In the third of our series of Brexit blog posts, our Policy Director Fiona Loud, talks us through how our exit from the EU may impact on the prescribing of specialised medicines in the event of a shortage in supply.
Kidney transplant patients have to take immunosuppressant drugs to stop a transplant from rejecting. Because these medicines are powerful, you will have been told to take the named brand and dose which you have been prescribed and if your medications change this will only be under the guidance of the doctors. The introduction of generic brands of immunosuppressants in recent years is cost-saving and many of you will have been swapped to them under clinical supervision. However, to avoid unplanned swaps there is already guidance in place. We are concerned that there is a chance that under the Serious Shortage Protocol some of these specialised medicines could be swapped by a pharmacist as opposed to a specialist.
This concern applies to the group of medicines which act as calcineurin inhibitors (CNIs) such as Tacrolimus and Cyclosporine and to the mTor-inhibitors (mTORis) such as Sirolimus and Everolimus.
Having made the DHSC aware of this concern through their limited and very short consultation late last year, we want to see a special arrangement put in place so that immunosuppressants can't be swapped without agreement and monitoring by specialist transplant doctors. Members of the NHS England Clinical Reference Group and Renal Association are working on this with us.
What you can do?
Patients should always continue to take their medicines as directed, and ask their renal team if they have any specific concerns. If you don't recognise the packaging or think you have been given the incorrect medication, don't be afraid to ask. We will continue to work on this and share more information as soon as we have it.
Please note that this is a precautionary move and that no such shortage is in place at the moment.