Pharmacists call for flexibility amid shortage of drugs to treat strep A and other bugs

‘Serious shortage protocol’ would allow alternative antibiotics to be dispensed without need to contact GPs

Pharmacists are calling on Government to put in place a “serious shortage protocol” to allow them to dispense alternative medicines to patients amid ongoing supply issues on a number of commonly used prescription drugs.

Several forms of amoxicillin and penicillin that would be frontline treatments for patients with infections such as strep A are currently not available in Ireland.

The website of the Health Products Regulatory Authority (HPRA) reports that two forms of the drug amoxicillin are currently unavailable, one of which has been out of stock since mid-October. Neither will be available before mid-February and, in one case, mid-March next year.

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The same is true of certain brands of penicillin, where four brands are listed as unavailable, three of them since last April, because of an “unexpected increase in demand”.

The other commonly prescribed version has not been available since mid-October because of manufacturing delays and is not now expected to be back in the State until Christmas week at the earliest.

“We are looking for the Minister to introduce a serious shortage protocol along the lines of the one brought in in the UK earlier this year,” said Clare Fitzell, head of professional services at the Irish Pharmacy Union (IPU).

“It would allow pharmacists to use their own professional judgment to supply equivalent products to the patient without the need to go back to the GP.”

She explained that getting in touch with already busy GPs could be a time-consuming process, especially as many patients falling sick use out-of-hours clinics. The problem is particularly acute when GPs prescribe a particular brand of medicine. Without their approval, the pharmacist is unable to supply an alternative even where they have it in stock.

The IPU said the amoxicillin shortages include the most widely used brand in Ireland. “There are quite a few products in that range out of stock,” a spokeswoman said.

She said it was possible to source exempt or unlicensed medicinal products from other countries, although that could involve a delay of a day or two.

Other pharmacists noted that as unlicensed medicines did not have an Irish drug code, people would have to pay for them privately rather than having them supplied under the medical card or drug payment schemes.

The IPU first called for such a protocol earlier this year when a shortage of several hormone replacement therapy products in the State sparked concern among customers.

The current supply problems are not unique to Ireland, with other countries across Europe and North America reporting similar issues.

“It is very difficult,” said Dermot Twomey, president of the IPU. Speaking on RTÉ, he said: “A number of key antibiotics that we would dispense on a daily basis are running short and it is very difficult for us as pharmacists trying to provide a good service to the public when we get prescriptions and we cannot fulfil the need.”

He said more shortages were expected. “It is antibiotics at the moment but there are issues around other medicines,” he said. “It is making our job impossible.”

In a statement, the HPRA acknowledged that there were shortages of some strep A antibiotics. “Whilst some EU-wide supply challenges affect some antibiotics currently, there are typically multiple forms, strengths and brands and generic medicines available from a range of sources to treat strep A infections,” the regulator said.

The IPU said the basic message for customers was that they should not be alarmed if a pharmacist does not have a particular product immediately. “It may take an extra day,” it said.

Dominic Coyle

Dominic Coyle

Dominic Coyle is Deputy Business Editor of The Irish Times