Even an orderly exit will mean big changes to medicine supply

THE supply of medicines and healthcare products to Ireland is not included in the Government’s Brexit Omnibus Bill to prepare Ireland for a no-deal withdrawal by the UK. Ensuring there are no post-Brexit roadblocks to the supply chain from factory to patient is reliant on expensive and well-planned logistics, rather than legislation, to get ahead of any problems.

A no-deal Brexit obviously poses the biggest risk because medicines bound for Irish patients could face delays at customs and border controls to and from mainland Europe, the UK and Ireland.

But even an orderly Brexit will eventually mean major changes to the way we get our medicines if the Irish health service is to avoid shortages and rationing.

There is reassurance from the Health Products Regulatory Authority (HPRA) that it has been working on contingency plans for two years to ensure continuity of supply, engaging with the Department of Health, HSE, wholesalers, drugs companies and industry groups.

The official message is that “to date no major concerns have been identified and it is considered unlikely Ireland will face general medicine supply issues in the period after March 29”.

It is estimated that up to 70pc of medications provided in Ireland are either made in the UK or sourced via the UK.

However, the biggest challenge will remain around medicines and healthcare products which have a short shelf-life, such as radioisotopes used mostly in cancer care.

Other products such as insulin and vaccines that need consistent cold storage will also need particular attention.

The HSE said that two to three months’ stock of vaccines is held in the national cold chain service which, along with the supplies held by companies, gives a fall back of around six months’ worth of product.

Patients have been told there is no need to stockpile medicines, although there is some evidence of this already happening – and this risks causing unnecessary shortages.

Although the supply of medical radioisotopes, used mostly in the diagnosis and treatment of cancer, has remained under the radar, it is one example of where any interruption in the chain could put patients at risk and lead to cancellation of procedures.

The longer they are delayed, the smaller the useful dose of isotope.

Ireland will remain a member of the Euratom Treaty, which governs the movement of these kind of nuclear materials, but the UK’s status is uncertain if there is a no-deal Brexit.

The HPRA said suppliers have arrangements in place to ensure supply to Irish patients who rely on radioisotopes in around 24 hospitals in Ireland.

With hopes rising that a UK crash-out from the EU may be avoided, the emergency measures to protect Irish patients will hopefully not be needed.