Medicines currently benefit from free movement across Europe. For Ireland, many of the medicines on the market are dual English packs for Ireland, UK and Malta. Brexit has the potential to disrupt the provision of medicines to not only UK patients, but Irish patients too. Why is this?
The medicine supply chain is a complex International trading arrangement. Active ingredients are usually manufactured in cheaper manufacturing bases in Asia, before then being sent to a pharmaceutical company for processing into the tablet, capsule, or liquid that can be taken by a patient. These products may have time critical deadlines – short expiry dates for example adrenaline mini-jets, adrenaline auto-injectors, or may require refrigeration such as insulin biological products, and anticancer agents. Delays at ports and or airports between Ireland and the UK could result in the medicines delivered to the patient having a shortened expiry for use, pushing up the supply required per patient per year. Disruption will place substantial pressure on hospital pharmacy teams who are already continuously responding to supply issues in the present supply chain. Hospital pharmacies are scanning for potential disruptions, taking action by sourcing alternatives and working with prescribers to ensure patients continue to receive a safe supply of medicine.
The EAHP has described medicines shortages that are currently experienced in the pre Brexit era as serious, and a threat to patient care in hospitals, requiring urgent action (EAHP Practice and Policy Medicines Shortages available here). The EAHP has identified medicines shortages as a diversion of significant amounts of the time and attention of a hospital pharmacist, diverting from other tasks. Irish hospital pharmacists daily face an empty shelf when looking for potentially life altering medicines. During the ‘Storm Emma’ disruption many hospital pharmacies in Ireland had to resort to the Irish Army for deliveries of much needed medicines. Imagine a situation where these medicines are not stuck in Ireland at a warehouse, but at an international border.
Brexit has the potential to cause serious disruption to the medicines supply chain, and the British Government have identified this with calls for a minimum of 6 weeks of medicines to be stockpiled in the UK. (https://www.gov.uk/government/news/dhsc-publishes-brexit-guidance-for-pharmaceutical-industry-and-suppliers-of-medical-devices)
The HPAI as the representative body for Irish hospital Pharmacists has written to the Minister for Health to ensure that the Government of Ireland has an awareness of this issue.
Members can view the letter and initial response on the forum.
The HPAI is awaiting a formal response, and plan from the Government of Ireland on this issue that will cause significant disruption to Irish Hospital patients, and has the potential to divert already under pressure pharmacy resources from front line clinical duties. Whilst no one wants a no deal Brexit, even a good deal may result in significant disruption to the provision of these complex goods, and the HPAI advocates that the Government with stakeholders prepare a report and work on mitigating this disruption to Irish patients.