Shortages

This webpage provides up to date guidance and information on all aspects of shortages.

Next

The latest Medicine Supply Alert Notices will be highlighted in Blue.

Date Released Drug Name Valid Until
20th April 2020 Acetazolamide End of July 2020
11th October 2019 Adrenaline Auto-Injectors Ongoing
13th March 2020 Clonidine End of April 2020
1st May 2020 Convulex® End of May 2020
16th April 2020 Cyclopentolate Hydrochloride Early April
18th May 2020 Cycloserine TBC
1st June 2020 Danazol n/a – action to be taken as soon as possible
21st October 2020 DDAVP® (Desmopressin) Mid-2021
9th April 2020 Diamorphine Hydrochloride Spring / Summer 2020
26th August 2020 Diazepam (Diazemuls®) September 2020
1st May 2020 Disopyramide 150mg Capsules Early May 2020
21st October 2020 Dulcolax® (bisacodyl) Early December 2020
2nd December 2019 Emerade® 31st January 2020
29th September2020 Enalapril Mid-End October 2020
27th August 2020 Esomeprazole early 2021
23rd October 2020 Ferrous Fumarate Late November 2020
23rd October 2020 Fluoxetine Mid-December 2020
29th September 2020 Fluticasone propionate Mid-February 2021
20th December 2019 Haloperidol Date to be determined
26th August 2020 H2-antagonists Various
23rd July 2020 HRT Please check MSAN for dates
25th June 2020 Imipramine Early August 2020
1st November 2019 Jext Ongoing
23rd July 2020 Ketotifen TBC
26th June 2020 Lacosamide w/c 2th July 2020
14th February 2020 Levomepromazine 24th February 2020
15th October 2020 Lithium carbonate (Priadel®) 200mg and 400mg modified release tablets Further Notice
25th June 2020 Lodoxamide TBC
29th Se[tember 2020 Metronidazole (Acea®) January 2021
26th June 2020 Mirtazapine Late July 2020
25th October 2019 Mytomycin-C Kyowa October 2020
26th August 2020 Nabumetone Early November 2020
26th August 2020 Oral Contraceptive Tablets Various
16th April 2020 Penicillamine Late April 2020
29th June 2020 Phenelzine No confirmed resupply date
29th June 2020 Phenytoin Sodium To Be Confirmed
26th August 2020 Prednisolone End of August 2020
29th June 2020 Promazine Ongoing
23rd June 2020 Ranitidine Various
23rd Otober 2020 Salazopyrin En-Tabs® (sulfasalazine) Early December 2020
16th April 2020 Salofalk 500mg - back in stock, 1g - Late July 2020
5th August 2020 Senna with ispaghula husk (Manevac�) granules (Mylan) February 2021
28th November 2019 Slo-phyllin® 28th February 2020
13th July 2020 Sodium cromoglicate (Intal®) Mid-November 2020
18th June 2020 Stanek® & Sastravi® Early August 2020
29th September 2020 Sterculia (Normacol®) Early October 2020
11th August 2020 Sulfasalazine End of September 2020
29th September 2020 Tuberculosis (TB) Oral Agents Various
1st June 2020 Valproate Early July 2020
29th September 2020 Zonisamide Late November 2020
1st June 2020 Zyban® End November 2020
Next
Previous Next

As all pharmacy teams will be aware, shortages are unfortunately a common occurrence and have been for many years. In 2019, we worked with NHS colleagues to agree on guidance which clearly describes what pharmacy teams can and cannot routinely do with the original prescription to ensure a patient’s supply of medication is maintained, without having to go back to the prescriber. The guidance should be read in full, but generally speaking, most possible courses of action are permitted, apart from:

  • Changing a part 7 drug for a non-part 7 equivalent (e.g. Metformin for Glucophage).
  • Changing one drug for another, different drug (e.g. Metformin for Gliclazide)

In relation to the second exception, the Human Medicines Regulations 2012 dictate that prescription only medicines may only be sold or supplied in accordance with a prescription issued by an appropriate practitioner, such as a GP, so it would be illegal to make a change like this. However, this regulation is subject to some exemptions (for example, Patient Group Directions, which allow supply under specific conditions). Serious Shortage Protocols (SSPs) are another, new exemption to this rule which will give pharmacy teams further flexibility to support patients without going back to their prescriber (GP). If issued, SSPs will look very much like PGDs in format, and will be time-limited while a serious shortage persists.

It is important to note that although legislation will permit the issuing of SSPs from 31st October 2019, an SSP will only be considered and issued by Scottish Government if there is a serious shortage of a specific medicine.  SSPs issued in England are not applicable in Scotland, and only Scotland specific SSPs may be acted upon.

If, in the Cabinet Secretary’s opinion, there is, or may be, a serious shortage of a medicine or appliance then he or she may consult, for instance with medical experts, and decide to issue an SSP. The SSP will specify an alternative product or quantity that may be supplied (an alternative strength or formulation, or generic or therapeutic alternative or less of the product) by community pharmacies. Community pharmacy contractors must consider the SSP and, if, in the supervising pharmacist’s opinion – exercising his or her professional skill and judgment – the alternative product or quantity is reasonable and appropriate for the patient, they may supply the alternative product or quantity (only as specified in the SSP and subject to any conditions in the SSP), provided that the patient consents/agrees to the alternative SSP supply.

The dispensed SSP product must be labelled to show that supply has been made in accordance with the SSP and identify the SSP (usually by its number) and the prescriber of the original product (that has not been dispensed) may need to be notified. For reimbursement and remuneration, the appropriate endorsement must be made as provided for in the Drug Tariff and, following the supply of the alternative product or quantity, the prescription (in relation to which the SSP supply was made) is no longer valid.

Changes to certain medicines, even where they are in short supply, will not be suitable for some patient groups – for example those with epilepsy, where changing a patient’s medicine brand or generic manufacturer could cause harm to the patient. SSPs will only specify changes to specific medicines that medical experts believe to be appropriate; and pharmacists will always have the professional discretion not to supply an alternative to any individual patient.

In advance of issuing an SSP, a Medicine Supply Alert Notice (MSAN) may be issued.  An MSAN provides information on the shortage of a specific item, or group of items.  The Medicines Shortages Response Group (Scotland) have developed priority definitions for shortage issues and potential responses depending on the severity of the impact of the supply issue, increasing in severity from a level 1 to a level 4 MSAN.  MSANs will, in the first instance support prescribers and dispensers’ knowledge of supply issues and appropriate responses.  The CPS shortage guidance document produced with colleagues who lead pharmacy primary care services can also support community pharmacy teams with appropriate action to take.

Previous Next
Previous Next

Live Serious Shortage Protocols

Date Released Drug Name Expiry Date
  There are no live SSPs at this time  
     
     
     
     
     
Previous Next
Previous Next

Click to download our flowchart outlining the steps which can be taken to manage shortages in Scotland. You should always start with this flowchart when faced with a shortage. This can be printed for use in your pharmacy.

Previous Next
Previous Next

The full version of this Shortages Guidance is available to download.

We have also produced a quick reference guide in the form of a flowchart. Both of these can be printed for use in your pharmacy.

Previous Next
Previous Next

Please report problems experienced in obtaining medicines. This includes generic items in the Scottish drug tariff part 7, non-part 7 items and branded medicines. The feedback you give us is sent on a weekly basis to the relevant department at the Scottish Government regarding availability and price information, on lines where price can be an issue.

Report a shortage

Previous Next
Previous

In recent years, the number of product shortages has increased due to a number of factors, including rationalisation of production sites, measures taken by manufacturers to control the market for their medicines, the growth in the use of generic medicines (nationally and internationally) and price pressures.

The shortage system was created to address very unusual cases where the generic could not be purchased at a price below the brand or for the price published in the Scottish Drug Tariff. The Scottish Government (SG) has also introduced an adjusted price system to deal with sudden price rises in high volume lines.

We liaise regularly with SG based on information from contractors around lines to attempt to get shortage or adjusted price concessions. However, as the supply chain is UK wide, it is actually driven very much by the Department of Health (DH) and their investigations as to whether a shortage or adjusted price is granted. Download the full Guide 'Drug Tariff Product Shortages & Adjusted Price Setting'

Current Adjusted Prices

Previous
Related Information