RETAIL/WHOLESALE

Berlin  -  In Great Britain a range of prescription-only medicines have been in short supply for months: Pharmacies are reporting difficulties with ordering; their telephone complaints are stacking up with wholesalers and pharmaceutical retailers. At the same time, the industry claims that enough medicines are available. However, the medicines urgently needed on the island are evidently being sold abroad in Europe.

According to information of the Pharmaceutical Services Negotiating Committee (PSNC), 46 prescription-only medicines can only be obtained with great difficulty. These include the osteoporosis medicine Actonel, the Parkinsons medicine Azilect, the impotence medicine Cialis, the anti-depressant Cymbalta, the statin Inegy, the neuroleptic Zyprexa as well as the asthma medications Singulair, Spiriva and Symbicort.

Instead of half a day, pharmacists and patients often have to wait up to two days for the desired medicines, a London pharmacy owner told PHARMA ADHOC. Every day he speaks on the phone for over an hour with manufacturers and wholesalers: "The wholesaler claims that he has no more goods – the manufacturer on the other hand insists that he delivered a hundred thousand packages the day before."

If the desired medication is defective, then the pharmacy has to switch to a different supplier, or most likely ask the manufacturer directly. It is after all precisely the medicines that pharmaceutical firms sell exclusively via certain logistics partners (direct to pharmacy, DTP), that are particularly difficult to obtain, according to British pharmacists.

With their novel sales concepts, the pharmaceutical companies actually wanted to monitor the whereabouts of their expensive medicines and prevent an outflow from British pharmacies into other channels – above all the high-priced US market. However, while the existing import ban to the USA was never lifted, the weakness of the British pound is increasing the demand on the European continent. The former import market has developed into an export market.

Because the wholesale conditions are additionally breaking away as a result of DTP, the export business seems to have become an attractive alternative for some pharmacies. The European reimporters are likely to be happy that they are able to tap the pharmacists, especially as the wholesalers – in the case of DTP pure contract logisticians – are largely becoming an official source of supply.

The manufacturers are banking on the setting of quotas, but the pharmacists claim that this only further aggravates the problem. If these are calculated too narrowly and inflexibly, then it would not be possible to absorb the usual fluctuations on the domestic market with quotas that have already been set, claims PSNC. Ordering difficulties, supply shortages and a tense atmosphere among the stakeholders.

"11 percent of the UK's 12,600 British pharmacies and a tiny number of dispensing doctors are exploiting the system", announced the pharmaceutical lobby recently. The market is apparently oversupplied; the companies often provide a third more than necessary. And yet the pharmacies prefer to export their goods rather than dispensing them to patients, the manufacturers criticised. According to estimations, medicines worth 30 million pounds are exported monthly.

The Medicines and Healthcare products Regulatory Agency (MHRA) also identified the alleged weakness: "Pharmacists exporting medicines or selling stock for exportation by others may be exacerbating existing supply problems or creating new supply problems." According to a proposal of the agency, in the future pharmacies that are not in possession of a wholesale license will only be allowed to sell medicines occasionally, in small quantities and not for profit.

With this alone, the actual problem will not be solved: By law, wholesalers are today already allowed to buy only from manufacturers and other large wholesalers. However, the number of these is on the rise: In 2009 the MHRA issued 203 new wholesale licences – almost twice as many as the year before. Just under 20 suppliers secured a permit in January 2010 alone; a further 97 applications are being processed.

Therefore, the requirements for licensure as a distributor are also to be significantly tightened. The aim of the authority is to reduce the number of licences from the current figure of around 2000. In this way, the risk of counterfeits within the normal supply chain is, on one hand, to be minimized. On the other hand, medications are to again reach the recipients for whom they are intended: the British patients.

Related topics: Difficult times for reimporters
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Janina Rauers, Wed, Februay 24, 2010 10:25am CET