Over 300 confirmed cases of Coronavirus were reported by Tuesday 10th March across the UK. As the country battles the virus outbreak, authorities have urged individuals not to panic-buy medical and hygiene supplies and asked pharmacies not to hoard essential generic medicines. This comes after India’s announcement last week where it imposed restrictions on the export of 26 pharmaceutical ingredients and the medicines and vitamins made from them. The supply of drugs likely to be affected owing to such restrictions includes paracetamol, vitamins B12, B1 and B6 among various other antibiotics, leading to fears of a global shortage of essential medicines.
UK imports 40% APIs from India and China
Dr. Bharat Shah CBE is the Co-Chairman of Sigma Pharmaceuticals which distributes packets of medicine every month, supplying pharmacies, hospitals and dispensing doctors via a next-day service. Speaking to Asian Voice, he said,
“For the last few months, there has been shortages of various generic medicines in the UK owing to several reasons including a shortage in raw material supplies from China, issues in regulatory and technical areas of production, issues in consolidation of pharmaceutical companies and finally the Brexit cloud. To make things worse, we now have a coronavirus issue developing in the UK.
“Now India’s declared restriction on the export of 26 pharmaceutical APIs (Approved Pharmaceutical Ingredient) directly applies to the finished formulations such as tablets, capsules, creams, and liquids. The pharmaceutical industry relies on supply ‘just in time’ and therefore, any issue that delays the delivery of APIs will result in disruption of the supply chain.
“The restriction of exports of the 26 pharmaceutical ingredients will certainly have a huge impact in the UK as it will further de-stabilise the already disrupted generic market.”
Shah says that his company imports essential medicines related to diabetes and other ‘painkillers’. Although it represents a small percentage of their total business, he is concerned about a domino effect in the market, where according to him, pharmacists are purchasing “more than normal quantities of medicines (‘in other therapeutic areas’) from us causing stock issues at not only distribution level but also at the manufacturing level”.
Panic-buying and stockpiling
He asserts that the class of medicines restricted by India is commonly prescribed in the NHS. According to him panic buying and stockpiling is bound to affect the supply chain and will cause price increases and possibly, medicines being bought from unregulated supply chain such as some internet companies.
India's drug makers rely on China for almost 70% of the active ingredients in their medicines, and industry experts have warned that they are likely to face shortages if the epidemic continues. The U.K. medicines regulator estimates that Chinese manufacturers make around 40% of all APIs used worldwide. Restricted supplies both from India and China will have a cummulative effect on the UK’s pharma industry among other global countries. However, urging pharma companies to remain calm, a spokesperson for the British Generic Manufacturers Association (BGMA), in a statement to Asian Voice said,
"The Indian Government’s action applies to 1% of Indian pharmaceutical exports and is not a blanket ban. Due to the high levels of API held by manufacturers, our assessment remains that it is extremely unlikely that disruption due to COVID-19 will impact medicinal supplies in the UK in the short to medium term.
“We continue to assess the situation, working closely with the Government and other industry and official bodies, to mitigate the effects of potential longer-term impacts to supply, which could be exacerbated as a result of similar actions by other countries. Part of these efforts include companies conducting thorough risk assessments of their global supply chains."
Restricted dental masks and hand gels
Amidst concerns around the manufacturing of these medicines is also anxiety around their distribution as key travel systems (flights, ship containments et al) from China remain suspended. While none of the high-street pharmacies have yet reported of panic-buying or shortage in supplies of generic medicines, other medical equipment is fast running out of shelves.
Earlier, last month the British Dental Association (BDA) had warned about the shortage of face masks sparked by the coronavirus outbreak unless rationing is eased. The BDA reports rationing has now left some practices unable to order more than 2 boxes of masks per day around 100 masks irrespective of their size.
"In recent weeks dentists have been hit by panic buying and rationing that has left many larger practices with few options. Unless we see a rapid increase in supply dentists without face masks will have little choice but to down drills," warned BDA Chair Mick Armstrong.
Boots and Lloyds have already confirmed that they are limiting customers to two bottles of hand sanitiser each as bulk buying of the product increases with the spread of the coronavirus. Tesco has limited shoppers to buy no more than five packets of certain goods, including antibacterial gels, wipes and sprays among others. Demand for the hand sanitiser gel has sky-rocketed following the outbreak of coronavirus with some online pharmacies such as Medino reporting a 1000% increase in the sale of these products.
“We’re in regular contact with both our members and the Government about any impact that the coronavirus could have on medicine supply in the UK.
“There are robust procedures in place to manage the supply of medicines in the UK, and companies will be taking all possible measures to secure supply for patients - in line with Government guidance,” Richard Torbett, Chief Executive of the Association of the British Pharmaceutical Industry (ABPI) said in a statement.
As part of the NHS’s ‘containment’ program, it has now unveiled a range of measures to stop fake news around Coronavirus to be spread on the internet. The government has also announced that it will extend shop delivery hours to ensure that supermarkets have basic items, amid stockpiling concerns.
In the meantime, ahead of delivering his first budget chancellor Rishi Sunak has already re-written a quotient of the budget stressing that the NHS will be well-equipped with essential resources to combat the virus. In a statement to The BBC, he pledged,
"I can say absolutely, categorically, the NHS will get whatever resources it needs to get us through this crisis. And I am keen to make sure when we get through the other side, we haven't lost these great small businesses permanently."
