The UK government has banned the export of 24 medicines that local community pharmacists have repeatedly found difficulties sourcing.

It follows research by Chemist and Druggist magazine where nearly 85% of the pharmacies they spoke to reported that they’d had issues getting hold of hormone replacement therapy drugs in the last six months, while two thirds had found contraceptive medicines to be in short supply.

In addition, a Serious Shortage Protocol has been introduced for the antidepressant fluoxetine giving pharmacists the option of dispensing a different strength of the medicine than the one on the patient’s prescription.

Supply shortages are not new are not really a product of Brexit preparations. They were a fact of life for High Street pharmacists long before David Cameron started the ball rolling on Brexit. It’s nothing new for a pharmacist to spend a huge proportion of their time on the phone and email trying to track down supplies, though it is, perhaps, getting worse.

Back in March, the pharmaceutical industry trade body ABPI called on the UK government to bring in a temporary ban on the export of medicines to ensure that medicines being put aside for a possible future no deal outcome were not having to be diverted to deal with shortages in the supplies to pharmacists today.

The bottom line is that there is money to be made for those who hold export licences to intercept medicines quite late on in the supply chain to the NHS and divert them, instead, abroad. It is no secret that the extent of this so-called ‘parallel exporting’ increases as the value of the pound drops. Buying in sterling and selling in euros to a wholesaler in a different EU member state can be very lucrative. On top of that, the price agreed for the NHS may be lower than that paid by the local health system in the receiving country.

ABPI was asking for a time-limited restriction to ensure medicines intended for patients in the UK were dispensed to patients in the UK.

Parallel exporting is not the only reason why some medicines are in short supply. The medicine supply chain is complex. Things go wrong in factories and warehouses. A batch that does not meet the standard set out by regulators will never leave the factory gate.

In 2013, the Department of Health in London issued guidance Trading Medicines for Human Use: Shortages and Supply Chain Obligations, stating that “recent increases in the export of medicines are a major contributor to supply problems and risk jeopardising patient care”.

The carefully worded document was endorsed by ten organisations including the bodies for pharmaceutical wholesalers, pharmacists and dispensing doctors, two pharmacy industry trade bodies and the medicines and pharmacy regulators.

The document reminds those along the supply chain of their legal and ethical obligations under the UK regulations and an EU directive to put patients first and maintain supplies. It is careful not to suggest that one link in the supply chain is leakier than any other.

The DH document concludes with the statement:

“The various different parties in the supply chain are asked to bear in mind their obligations in respect of supply of medicines and to be aware of the consequences of exporting medicines for the supply of medicines to UK patients.”

So, if this is about profits – some might use the more subjective term ‘profiteering’ – then might a no-deal Brexit and the imposition of tariffs on goods entering the EU27 put an end to this?

The answer is “probably not”. According to evidence presented by the UK Government to the House of Commons Business, Energy and Industrial Strategy Committee, the longstanding World Trade Organisation Pharmaceutical Tariff Elimination Agreement will continue to keep tariffs on medicines in and out of the UK at zero.

In the meantime, the extent to which exporting has been causing shortages will become clear fairly quickly if supplies of the 24 named medicines stage a recovery.