Sinn Féin spokesperson on Health, David Cullinane TD, has said that a failure to plan for a predictable rise in demand for medicines in response to the winter respiratory infection surge has led to the current major medicines shortage.
Teachta Cullinane said that while global supply constraints are part of the problem, this has been exacerbated by government failure to put in place a proactive medicines supply and management strategy.
Following a meeting with the Irish Pharmacy Union today, he called on government to legislate for serious shortage protocols and to enable pharmacists to practise at the top of their licence, which would allow greater flexibility in the substitution of out-of-stock medicines with appropriate alternatives. He said that government must also examine a ‘pharmacy first’ model for minor illnesses to ease pressure on GP practices.
He called on the government to start thinking radically about how the state manages and ensures a consistent supply of medicines. He added that government has a responsibility to ensure that domestic supply chains and production, appropriately flexible pricing arrangements, and a rapid licensing process for substitute products are all in place.
Teachta Cullinane said:
“The medicines shortage being experienced today is, in large part, a consequence of a failure in planning. The increased demand on the supply of antibiotics, penicillin, and other medications was predicted.
“While not avoidable, there were and are steps which government could take to ease the burden on people, pharmacists, and GP practices caused by this lack of supply. In general, community pharmacy can also play a much greater role in dealing with minor illnesses under a ‘pharmacy first’ model, which would ease in part the pressures currently faced by GPs.
“The government has no strategy to secure domestic production and supply of medicines, to enable pharmacies to provide substitutes without repeat GP consultations, or expand the number of licenced alternatives. We are below the EU average for licenced alternatives, meaning that we are overly reliant on single suppliers of vital medicines where there is the potential for multiple suppliers.
“Ireland has a higher than average ‘single brand availability’ and a higher reliance on licence-exempt products, which makes it more difficult to ensure consistent supply. The State also does not trust pharmacists to advise on appropriate substitutes for out-of-stock medicines, despite this being within a pharmacists’ area of expertise.
“Additional constraints exist on the HSE in the context of older medicines and medicines in particularly short supply where there is no purchase price flexibility. While this is not a favourable solution, it has been pointed out that pricing inflexibility in the context of global supply shortages means that the HSE is at a disadvantage.
“A proactive, strategic, and long-term government-led response is needed, which deals with each of the above to ensure that the state is better prepared for medicine shortages.”