The NHS is running low on dozens of lifesaving drugs, a report shows.
A Department of Health and Social Care document, leaked to The Guardian, reveals the health service is short on medication for everything from cancer to epilepsy.
“Ongoing issues” are affecting 69 different types and doses of drugs, with eight being discontinued.
One is a drug for stomach and pancreatic cancer, which has “no alternative” in the UK.
Doctors have been told to prioritise some patients over others and even break tablets in half to meet demand.
Experts blame Brexit stockpiling and a “change in pharma companies’ behaviour” for the “alarming” turn of events.
“This situation is absolutely unprecedented,” Dr Nick Mann, a London GP, told The Guardian.
“Previously we would have one or two or three drugs that would go offline for a while, but this is something on a different level.”
Figures from the NHS Specialist Pharmacy Service show more than 900 drugs have been in short supply since 2014, Pulse reported.
With things taking a dramatic turn for the worse, the 24-page document was circulated to some doctors last week, with a warning the information was “confidential to the NHS”.
Last week alone, 17 new drugs were in short supply. These treat a range of conditions including mental-health problems, eye conditions and Parkinson’s.
The sole supplier of a cyanide-poisoning drug is also experiencing “long-term out-of-stock issues”.
And two suppliers are out-of-stock for antibiotics for tuberculosis, with a third “unable to support any uplift in demand”.
Stocks of diamorphine, which relieves severe pain, is “insufficient to cover full forecasted demand”.
And an anti-epilepsy drug will be out-of-stock until March next year. Dr Mann warns medication is not “interchangeable” for these patients.
For the stomach and pancreatic cancer drug, doctors were told to consider making some patients a priority, namely those “completing a course of treatment and those already booked for surgery”.
The Parkinson’s drug procyclidine is also out-of-stock until March next year. The document recommends pharmacies “share remaining stock locally”.
For the migraine drug Relpax, medics were advised to break higher-dose tablets in half.
The document admitted, however, “there is no data” supporting this as an effective treatment.
A lack of licensed drugs means unlicensed alternatives may be called in, with import times “varying”.
Medications are normally licensed to treat a specific condition.
Doctors can prescribe other drugs for the disorder “off label”, however, the outcome is less certain.
In better news, the report claims supply issues that affected 20 drugs have been resolved.
Dr Mann blamed a number of recent events for the incident.
“Beyond Brexit stockpiling and manufacturing diversions, and parallel exporting, there appears to be a change in pharma companies’ behaviour causing a potentially dangerous level of instability in previously reliable, standard treatments,” he said.
The UK’s medicine supply chain is “intrinsically integrated with the rest of the EU”, according to Professor Key Sander, medical director of the Epilepsy Society.
Products often cross the UK-EU border several times. In the event of a no-deal, the UK could become a “‘third country’ with delays at the borders”.
The Royal Pharmaceutical Society claims “manufacturing problems, global demand and fluctuations in the exchange rate” could all be to blame.
And with the UK negotiating some of the cheapest drug deals on the market, it “tends to be the last place manufacturers will put stock into because they can get a better return somewhere else”, community pharmacist Fin McCaul told HuffPost.
A spokesperson from the Association of the British Pharmaceutical Industry added manufacturers do “everything they can” to prevent these incidents occurring and try to resolve them as quickly as possible.
What to do if your medicine is in short supply
Running out of a drug you need is sure to cause anxiety, but there are things you can do to get your supply back on track.
Your pharmacist should be the first port of call, with them being able to phone up other branches to check their stock.
When it comes to your prescription, it may also pay to be prepared.
Professor Sander recommends taking your prescription to a pharmacist up to a week before you need it.
This gives them time to call it in if necessary.
And if you have a regular prescription sent electronically to a specific pharmacy, consider asking your doctor for a handwritten one.
This will more easily enable you to “do the rounds” of local pharmacies if required.
You could also ask your pharmacist to point out “legitimate” online pharmacies, being careful to avoid counterfeit drugs.
While it may be tempting, do not stockpile medicine, as this could put another patient at-risk.
After Brexit, the Serious Shortages Protocol will allow pharmacists to dispense alternative drugs to those prescribed by a GP if one is in short supply.
This will only be done in extreme circumstances. For safety reasons, certain patients - like those with epilepsy - will not be eligible.
Patients are also entitled to turn down the new medication offered to them, Professor Sander added.