UK drug wholesalers are calling for the creation of two  “duties of supply,” as a way of tackling the continuing shortages of medicines.

The British Association of Pharmaceutical Wholesalers (BAPW), which represents the full-line wholesalers who distribute over 80% of medicines in the UK, has condemned as "shocking" the fact that over 80% of UK pharmacists say it is now more difficult to obtain medicines, as reported in the journal Chemist and Druggist’s annual stock survey this month. This is "an indictment of what used to be an efficient and resilient medicines supply system for patients, doctors and pharmacists,” the group adds.

The  current supply model, which has developed over time in response to healthcare systems and patient needs, is now under significant threat as a result of the “different business models and practices” which have gradually been imposed on the way medicines are distributed throughout the UK, says the BAPW. In the long term, this could not only destroy the patient convenience of the present system but also increase costs to the NHS, it warns.

“Many of us working in the medicines supply chain have been warning that this situation might arise for some time now, but the regulators and authorities do not have the powers to intervene unless there is either a cost to the NHS or patient harm is proven,” says the BAPW.

The wholesalers’ group is calling for consideration to be given to the creation of two clear “duties of supply.” The first, a “patient convenience” criterion, would detail how quickly a UK patient should expect to receive an NHS-prescribed medicine once the prescription has been communicated to the dispenser, while the second, a “timeliness” criterion, would detail how quickly a UK NHS pharmacist or dispensing doctor should expect to receive a medicine following an order being submitted for that medicine.

“By adopting such duties and best-practice criteria, the resilience of the UK’s NHS medicines supply chain might be assured and not be weakened beyond repair,” says the BAPW.

There has been widespread frustration at the perceived lack of progress towards a solution since the government convened a summit on the issue of drug shortages back in March. Critics say the problem is due not only to parallel exports but also to manufacturers’ quota systems, and they condemn the lack of information about what effects the situation might be having on NHS costs.

Asked in the House of Commons in July what estimates the Department of Health has on the effects of parallel trading and manufacturers’ quotas on NHS costs over each of the last three years, Health Minister Simon Burns replied that such costs and savings were “not separately identifiable.”

Nor has the Department made any assessment of the number of patients who have had to wait more than 48 hours to be dispensed medicines after presenting a prescription, Mr Burns added, in response to questions from Adrian Sanders, Liberal Democrat MP for Torbay.

“We are aware of various issues that are causing supply difficulties and delays to the dispensing of some medicines and manufacturers - wholesalers and pharmacists are making additional efforts to ensure patients get their medicines when they need them,” said Mr Burns. “The Department continues to work collaboratively with supply chain organisations to explore further measures to help alleviate the situation,” he added.