Last autumn, the “vast majority” of a list of branded drugs were supplied only after they had been ordered at least three times by a pharmacist, dispensing doctor or hospital, says a newly-published survey.

Following a similar exercise the previous year, the British Association of Pharmaceutical Wholesalers (BAPW), which represents full-line wholesalers, asked its members to provide it with records of the orders received from all UK pharmacies, dispensing doctors and hospitals for some of the biggest-selling branded medicines in the UK during September-November 2010. The medicines selected had been identified independently as being in short supply by the Pharmaceutical Services Negotiating Committee (PSNC).

The survey found that, while over 90% of the time a “normal” medicine order from a pharmacist would be expected to be fulfilled by a wholesaler immediately at first ordering, only two of the branded drugs achieved a 65% order fulfilment ratio during the three months, and the vast majority were supplied only after they had been ordered at least three times, says the BAPW, which describes the picture as “very worrying.”

The worst supply situation was found for Novartis’ Emselex (darifenacin) tabs 15mg used in the treatment of urinary retention and incontinence, for which just 1.57% of the quantity ordered was supplied. Other low percentages of supplies in terms of quantity of product ordered were found for Boehringer Ingelheim’s Micardis Plus (telmisartan) tab 40mg (8.40% of the order actually supplied) and 80mg (9.57%), Sanofi-aventis’ Co-Aprovel (irbesartan/hydrochlorothiazide) FC 300mg/12.5mg (10.18%), both treatments for hypertension, plus Genzyme Therapeutics’ Renagel (sevelamer hydrochloride) FC tab 800mg (11.33%) for chronic kidney disease and Daiichi Sankyo’s osteoporosis treatment Evista(raloxifene) tab 60mg (11.47%).

The two products for which over 65% of the quantities ordered were actually supplied were Boehringer Ingelheim’s Persantin Retard (dipyridamole) cap 200mg (73.48%), used in the treatment of stroke, and Sanofi-aventis’ antihypertensive Aprovel (irbesartan) tab 300mg (66.11%).

The BAPW says it is even more concerning to note that, almost without exception, the figures for the branded medicines tracked are much worse than the figures reported the previous year. Other European Union (EU) countries, including Germany and France, have legislated to pre-empt similar issues occurring in the countries, using public service obligations and regulations “to protect their healthcare systems from untrammelled market forces,” the Association points out, and adds: “we believe a balance needs to be struck between supply chain incentives and public health obligations.”