The Pharmacist September/October 2018 - Page 13

75% of the NHS’s daily medicine use comprises generic medicines, of which around 80-90% are imported hink back to June 2016, when the UK voted to leave the European Union (EU). What did you imagine would be the greatest changes to come from Brexit? That Britain would be able to ‘take back control’ from European bureaucracy? That holidays on the continent might become more expensive? That the value of the pound was at risk? It may not have been the first consequence to spring to mind, but Brexit could have a profound impact on the UK’s crucial stock of medicines. The trade and supply of drugs between the UK and the EU is significant. The European Federation of Pharmaceutical Industries and Associations (EPFIA) estimates that the UK supplies 45 million medicine packs to the EU every month, while 37 million travel in the opposite direction to enter the country. As a member of the EU – although not for much longer – the UK is part of the single market, a series of trading arrangements that offer free movement of goods, services, people and capital. Once the UK leaves the EU in March 2019, it is likely to lose these benefits. While the negotiations between EU and UK leaders are still ongoing, many fear a no-deal Brexit (see box, right) could be catastrophic for the UK supply chain, pharmacists and patients alike. T Impact on the supply chain The UK heavily relies on the EU for its medicine supplies. In the absence of a favourable, or indeed any, Brexit deal, the supply chain could be severely disrupted, with reduced access to pharmaceutical products. Generic medicines alone make up 75% of the NHS’s daily medicine use, of which around 80-90% are imported, according to a House of Commons report published in May. In 2016, the UK imported £24.8bn of pharmaceutical products, of which 73% (£18.2bn) were from the EU. According to Christopher Vowels, head of medical valuation at commercial real estate agency Christie & Co, the UK has benefited from sourcing medicines from Europe due to ‘lower’ prices. Therefore, crashing out of the EU without a deal could increase the cost of medicines for contractors. He says: ‘Without a free trade agreement, this could have an impact on drug prices resulting in price increases and reduced gross margins. Fluctuations in [the value of] sterling will also potentially increase the cost of imports, resulting in higher cost pressures on drug suppliers and ultimately retail pharmacies.’ Potential harm to patients Introducing customs barriers in a post-Brexit UK could create a significant challenge for patients, as they might be forced to wait for their medicines to become available. Moreover, any time or temperature sensitive drugs – such as insulin, which must be kept in a fridge between 2°C and 8°C – become unusable when not stored properly or used within an allotted time. Naturally, this poses a threat for patients who urgently need access to life-saving medicines. Royal Pharmaceutical Society (RPS) president Ash Soni tells The Pharmacist: ‘If we have a hard Brexit (see box, below) and people need to go through customs or there are issues about where the product is supplied to, we may face greater problems in terms of access [to drugs]. ‘That may create a situation where we have greater shortages, with the likelihood that they have an impact on patient care. ‘From the pharmacist point of view, the risk is that people blame us for the problem when we’re obviously not responsible.’ Brexit explained In 2016, the British Government held a referendum that offered people the choice for the country to leave or remain in the EU. The outcome saw 52% voting for what became known as ‘Brexit’ against 48% wanting to stay. Britain is set to exit the EU in March 2019, followed by a 21-month transition period provided a deal is reached. The changeover will see British MPs leave the European Parliament and enable the UK to negotiate its own trade deals and settle the terms of its departure. For the past two years, UK and EU leaders have tried to reach a deal – with little success thus far. The four possible Brexit scenarios No deal. If the UK does not reach a deal with the EU before the March deadline, it will leave the EU without a transition period and no guarantee that EU citizens’ rights will be protected. The UK will be subject to the same customs rules and commercial taxes as non-EU countries. 1 2 Hard Brexit. The UK will lose access to the single market, the European court of justice and the customs union. However, the UK might still be able to negotiate some deals, including the free movement of people. 3 4 Soft Brexit. Under this deal, not many things change, with the UK potentially staying in the single market and customs union. Chequers plan. In September, Prime Minister Theresa May came up with a plan under which the UK stays close to the EU while having more freedom to strike worldwide deals with other countries and being able to end the free movement of people. September/October 2018 | The Pharmacist | 13