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G. Comments of a general nature, including a description of the
elimination of restrictions notified under D.2.2 and the date they ceased to
be in force.
1._ The UK is notifying the addition of 20 medicines to the list in
critical short supply, in lieu of other shortage mitigations taking effect.
2._
Molnupiravir and Nirmatrelvir (3004.90.00) are antivirals
used to treat patients who remain at risk of Covid following the vaccination
programme. The UK is further protecting existing supply by placing limits on
the amount of each drug that can be ordered from any community pharmacy.
3._
Semaglutide,
Dulaglutide, Exenatide, Liraglutide and Insulin/GLP-1 combination (3004.39.00) are critical
medicines used in the treatment of Type 2 diabetes. A global supply problem
with these medicines is expected until mid-2024. There are alternative
classes of medicines available to treat Type 2 diabetes; however, switching
to an alternative medicine can cause complications for patients.
4._
Glucagon
powder for injection and pre-filled syringe (3004.39.00) is a critical medicine used in the treatment of severe
hypoglycaemia and beta blocker overdose. There is an intermittent supply
problem and licensed alternatives are also in short supply; however, the UK
is regularly engaging with the manufacturers to monitor stock levels.
5._
Progesterone
100mg capsules (3004.39.00) is used in
hormone replacement therapy for post-menopausal women. There is no licensed alternative
available, however the UK has issued a Serious Shortage Protocol (SSP) to
limit the amount that a pharmacist can dispense to a maximum of two months'
supply.
6._
Permethrin 5% Cream (3004.90.00) is a medicine used to
treat scabies. The disruption has been caused by an uptick in demand. There
is no direct alternative medicine available, but the UK has engaged manufacturers to take
steps to increase supply.
7._
Ketamine (3004.90.00) is an anaesthetic used in short procedures
not involving intense pain. Although a limited supply of an alternative has
been diverted to the UK by the supplier, this is not sufficient to meet
demand.
- Bupivacaine with Fentanyl and Levobupivacaine (3004.90.00) are used for pain
management and the induction of anaesthesia, particularly for epidural
procedures. Supply has been restricted for use in epidural procedures as
no other alternative medicines are available.
9._
Human corticotrophin releasing hormone (3004.32.00) is used to diagnose
Cushing's syndrome, a hormonal disorder. There is no direct alternative
available and the UK has prioritised the use of existing supply for specific
specialist centres.
10._
Hyoscine hydrobromide (3004.90.00)
is used to treat travel sickness symptoms. Supply has decreased due to the
closure of the manufacturing site, however transfer to a new manufacturing
site has been scheduled.
11._
Bumetanide (3004.90.00)
is a critical medicine used to treat oedema. The disruption has been caused
by issues with the supply of the active pharmaceutical ingredient used to
produce the medicine. Although there are alternative medicines available,
some patients may be intolerant to these.
12._ Methylphenidate
hydrochloride, Atomoxetine, Dexamfetamine sulfate and Guanfacine (3004.90.00) are critical medicines used to
Attention Deficit Hyperactivity Disorder (ADHD). Advice has been given to
healthcare professionals to manage existing supply as global demand for ADHD
products increases.
13._ The UK is
also notifying minor technical changes to existing medicines on the
restricted list.
14._ Two
duplicated listings of steroids used to treat a wide range of health
conditions, Dexamethasone (tablets and capsules) and Dexamethasone (oral
solution) (3004.32.00), are being combined into one listing, Dexamethasone
(All) (3004.32.00).
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