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Posted (edited)

I had this problem recently when I couldn't get antibiotic eye drops anywhere which I needed urgently for an eye ulcer.

Wholesalers had run out.

I had to get a new prescription for an alternative antibiotic. Might whoever has prescribed yours be able to suggest an alternative, even on a temporary basis, or is that not possible?

I have read that this is happening all over the country. I believe it is partly but not wholly to do with Brexit.

What seems ridiculous to me is that there is apparently no central system to be able to find out  what wholesalers/pharmacies have a particular medication in stock.

People who need urgent treatment are stressed enough already without having to phone round themselves to find a place who has what they need.

Edited by Sue

Yes, it's crazy! I called the doctor to see if there's any way to find out who has them, and they just said I need to call around. Unfortunately I can't really take an alternative. I've finally found one that has 17 days worth, so I'm going to run before they get taken before me. 🙂  I had called 30 different pharmacies in South London, madness.

  • Sad 1
Just now, radnrach said:

Yes, it's crazy! I called the doctor to see if there's any way to find out who has them, and they just said I need to call around. Unfortunately I can't really take an alternative. I've finally found one that has 17 days worth, so I'm going to run before they get taken before me. 🙂  I had called 30 different pharmacies in South London, madness.

You have my complete sympathy.

In my case, I discovered you can't even go to an eye emergency clinic any more. You have to phone round opticians on a list who are part of a scheme.

The only one in East Dulwich who was part of the scheme had a six week waiting list. That isn't very helpful when you are in danger of going blind.

I was lucky that another East Dulwich optician told me to try one in Crofton Park, who was able to see me that day.

They told me it was good that the ulcer had been caught early. Hollow laugh. It was three days and a long long saga  before I could get the eye drops.

Ironically, I paid for a private prescription rather than the optician sending it to my GP to prescribe because I thought it would be quicker 😭

And then I couldn't get the effing drops anywhere anyway.

  • Sad 1
Posted (edited)

I see that in Nottinghamshire the local NHS Area Prescribing Committee is recommending that prescriptions should be for generic methylphenidate, giving their pharmacists the option of supplying any brand (or presumably a generic product). https://www.nottsapc.nhs.uk/media/bw5df5pu/methylphenidate-pil.pdf

It might be worth checking with your local pharmacist(s) to see whether this will help them if, as I suppose would be necessary, your GP issues a replacement prescription.

I'll have a look around our local NHS websites now, to see if I can find anything there.  Nottingham, btw, provide more information, nominally for clinicians, at https://www.nottsapc.nhs.uk/media/vwxjkaxa/adhd-medicines-supply-advice.pdf.  And at https://www.nottsapc.nhs.uk/adhd-shortages/.

 

Edited by ianr
16 minutes ago, ianr said:

It might be worth checking with your local pharmacist(s) to see whether this will help them if, as I suppose would be necessary, your GP issues a replacement prescription.

I'm not sure pharmacists have any discretion to alter specific medication prescriptions, although they can choose supplier where a generic is prescribed which may be offered by more than one company. This will only be for older medicines which are effectively 'out of copyright' . They can't issue alternatives on their own authority as they don't know what counter-indications there may be for specific patients. GPs may prescribe a specific supplier of a generic medicine where, for instance, they know patients have an adverse reaction to e.g. the medicine casings, so the Nottinghamshire directive to specify only generics where available may not always be helpful. 

Posted (edited)

Noted. I wasn't quite sure from their material whether the 'ad lib' supply by pharmacists had to be mandated; hence the suggestion to check.  There are plenty of individual manufacturers of generic methylphenidate, probably quite a bit cheaper too.  I'm afraid I didn't see radnrach's "can't really take an alternative", so apologies for presuming otherwise.  For myself I'm generally willing to trust that any manufacturer's offering of, say, 27 mg methylphenidate hydrochloride tabs, would contain that, and I'm not too worried about the minor quirks of things like their slow-release technology.

I think it's likely that the medicines Serious Shortage Protocol does definitely give pharmacists some degrees of freedom. But it's apparently not in operation here. See the Minister's recent reply to a written question: https://questions-statements.parliament.uk/written-questions/detail/2023-11-13/1660#.   , which seems to approximate to: we can't apply the shortage protocol here because the drugs are in short supply.

Edited by ianr
  • 2 weeks later...
  • 3 weeks later...

Not sure if this applies to the specific drugs mentioned above but recently I was looking for antibiotics my toddler had been prescribed. I went to five different pharmacies in the area and they all said they were out. Finally the bigger one in Nunhead explained to me why. Apparently for every prescription the pharmacies complete they get a set fee (I don't remember exactly but £20 or so) but this is fixed whatever the price of the drug is. The Dr had prescribed a drug that was more than £20 for the course, so any pharmacy who completed the prescription would lose money. Hence none of them stocking it. Seems like a totally mad system!

Posted (edited)
6 hours ago, Nigello said:

I’d have thought that the professional body that oversees chemists would like to know about that, even if it condones it so as to keep records as a way of putting pressure on whoever makes up the rules. 

Surely if this is true (and it seems bonkers to me) and this professional body doesn't already know about it, then they can't be very professional?

Who are they, and what are they supposed to be there for?

I would have thought other reasons for the short supply of some medication were more plausible, but what would I know?

Surely pharmacists themselves have some kind of professional responsibility to supply prescribed medication where it is actually available?

Edited by Sue
  • Thanks 1
Posted (edited)

The NHS Electronic Drug Tariff, which is updated monthly, is viewable online.  Here's the current version, opened at Part IIIA, professional fees:  https://www.drugtariff.nhsbsa.nhs.uk/#/00859526-DC/DC00859454/Part IIIA - Professional Fees (Pharmacy Contractors).   The basic fee in England for dispensing an item is shown there as £1.27.  I see that  £20 appears as the dispensing fee for medicines that aren't on the standard list of licensed medicines.

The prices for the medicines themselves are in Parts VIIIA (standard licensed medicines) and VIIIB (unlicensed, etc).

There's also a FAQ page https://faq.nhsbsa.nhs.uk/knowledgebase/article/KA-01473/en-us which partly explains the categories A, C and M that appear throughout the price lists. 

There appear to be some ongoing revisions to the reimbursement scales that I don't know anything about.  There are obviously people actively in charge of what appears to be a large and complex system, which I also don't know much about.  The current problems seem to me to be largely about ongoing wide shortages of a significant number of medicines.   Why they've occurred and how they may be remedied I don't know.  If anyone wants to research this I'm sure there will be be some competent  commentaries  somewhere on the web.   I'd be glad myself for pointers to any usefully well-informed and informative articles. (And please also include any detailed stuff about any systemic quirks or faults that might make some transactions unprofitable for pharmacists.)

 

 

Edited by ianr
Added final sentence
  • Thanks 2
  • Joe changed the title to Problems finding Delmosart and other medicine in pharmacies
  • 3 weeks later...

Interesting post by a courier today:

 

"

Want to know why pharma  is so hard to get in the U.K. ?

A friend of mine has been stuck since 6AM Monday at a port in the U.K. coming into the U.K. because of a problem with paperwork . 

In a fridge van that’s been running non stop .. 

It’s now Thursday"

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