NHS trusts slammed by DH over 'unacceptable' plans to export drugs

The DH’s chief pharmceutical officer Keith Ridge has written to all NHS trusts, castigating a “small number” that have been considering exporting the drugs.

Dr Ridge said it was particularly irresponsible to export pharmaceuticals at a time when the supply chain was threatened by the swine flu pandemic.

He warned the plans were “wholly unacceptable” and “threaten patient care”.

A source close to the DH told HSJ senior NHS managers and financial directors had been “putting pressure” on hospital pharmacy departments to cash in on the burgeoning export market in UK medicines.

The source said the letter was intended to give hospital pharmacy departments “a weapon to wave under their finance director’s nose” to give them the power to resist the pressure.

One NHS finance director shown the letter by HSJ said he was “gob smacked” any trust would consider such a move. He said: “Somebody is skirting with a public accounts committee appearance if they are caught.”

Another senior source said it was “surely a misuse of public money to run an import and export business funded by the tax payer”.

The opportunity for trusts to make substantial financial gains from exporting medicines has arisen because of the low value of the pound and the DH’s pharmaceutical price regulation scheme, which keeps UK medicine prices low. Over recent months the UK market has become a target for dealers aiming to buy drugs in sterling and resell them in countries such as Germany where prices are higher.

Pharmacists have warned that this parallel trade in pharmaceuticals has caused shortages in medicines and delays in patients getting certain drugs. These shortages have been exacerbated by quota systems enforced by manufacturers who have attempted to ration each pharmacy to just their expected volume of each drug to prevent them ordering extra supplies for export.

Drugs in short supply include Myfortic, which is used to prevent rejection in kidney transplant patients. Analysis by the Association of British Pharmaceutical Industries found that manufacturers have increased supplies by 65 per cent to cope with the extra demand.

The timing of the letter is significant as the DH is concerned the entire pharmaceutical supply chain could be disrupted if the flu pandemic worsens.

The department is now preparing to stockpile huge quantities of drugs and has asked pharmaceutical suppliers to bid to supply 445 separate lots of the medicines an expert group determined to be the most vital for NHS patients.

The list includes several drugs which are current in short supply, including the generic version of Myfortic (mycophenolate).

The three biggest orders are for 1.3 billion packs of lactulose liquid – used to treat chronic constipation, 1 billion packs of methadone and 486m packs of simvastatin.

A spokeswoman for the DH said the drugs on the list are not those the department anticipates will be more heavily demanded due to the pandemic, but rather represents an attempt to stockpile reserves of the most vital drugs in case international supply chains and pharmaceutical manufacturing grind to a halt due to the pandemic.

The DH will not receive all the drugs immediately as that would cause some to deteriorate. Instead it is asking suppliers to store the drugs in the UK and to manage their stocks to ensure a fresh supply is available if needed.

Although most experts have predicted the flu pandemic will last just two years the DH has set the contract period for the emergency stockpile at five years, with a break point after two years.