Irish community pharmacists continue to be challenged by the impact of managing medicine shortages and strive to be as pro-active as possible about mitigating the impact of medicine shortages on patients. The IPU run an annual survey to understand the impact of medicine shortages on pharmacists and in our 2024 survey the average community pharmacist was spending four hours 37 minutes a week dedicated to this critical issue.

There is an expectation that the Critical Medicines Act will improve the national availability of critical medicines such as anticoagulants, antibiotics, insulin to name a few of those listed on the Union List of Critical Medicines. However, like all legislation, the positive impact of improved availability for patients, pharmacists and prescribers will require sometime before it is realised. Whilst waiting for this legislation, and the medicine shortages measures within the wider EU pharmaceutical package, community pharmacists continue to call for more pro-active measures to manage medicine shortages at a national level. One such measure is to facilitate pharmacist-led therapeutic substitution, which allows pharmacists as medicines experts to utilise their knowledge and skills to manage therapeutic substitution when medicines are unavailable. Enabling community pharmacists to substitute medicines without reverting to prescribers for a new prescription will streamline administrative processes, reduce delays for patients and alleviate pressure on the health system.

Critical Medicines Act: what does it mean for Irish patients?

The impact of this legislation for the Irish patient should be a positive one. The Critical Medicines Act should lead to a more robust and reliable supply chain for the critical medicines identified, which would ultimately benefit the Irish public. It will be interesting to see how the joint procurement aspects of this legislation will work alongside our existing national legislation, such as the Health (Pricing and Supply of Medical Goods) Act 2013, and HSE procurement policies. Ensuring that medicines are available for supply within the Irish market is one thing; ensuring access to these medicines through the funded community drug schemes is another element, which needs to be considered carefully to ensure equity of care across the entire population.

It is also important that obligations imposed on market actors to provide information under Article 29 of the Critical Medicines Act be carefully considered/implemented to ensure that the EU achieves the ambition of keeping critical medicines available for Member States. It is important that any data on product availability arising from such monitoring should be reflective of the actual available supply of medicines in each member state, i.e. from an Irish community pharmacy perspective this would be medicinal products available for supply on the Irish market. Information on medicine supply availability that does not reflect the current market reality could potentially lead to difficulties in prioritisation of our efforts in regard to these critical medicines.