- Government officials reportedly admitted an “increased medicines bill” could result from air-freighting some cancer treatments
- Unclear if trusts will be helped to manage these extra costs
- Royal College of Radiologists warns officials need to schedule delivery of isotopes to trusts to avoid a “cascade” impact
- Relationship with Euratom not resolved
Medical air freight costs could be “passed on to hospitals” in the event of a no-deal Brexit, a royal college has reported after a briefing from government officials.
Referring to a meeting with the Department of Health and Social Care last week, the Royal College of Radiologists said its officials were unable to confirm whether funding would be provided to trusts to help with the costs.
In a published statement, it said officials had confirmed an increased bill for urgent medical products and medicines was a potential outcome of air freighting and “could not comment on whether funding might be available to help hospitals manage extra costs”.
It added: “[An] anticipated unwelcome consequence could be increased air transport costs being passed on to hospitals”.
The government announced yesterday it had booked “space on aeroplanes for products that require an immediate shipment due to short shelf life or specific storage conditions”. It said the planes would fly between Maastricht and Birmingham.
The RCR has particularly been asking about radioisotopes, which are used to diagnose and treat some cancers. They are one of the major medical products that would need to be air freighted into the UK in the event of a no-deal Brexit, as the material decays too quickly to allow it to be stockpiled. The application of the potential bill for trusts more widely is not known.
The RCR also said if the delivery of medical isotopes to trusts was not properly scheduled, it could create a “cascade” effect that could “impact on other services” such as MRI scans.
It said radioactive substances need to reach hospitals early in the morning to be administered. If they were not available, this would “significantly and adversely impact on the amount of radioisotopes that hospitals need to order and budget for”.
The college said officials at the meeting also reported: “NHS England had not conducted specific prioritisation and product substitution planning to help providers who may be unable to access particular radioisotopes.”
The RCR and British Nuclear Medicine Society are now urging officials to address these concerns “particularly as scans and staff rotas are planned many weeks in advance and because supply issues could and would cascade down to impact on other services – for example, needing extra MRI machine capacity to scan patients who would normally have had a nuclear medicine scan”.
The Department of Health and Social Care said in a statement: “We recognise manufacturers may incur additional costs when switching to air freight for certain medicines, as part of our contingency programme, and we are considering how best we might support these suppliers.”
RCR said its meeting with DHSC on 21 February also included the BNMS, other clinicians and multiple government departments.
Customs and Euratom
Suppliers will also have to include new customs declarations for inbound products in the event of a no-deal Brexit. RCR said the government wanted to “mitigate” the impact of these new declarations, which might include increased paperwork or time spent at borders.
It said: “Officials also admitted that the EU could choose to impose additional customs requirements before radioisotope shipments leave EU countries for the UK, which we can only speculate upon, and over which we have no control.”
The statement by the RCR also confirmed that talks between Department for Business, Energy and Industrial Strategy and EU about its post-Brexit relationship with Euratom “have yet to take place”. The Euratom treaty regulates civilian nuclear activity and supports the “secure and safe supply and use of medical radioisotopes”.
Last week Sanofi, the pharmaceutical firm, told HSJ it was “in discussions [with DHSC] about who should pick up the bill” if the company has to air-freight flu vaccines. These cannot be stockpiled as this year’s vaccine is still in production. It is thought these costs cannot easily be passed onto the NHS as GPs have already signed vaccine contracts with suppliers.
Correction: This story was updated at 10:20am on 27 February to change “Royal College of Radiology” to “Royal College of Radiologists”
The Royal College of Radiologists statement, government statement
26 February 2019; 25 February 2019