When talking about the ‘B’ word, it’s important to remember that Brexit is a negotiation and we as a country are part of what is very much an active negotiation. One of the remaining powerful cards that UK plc. has left to play is the ‘No Deal’ scenario – a somewhat perverse position that threatens potentially damaging consequences for our EU friends but at the expense of even greater destructive risk to ourselves. But whilst we leave the politicians to their game of Bluff what are the risks to our supply of medicines if we are indeed left picking up the cards?

To give a sense of scale, the UK imports 37 million packs of medicines each month from the EU although it exports even more. More than one billion items are dispensed annually by community pharmacies, and the total bill for medicines is more than £17bn.

Logistically, the supply of drugs is a complex and timely affair. Many of the active ingredients needed are often manufactured in India and the Far East. These are transported to manufacturing plants that turn them into the tablets and liquids that get prescribed to patients. Many of the factories that supply the UK are elsewhere in Europe. From there, they are sent to wholesalers here who in turn distribute them to pharmacies and hospitals that dispense to patients.  In terms of Brexit the key risk identified in that chain is the timely transportation to the UK wholesalers as delays here can lead to tightened supply, increased cost and ultimately – a potential risk to patients.

The Department of Health and Social Care in August 2018 directed pharmaceutical companies to stockpile 6 weeks of additional drug supply above usual buffer stocks to cope with any potential border delays resulting from a disorderly Brexit. It asked these companies to confirm their plans on a product-by-product basis and also put a team in place to monitor the tally. Furthermore, the government has advised that planes are chartered to fly in drugs that can’t be stockpiled, warehouses with refrigeration capacity are rented and additional ports are opened to ease the flow of medical supplies into the country.

This all seems very reassuring but with a 6 week stockpile equating to nearly £2bn and pharmacies getting paid only when drugs are dispensed, who in this chain will front the bill? Like much of the unchartered issues around Brexit, only time will tell. But one thing is for certain; there are a couple of jokers left in this pack of cards.

Devneet Atherton