NHS hospitals alerted about life-saving drug shortage

Hospitals  advised to place urgent orders for unlicensed imports of salbutamol nebuliser liquid

The Department of Health and Social Care (DHSC) and NHS England last month issued a “safety critical” national patient safety alert, warning about the UK-wide shortage of a life-saving drug used to treat patients with chronic breathing issues.

NHS trusts, health authorities, ambulance services, GP practices, private healthcare providers, and community pharmacy contractors were informed that salbutamol 2.5mg and 5mg nebuliser liquid unit dose vials are in short supply, with the latter likely to remain “out of stock” until mid-April 2024.

As per the alert, the shortage of the drug resulted from a combination of manufacturing issues, leading to heightened demand for alternative suppliers.

It was mentioned that while terbutaline, salbutamol with ipratropium, and ipratropium nebuliser liquids remained available, they could’t meet the increased demand.

Hospitals were advised to “liaise with local pharmacy teams and place urgent orders for unlicensed imports of salbutamol nebuliser liquid.”

Healthcare providers were directed to use high-dose salbutamol pressurised metered-dose inhaler (pMDI) in patients with mild to moderate asthma attacks or chronic obstructive pulmonary disease (COPD), and prescribe nebuliser liquids where the inhaler is not appropriate.

Supplies of salbutamol nebuliser liquids should be prioritised for “acute, severe exacerbations of COPD and asthma; bronchospasm secondary to refractory anaphylaxis; in patients who cannot use a pMDI; other conditions where the use of high-dose salbutamol pMDI via a spacer is inappropriate e.g. moderate to severe hyperkalaemia.”

In January, the British Association of Dermatologists (BAD)cautioned that the shortage of medicines was contributing to the outbreak of scabies in the UK. Both permethrin 5% cream and malathion liquid, two main topical treatments for scabies, were reported to be in limited supply since May 2023.

According to the British Generic Manufacturers Association (BGMA), more than 100 products were facing supply problems last year, the highest on record in the UK, and more than double the number recorded at the start of 2022.