The effect of Brexit on accessibility to medicine

Abstract

According to article 12 of the International Covenant on Economic, Social and Cultural Rights Health is a basic human right and access to medicine is a fundamental means to ensure health. It recognizes the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Nearly 2 billion people have no access to basic medicines. This research aimed to develop a rational and prompt medicines accessibility issues. The objectives were to critically analyze the demand and supply of medicines in Malta by addressing the sourcing of medicines in Malta in relation to Brexit effect; to explore alternative solutions to accessing medicines and to review the current NHS formulary in relation to rational prescribing. The research methodology involved analysing data collected from Central Procurement Supplies Unit and the Malta Medicines Authority. A focus group discussion and interviews were set up to identify challenges with accessing medicines and to generate ideas for the purpose of formulating recommendations to enhance access to medicine. The data collected was analysed in terms of therapeutic area and different alternatives for sourcing. The focus group reviewed the Government Formulary List (GFL) and private list of medicines and identified challenges with accessing medicines as Brexit; the UK ban on export of medicines; Lack of cooperation in the regulation of medicines between the EU and the UK post Brexit; Licensing and registration of medicines; Shortages; serialisation-FMD; Problems with drugs in GFL; Patients’ perspective. The focus group gave examples from patients within their practices and the implication of access, and the risk posed to the patients. The focus group recommended that a list of best options for medicines were duly compiled, and the following are examples: a. GFL: Atenolol tablets 50mg x 2 was suggested instead of atenolol 100mg tablet. b. Private market list: Atorvastatin tablets 100mg – Different brand of generic in other country not the UK was suggested. An innovative way to detect, address and mitigate challenges to access medicines was developed to proactively enhance accessibility to medicines. The lack of cooperation in the regulation of medicines between the EU and the UK post Brexit has proven to be more difficult to address because it requires co-operation between other countries. Partnership, consultation, collaboration between the health system and pharmaceutical industry is important to avoid and control medicines accessibility challenges.