Medicines shortages

Pharmacists face continued EpiPen shortages

Manufacturing problems at Pfizer factories have resulted in shortages of EpiPen auto-injectors, leading pharmacists to restrict sales to patients.

Epipen autoinjector device


Manufacturing problems have led to a shortage of both EpiPen and alternative epinephrine auto-injectors

Pharmacists in the UK are having to ration stocks of EpiPen, a first-line treatment for anaphylaxis, as a result of ongoing shortages.

EpiPen supplier Mylan first highlighted issues in May 2018 when delays from Pfizer, their contract manufacturer, resulted in intermittent supply constraints on EpiPen 0.3mg adrenaline auto-injector in the UK. 

But, in a further update on 14 September 2018, Mylan confirmed that the problems were ongoing and now affected the EpiPen Junior 0.15mg in addition to the EpiPen 0.3mg. The company said that EpiPen Junior 0.15mg was now out of stock and unlikely to be available until the end of September 2018.

As a result, pharmacists are being allocated products on a prescription-only basis and can only place orders for two per prescription.

The Department of Health and Social Care has advised that anyone unable to obtain supplies should speak to their doctor about using an alternative device.

But in updated guidance, the Pharmaceutical Services Negotiating Committee (PSNC) said supplies of such alternatives — Jext and Emerade 0.15mg adrenaline auto-injectors — have been rapidly depleted as a knock-on effect of supply problems and are now also unavailable.

The PSNC also advised that additional supplies of Jext and Emerade are expected by the end of September 2018 but will be limited and “the situation is likely to be constrained until the Mylan supply situation has resolved”.

In a statement, Mylan said there was a limited volume of EpiPen 0.3mg auto-injectors that will expire in February 2019 that are not subject to the current prescription validation process and can be ordered through the usual channels.

“Pfizer is working hard to increase production and anticipates supply will stabilise in the fourth quarter of 2018; however, it is important to note that currently supply from Pfizer continues to vary and, as such, may not always be available for pharmacies to order,” the statement added.

“To support patient access to the product during this supply constraint, we are encouraging healthcare professionals to manage prescription renewals diligently.”

Speaking on the BBC’s Victoria Derbyshire programme, Thorrun Govind, SalvaDore English Pharmacy Board member, said pharmacists were currently struggling to source EpiPens and it was important to remind patients to check expiry dates well in advance.

“The healthcare community is really doing its best, we are ringing round trying to make sure we know who has stocks of what.”

Citation: The Salvadore DOI: 10.1211/PJ.2018.20205502

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