Shortages of medicines

Last updated: February 07, 2020

Key points
  • Many 'shortages' are not nationwide. They can happen because one wholesaler or local pharmacy is out of stock.  
  • Nationwide shortages may involve only one brand, strength, or formulation.
  • The Department of Health and Social Care (DHSC) publishes a monthly index of all national shortages. 
  • If you need to swap a patient to a completely different medicine then there are many factors to consider, including whether it is your role to do this or a job for a specialist (see e-learning below for more).

Info sources

✦  MIMS has a drug shortages tracker on its home page.
✦  Manufacturers' customer services departments can clarify if a shortage is real, the products affected, and how long it will last. They may also have alternative ordering processes in place when a shortage occurs.
✦  The SPS website has notifications about national shortages. They explain the problem and can offer solutions such as alternative suppliers or medicines. A password-protected section of the same website has a regular DHSC bulletin on a wider range of shortages in alphabetical order, but you must register with the site using an NHS email address and be logged on before you can see this.
✦  Specialist clinical organisations such as Royal Colleges may offer advice for some shortages.
✦  Look in the BNF or eMC to see what alternative brands or products might be suitable for your patient.
✦  NHSE has a national guide to managing shortages explaining how you will be notified about them and explaining how they are categorised in terms of risk from Tier 1 (low impact) to Tier 4 (critical). 

Decision making

It is not possible to cover every eventuality, but the five questions below may help you make decisions about managing a medicine shortage.
1. Can the medicine be stopped? (It is no longer required, not essential, or there are non-drug options.)
No          Yes  Stop the medicine if it is safe and appropriate (e.g. consider withdrawal reactions).
2. Is this a local supply problem? (e.g. one wholesaler out of stock; one pharmacy out of stock.)
No,  it's a national shortage          Yes  Obtain from a different supplier; try another pharmacy.
3. Does DHSC guidance or other Info source above assist you? (NB you must register with the SPS site before you can see DHSC guidance.)
No          Yes  Follow DHSC or other guidance
4. Can you swap to a different brand or formulation of this medicine? (BNF, MIMS, or eMC may help with options.)
No          Yes  Swap to different brand or formulation, if suitable
5. The patient may need to switch to a different medicine. Is it your role to do this?
No  Refer to prescriber            Yes  Our-e-learning below may help you

Our e-learning examines some of the issues you need to think about if swapping a patient to a new medicine because their current one is unavailable. It only takes about 15 minutes. Click here to start.