the British Pharmaceutical Industry (ABPI) comes after ministers said this week they were working to safeguard supplies of drugs as well as food, in the event Britain crashes out of the EU next year without a negotiated deal.

‘Companies have already been starting to stockpile,” ABPI chief executive Mike Thompson told AFP in a phone interview, adding the government was “making sensible contingency plans…We’re being asked to do this for every single medicine that is being supplied,” he said, “and that is the biggest peacetime logistical challenge the industry has ever faced.’

Fears of a disorderly Brexit next March have risen as Prime Minister Theresa May struggles to win agreement for her plans to retain close trading alignment with the EU.

‘Patients could be seriously disadvantaged by Brexit, if we don’t get our act together’

The Pharmaceutical Journal, Gino Martini, 27 July 2018

The Pharmaceutical Journal reports on an interview with Sir Michael Rawlins, the Chair of the UK medicines regulator, the MHRA.

In the interview, Rawlins said that the UK needs to make sure that it does not run out of medicines in the event of a ‘no-deal’ Brexit. He said that ‘disruption to the supply chain is one of the ways that patients could be seriously disadvantaged. It could be a reality if we don’t get our act together.’ Using Diabetes as an example, Rawlins said that the UK imports “every drop” of insulin, a vital medication used by some 3.7 million people to manage the chronic condition.

Rawlins also said that the ‘ideal scenario’ would be ‘what’s called associate membership of the European Medicines Agency (EMA), where we would contribute to the scientific assessments of medicines going through the centralised and decentralised procedures. We would be present at all committee meetings, including the scientific advisory committee meetings. We wouldn’t have a vote, but my colleagues tell me that that’s not important — it’s about explaining our views, which are listened to very carefully, and then accepting whatever decision the EMA makes. It would be a participatory membership — we can’t just sit at the edge of the room watching what’s going on, not speaking: we need to have a say.’

Read the full interview here

Parliamentary Coverage

There was no parliamentary coverage today.

Full Coverage

Stockpiling medicines threatens cash flow headache for local pharmacies

The Telegraph, Helen Chandler-Wilde, 29 July 2018

Independent chemists face a cash flow crisis if they are required to stockpile medicines for a no-deal Brexit, the president of the Royal Pharmaceutical Society has warned.

Ash Soni said that small community pharmacies cannot afford to purchase and store large amounts of medicines on behalf of the NHS. Mr Soni, who owns three chemists, said this would create problems for small businesses in the sector.

“If it sits on my shelf for three months, I will be in a position where I don’t get paid for three months. If I don’t dispense it, I don’t get paid,” he said. “It’s a major problem for cash flow. I am bearing the risk on behalf of the NHS, that seems unfair to me.

“If the NHS wants to stockpile medicines, it should take the responsibility to make sure they’re paid for.” Matt Hancock, the Health Secretary, has said the Government is preparing “for a potential need for stockpiling”.

Mr Soni said: “Some medications, I use around 150 packs a month, so if you want me to store six months’ worth, that’s 1,000 packs.

“Even if the cost is low, just £1 a pack, that’s £1,000. We dispense 8,000 prescriptions a month, which is £50,000 of medicines in each branch every month. If every pharmacy has to do that across England, that’s 12,000 pharmacies, that’s a massive amount of money.” He added that storing so much medication, some of which has a short shelf life, would be an added challenge for small pharmacies.

“We’d also have to find the space to store them – and pharmacies aren’t huge places,” he said. “If they are cold store items, do I have to buy more fridges?” The Brexit Health Alliance estimates that 45m packs are exported to the EU from the UK each month, more than the 37m packs that are imported. This could also leave the EU exposed to shortages of medicines, according to Martin Sawer, the executive director of the Healthcare Distribution Association.

“The UK exports more packs than it imports – there is trade both ways, so it’s important that there is alignment in the market,” said Mr Sawer.

“Companies are putting extra medicines into the UK already in buffer stocks. The essential medicines, the Government buys and stores them, but that’s not the case here. The supply chain would have to sort it out. Pharmacies need to be told about the plans as soon as possible.”

Drug wholesalers discuss contingency plans with government to prepare for ‘no-deal’ Brexit

The Pharmaceutical Journal, Debbie Andalo, 26 July 2018

The Healthcare Distribution Association has said current preparations to build up buffer stocks in case of a ‘no-deal’ Brexit scenario mirror those of a flu pandemic.

The Healthcare Distribution Association (HDA), which represents drug wholesalers and distributors, has already met with the Department of Health and Social Care (DHSC) to discuss contingency measures in the event of a “no-deal” Brexit, its executive director has told The Pharmaceutical Journal.

“We are talking to the government to try and assess what the preparedness state is at the moment [in the event of a no deal],” Martin Sawer, executive director at the HDA, has said.

“It’s about understanding the capacity of the UK market and building up a buffer stock should there be a no-deal scenario. Communication is going to be key.”

Sawer said that the current discussions and moves being suggested mirror those which would traditionally happen in anticipation of a pandemic flu outbreak, or the steps that were taken across the sector around potential medicine demand before the Olympic Games in London in 2012.

He said it is likely that wholesalers will request extra stock from their pre-wholesaler suppliers from January 2019 until March 2019, when the UK is scheduled to depart the EU.

“The other role we have is to talk to the pre-wholesalers, who supply wholesalers, to ‘sensitise’ them to our demands and quantities of medicines that we need, so that there aren’t any gaps [in the supply chain],” he said.

Sawer was unable to predict which specific extra drug stock might be needed and expected that decision would be down to the DHSC.

“Each medicine will be looked at in terms of its route and how it will get to pharmacies — the devil will be in the detail.

“The government is doing the best that it can and it would be irresponsible if it was not doing any planning in the event of a no deal.

“One person not getting their critical medicine if there is no deal is one person too many.”

On 24 July 2018, health and social care secretary Matt Hancock told a meeting of the House of Commons health select committee that he had asked civil servants to “accelerate” plans, including preparation for the potential need for stockpiling of drugs, to deal with the consequences of the UK leaving the EU in 2019 with no agreement in place.

President of the Royal Pharmaceutical Society (RPS), Ash Soni, said that the risk of the Brexit resulting in delays in patients accessing medicines was a concern widely recognised across the healthcare sector.

“With some medicines manufacturers now talking about contingency plans to stockpile medicines in the absence of a negotiated deal, we are engaging with regulators and the NHS about their plans to minimise any potential disruption to the medicines supply chain.

“It’s understandable that current uncertainties about Brexit are raising concerns about patient care. Ultimately, I’m confident that pharmacists will continue to ensure that patient safety remains their top priority, and that the RPS will be on hand to help the profession manage future changes.”

Doctors warn border delays could ruin medicines amid fears No-deal Brexit ‘will put cancer patients at risk’

The Daily Mail, Stephen Adams, 29 July 2018

Leading doctors last night warned that the treatment of thousands of cancer patients could be dangerously delayed in the event of a no-deal Brexit.

Critical supplies of radioactive medicines used to treat a range of tumours are at risk of being held up if the UK crashes out of the European Union.

Some of the treatments only work for a matter of days after being created, meaning any delay in transporting them can diminish their effectiveness.

Cancer specialists fear there will be hold-ups when the UK exits the Euratom agreement, which allows ‘medical isotopes’ to be whisked across borders.

The NHS sources most of the nuclear medicines from Europe and they benefit around 10,000 cancer patients a year. Some would not survive without them.

Certain isotopes are also used in around 700,000 scans a year to help diagnose cancer as well as conditions including lung clots and osteoporosis.

Dr Jeanette Dickson, vice president of clinical oncology at the Royal College of Radiologists, said: ‘These medicines are like a burning fuse.

‘They start off with a certain amount of radioactivity and you have a set time to get them to hospital when they are still effective. If you delay them for a few hours, you begin to lose activity.’

Under Euratom, potentially dangerous medical isotopes can cross EU borders ‘without prior warning or consent’.

They are usually imported via the Channel Tunnel at night ‘without touching customs’, said Dr Dickson, who warned leaving Euratom could add lengthy checks.

Dr John Buscombe, a consultant at Addenbrooke’s Hospital in Cambridge, said not knowing when the medicines would arrive could jeopardise treatments.

He said: ‘Let’s say I’m using a medical isotope to help scan a child with a rare cancer who’s booked in for a particular day. If that medicine is delayed, the patient will miss their slot.’

Booking a new time might take ‘another week or two’, he said. ‘And if we can’t get these scans done, these children can die.’

Doctors fear added bureaucracy may lead to manufacturers raising prices or reducing NHS supplies.

The biggest impact could be from disruption to supplies of Technetium-99m, used in 80 per cent of nuclear medicine scans.

Other treatments that could be affected are types of targeted radiotherapy for cervical and prostate cancer.

One, called brachytherapy, is used as a knock-out blow for cervical cancer. Up to 1,500 women a year benefit from it.

The treatment helped cure Kerry Danns, 39, of cancer. The mother-of-three from Ruislip, West London, said: ‘Without that, I don’t know what situation I’d now be in.’

The warnings come days after Health Secretary Matt Hancock said the NHS was looking to ‘stockpile’ medicines to prepare for a no-deal Brexit.

Conservative peer and former minister Ros Altmann said radioactive isotopes could not be stockpiled and said the issue ‘could be life-threatening’.

The Government confirmed in January that the UK would be leaving Euratom, which is closely tied to the EU.

A Department of Health spokesman said: ‘The UK’s ability to import medical isotopes from Europe and the rest of the world will not be affected.’

Army ‘on standby to deliver food and medicine’ if no Brexit deal is reached

The Evening Standard, Fiona Simpson, 28 July 2018

The Army could be drafted in to deliver emergency food, fuel and medicine if Britain exits the EU without a Brexit deal.

The military would be called in if blockages at ports after Britain leaves the EU led to shortages in supplies, ministers told the Sunday Times.

Blueprints usually reserved for civil emergencies have been included as part of the “no deal” planning, the newspaper reported.

Helicopters and army trucks could be used to carry medicine to vulnerable people outside the south-east.

Under pressure: Theresa May took ‘personal responsibility’ for Brexit last week (Getty Images)

A Ministry of Defence source told the Sunday Times that “no formal request” to supply aid had been received but said the department has “a blueprint for us supporting the civilian authorities that can be dusted off”.

The revelation comes as supermarkets issued a warning to suppliers to stockpile customers’ favourite tea and coffee while the NHS said it would stockpile drugs brought in from outside the EU if Theresa May fails to strike a deal with Brussels.

Jeremy Hunt warns no-deal Brexit ‘now a real risk’

Last week, health secretary Matt Hancock said he met with medical industry leaders to “accelerate” preparations for the possible outcome

Mr Hancock said he was confident a deal would be reached but that it “responsible to prepare for all outcomes”.

Speaking at the Health Select Committee on Tuesday, he said: “Any responsible government needs to prepare for a range of outcomes, including the unlikely scenario of a no-deal

“We are working right across Government to ensure that the health sector and the industry are prepared and that people’s health will be safeguarded in the event of a no-deal Brexit.

“This includes the chain of medical supplies, vaccines, medical devices, clinical consumables, blood products.

“And I have asked the department to work up options for stockpiling by industry.”

An ounce of prevention: UK drugmakers start stockpiling

Pharmacy Business, Kiran Paul, 28 July 2018

Britain’s drugs industry said Friday it is stockpiling medicines to guard against a chaotic Brexit, but urged the EU to do more to protect patient lives on both sides of the Channel.

The action by the Association of the British Pharmaceutical Industry (ABPI) comes after ministers said this week they were working to safeguard supplies of drugs as well as food, in the event Britain crashes out of the EU next year without a negotiated deal.

“Companies have already been starting to stockpile,” ABPI chief executive Mike Thompson told AFP in a phone interview, adding the government was “making sensible contingency plans”.

“We’re being asked to do this for every single medicine that is being supplied,” he said, “and that is the biggest peacetime logistical challenge the industry has ever faced”.

Fears of a disorderly Brexit next March have risen as Prime Minister Theresa May struggles to win agreement for her plans to retain close trading alignment with the EU.

But despite the doomsday talk of shortages of vital supplies after Brexit, May says the public should take “reassurance and comfort” from the government’s preparations for the eventuality of a no-deal Brexit.

Speaking to Channel 5 News on Wednesday, she stressed the government was still working hard to secure a negotiated settlement.

“This is not just about stockpiling. That concept… is about making sure that we will be able to continue to do the things that are necessary once we have left the European Union, if we leave without a deal,” she said.

Britons may have to make some lifestyle changes after Brexit if supplies of imported European foodstuffs run short or jump in price. Medicines, on the other hand, are not so easily changed.

In future, the EU wants all UK-manufactured drugs to be subject to new quality-control tests in European laboratories before they can be administered to patients.

This will disrupt the flow of millions of medicines including a prostate treatment that is currently only made in Britain and is used widely in the EU, according to the ABPI.

“Disease doesn’t recognise borders. We don’t have much time as an industry. We need to be working practically together,” Thompson said.

“My concern is that other (EU) member states are not doing this,” he said of the British government’s contingency planning.

The ABPI groups all the biggest pharmaceutical companies including European and US giants, and Britain’s leading role in the industry was recognised by the EU’s decision to headquarter the European Medicines Agency in London.

But the agency – which is responsible for approving all new medicines sold in the EU – and its 900 staff are due to relocate to Amsterdam after Brexit.

Thompson said that while May’s government has called in a white paper for drugs to be included in future customs arrangements, the EU has yet to spell out how it intends to handle the importation of medicines made in the UK.

“We are hopeful that when the EU responds to the white paper, they will signal they accept those arguments and will agree to continued cooperation,” he said.

Millions of patients could be affected by ‘no-deal’ Brexit medicines shortages, says MHRA chief

The Pharmaceutical Journal, Nigel Praities, 27 July 2018

In an interview with The Pharmaceutical Journal, Medicines and Healthcare products Regulatory Agency chair Sir Michael Rawlins has warned that insulin supply could be disrupted in the face of a ‘no-deal’ Brexit because the UK imports “every drop of it”.

Many patients — including the prime minister herself — could be “seriously disadvantaged” by disruption to the drug supply chain if the UK exits the EU without a deal, the head of the UK’s medicines regulator has said.

In comments made in a “personal capacity” to The Pharmaceutical Journal, Sir Michael Rawlins, chair of the Medicines and Healthcare products Regulatory Agency (MHRA), said that the supply of medicines such as insulin could be disrupted because the UK does not manufacture it and transporting it is complicated as its storage has to be temperature-controlled.

Prime minister Theresa May has type 1 diabetes and is known to use insulin to control it.

Rawlins said that the government needed to “work out how” the supply of some medicines are going to be guaranteed in the event of a ‘no-deal’ Brexit.

He said: “There are problems and the Department for Exiting the EU and the Department of Health and Social Care (DHSC) needs to work out how it’s going to work.

“Here’s just one example why: we make no insulin in the UK. We import every drop of it. You can’t transport insulin around ordinarily because it must be temperature-controlled. And there are 3.5 million people [with diabetes, some of whom] rely on insulin*, not least the prime minister.”

Rawlins went on to say that the government needed to honour its promises that patients would not be disadvantaged by the UK leaving the EU in March 2019.

He added: “Disruption to the supply chain is one of the ways that patients could be seriously disadvantaged. It could be a reality if we don’t get our act together. We can’t suddenly start manufacturing insulin — it’s got to be sorted, no question.”

Rawlins’ interview with The Pharmaceutical Journal was carried out before Matt Hancock, the new health and social care minister, told MPs that “contingency planning” was in place to ensure that “people’s health will be safeguarded in the event of a no deal”, with stockpiling of medications an option being considered. The Pharmaceutical Journal understands from the DHSC that this includes looking at the storage of insulin.

In the interview, Rawlins also said that it was important for the UK to have “associate membership” of the European Medicines Agency (EMA) — as stated by the prime minister — so that it can influence decision-making, and that he hoped to get all the authorisation work for 370 products recently reallocated to other EU agencies.

He said: “We can’t just sit at the edge of the room watching what’s going on, not speaking: we need to have a say.

“We do about a third of scientific assessments for the EMA, so we make a major contribution. The EMA has reassigned the UK’s portfolio of centrally authorised products to other EU member states, but the ideal solution would be to get it all back again.”

Wholesalers have begun talks with the government over the implications of a no-deal Brexit and the Royal Pharmaceutical Society has also expressed concern over medicines supplies.

A Brexit forum representing community pharmacy and other organisations have been set up to share advice and information about any medicines shortages and maintaining the supply chain in the run up to Brexit.

A statement from the National Pharmacy Association, a membership organisation for community pharmacy, said: “Community pharmacists and everyone in the medicines supply chain, need certainty as soon as possible in order to prepare appropriately to meet patient need. The onus is now on the government to achieve that certainty.”

Media And Political Bulletin – 30 July 2018

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