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Let your next career move come to you.

a question for them as knows about pharmaceutical supply chains

what's the deal with the HRT and contraceptive implant shortage?just reading about it in the Graun and apparently "nobody knows why it is happening". How can this be>?! Surely with all the clever Lean thinkers in the industry it must be possible to identify the problem?

No idea why but shortages of various medications are surprisingly common, constantly getting alerts about trying to avoid prescribing something or other (the implication being that normally I don’t bother and just prescribe the first thing that comes to mind)

in this article it says the UK is uniquely affected in this instance, despite UK government restrictions on exporting the in-demand products

just wondered if they had been moving around manufacturing sites or something

 

The UK (sensibly) approved three main products on the market.  The one made by Theramex ran into a problem with production (glue on their patches, manufactured in China) and the other two manufacturers can't keep up with the demand which the main supplier disappearing has caused.

You are confused Clergs because the Independent and Grauniad are DESPERATE for there to be medicine shortages because of Brexit.  Which there aren't, and won't be.

The approval of medicines and their production is a very complicated process.  Even if there were a fourth supplier they would have to go through the approval process for access in the UK, and why would they bother when they would only have a short period to sell and then when the other three got themselves sorted again they would be down to zero?

Three major suppliers for a product is a lot.  For some products there is absolutely no substitutability and patent protection, so there is only one.  If the manufacturer fooks up supply in those circumstances, patients can die.

so, isn't this a reason why it is NOT sensible to only have three suppliers? shouldn't it be a free for all (assuming you meet the threshold)?

Even if there were more than 3 manufacturers, allowing unlimited approved products on the market might result in one or all of them saying it's not worth bothering with 

interesting 

so, competition kind of has to be tempered to make it sufficiently profitable for anyone to bother supplying the essential supply

I wonder if there are any other industries where a similar dynamic arises

will they stop relying on china in the future? guessing no

The issue is that a medicine costs, on average $2.7m to bring to market.  The launch costs are eye-watering, and the application for marketing authorisation is torturous and expensive.  If a manufacturer feels they won't recoup sufficient profit by launching in a market, they just won't.  If you allow a market to be flooded with identical products which they can't differentiate in, they might not bother.  This is the tightrope that national regulators face, as they are rightly screwed when supply goes awry.  The issue is there is no quick fix - you can't make this stuff overnight.  Setting up production takes years.

will they stop relying on china in the future? guessing no

 

 

The manufacturing and supply chain for pharma is WAAAYYYYYYYY more complex that just "China".  A lot of countries demand jobs be provided in countries in return for market access, so lots of manufacturers have facilities in countries which make no logistical or practical sense, because the government (payers) have demanded it.  

I assume (without knowing anything about this) that the patent has expired and the products are generic. There is no/limited profit in producing generic medicines so probably no other party wants to make them. Also, even if there was, the process of getting approval (a marketing authorisation) is onerous and takes a while as the company has to prove it can make the products to the correct spec and it's all about patient safety etc. Getting an MA can take easily over a year, sometimes two. 

So the first person on this thread to mention Brexit (with replies from Clergs and Wibbles ALL CAPS BRILLIANCE) was a right wing frother who constructed a fabulous straw man and then brutally disembowled it before our eyes.

Phil Stamp, you are a true hard man of Brexit.

tbf he did give us some good facts

(I am a bit astounded that "oh well we have no drugs now" is the upshot but I guess it is a salient reminder of the precariousness of supply chains for all essentials)

The fact that generic ibuprofen has been almost impossible to buy for months now has caused a lot less fuss than I would have expected.

I guess it's not the end of the world as you can still pay £2.50 for a box of Nurofen, but it's crazy that the generic version of such a staple drug can just vanish from the shelves. 

NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may be increased in patients with cardiovascular disease or risk factors for cardiovascular disease. Naproxen is contraindicated in the setting of CABG surgery. NSAIDs can also cause an increased risk of serious gastrointestinal (GI) adverse events, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. Elderly patients and patients with a history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.

one of the shit things about 40 coming down the line is that I am no longer going to be able to read those warnings and think "yeah but that's mostly for old people in their forties isn't it"

alas

 

FWIW when I was on fairly large doses of Naproxen I didn’t have a PPI prescribed. Can’t remember how much they were but the co-cos I was prescribed at the same time were stronger than the ones my wife had at the same time for her c-section.
 

So it’s not like my GP was fvcking around with the dosing...

Phil it's its way too late to reply but I'm doing it anyway. I take exception to your Guardian / Indie strawman that they would love to publish stories about drug shortages due to the B word. 

They didn't mention the B word. Prob cos we haven't properly left yet as you know.

They will probably revel in 'i told you so' stories come 2021. 

NHS had a fixed price Sterling rate to buy it. There are shortages, and because of the devaluation of Stg since the price was fixed, the manufacturers are focusing on sales to more lucrative markets. 

 

Soz if anyone posted. CBA reading this all. 

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