Following the General Election, the risk of a no-deal Brexit has subsided for now. The UK will leave the European Union with an agreement by 31 January. The UK will then enter a Transition Period, which will end on 31 December 2020. During the Transition Period, the UK will remain aligned to EU law, the supply of medicines and access to medicines will continue as it has before.
At the end of the Transition Period, unless a trade deal has been agreed between the UK and the EU, there is a further risk of a no-deal Brexit. We’ve been working with drug manufacturers and the Government to make sure men with prostate cancer can still get the treatments they need, whatever form Brexit takes. It’s unlikely you’ll have any problems getting treatments for prostate cancer – you should still be able to get the medicines your doctor thinks are best for you, and the way you order and collect or receive them should stay the same.
If you’re worried, or if you do have problems getting your usual prostate cancer treatment, get in touch.
In the event of a no-deal Brexit, it will take longer to bring goods – including medicines – into the country, as extra checks will be needed. The Government is working on a system to reduce these delays, but even if this works perfectly we can still expect imports to take longer because of the extra checks. In particular, goods arriving through Dover – which currently receives around 17% of UK imports – are likely to experience delays.
Understanding the impact that medicines shortages could have on prostate cancer patients, Prostate Cancer UK has been working to highlight this concern to Government and ensure that mechanisms are in place to ensure patients can still receive the treatments they need.
This involves speaking with drugs manufacturers and senior officials at the Government’s Department of Health and Social Care, including experts in trade and logistics.
Even before any no-deal Brexit, medicines shortages sometimes happen. For instance, batches of medicines may fail their quality control meaning that production has to be re-run; there may be shortages of specific chemicals used to produce drugs; factories may be closed down by safety concerns or industrial action, or transport and logistics issues may make it difficult to transport medicines.
Generic, or off-patent, drugs can be shielded from some of these influences as multiple manufacturers can produce them, however, shortages of generic drugs still occur.
A number of systems are already in place to deal with medicines shortages:
There is a team at the Department of Health and Social Care that is responsible for dealing with medicines shortages. It works with the manufacturer(s) to understand the cause of any shortages, what might help, and when the problem should be resolved. Prostate Cancer UK has spoken to this team about their plans and will work with them in the event of any medicines shortages post-Brexit.
The UK has a system to stop price fluctuations from impacting patients’ access to these treatments, called the concessionary prices scheme. This system is designed as a short-term measure until prices return to normal.
The Government has brought forward legislation to create a serious shortages protocol. This would allow pharmacists to prescribe different treatments in the event of medicines shortages. Alternative treatments would be recommended by clinical experts and explained to pharmacists. This protocol is unlikely to be used unless there are serious and sustained shortages of treatment, along with an alternative treatment that can safely and easily act as a substitute. We would recommend men speak to their doctor about any changes in treatment.
The Government recognises that the continued supply of medicines is essential to patients and so has taken a number of actions to guarantee this and prioritise the import of healthcare products over other goods.
The Government:
Read the latest information on Government activity.
All the nations of the UK are working very closely together to deal with any potential problems. In Scotland, they have set up an ‘NHS Scotland Medicines Shortages Response Group’ to feed into wider UK activity. Wales and Northern Ireland are also working closely with the UK nations, and Northern Ireland’s Department of Health has put together a dedicated FAQ on Brexit preparations.
In particular, we have sought clarification about the supply of radium-223 (Xofigo®) given to some men with advanced prostate cancer. This is a radioactive medicine that decays over time and so there is a time limit after which it is no longer likely to work if given to the patient. As a result, it cannot be stockpiled. The manufacturer has assured us that this treatment will now enter the UK by air, which should guarantee no shortages.
The Government and NHS are treating clinical trial medication the same as other medicines. Organisations running clinical trials have been encouraged to consider their supply chains and ensure that appropriate supplies of trial drugs are in place. The manufacturers of trial drugs are the same ones that provide medication to the general public, so we don’t expect patients or organisations to experience any additional difficulty in getting the trial medication they need.
The official advice is to keep ordering your repeat prescriptions and taking your medicines as normal. It is unnecessary to change how you order and take your medicines.
It's important you don't ask for more medicines than you normally need, doing so risks pressure on availability of medicines for other people.
Until 31 December 2020, every UK citizen who lives, work or travels abroad will be able to use the European Health Insurance Card (EHIC). This also applies to EU citizens in the UK.
It is unclear at this point exactly what will happen to EHICs after the transition period, but it is best to assume that they will no longer be valid. We would advise anyone travelling to the EU, EEA or Switzerland to ensure they have health insurance cover. UK nationals living abroad are also likely to require new health insurance arrangements, but these may vary depending on the policy of the country you are living in.
Read the latest NHS advice on EHIC cards.