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April 2020

Inhalers in short supply – new guidance to limit prescribing

The British Thoracic Society has appealed to prescribers to limit prescribing of inhalers to monthly repeats rather than issuing a prescription for several months at a time, and to discourage patients from stockpiling.

The BTS guidance comes as reports emerge of a significant surge in demand in the supply chain for inhaler products, leading to wholesalers experiencing stock shortages.

For some inhalers, demand has soared by 400% above normal – but manufacturers have assured prescribers that this is not related to coronavirus.

One of the first products to go out of stock was Chiesi’s Clenil Modulite 100mcg pressurised metered dose inhaler, which is expected to face intermittent supply problems over the next month or so. Chiesi has appealed to prescribers to help them maintain supply by not writing multiple prescriptions for the same products until such time as the acute pressures begin to ease.

Chiesi states: ‘As the UK continues to be in lockdown, we are seeing a vastly larger number of prescriptions being filled than usual and we have seen a dramatic increase in inhaler demand – approximately four times higher than average. This is leading to our wholesaler partners experiencing out of stock situations whilst they are waiting for a replenishment delivery.

‘We are working closely with all stakeholders involved to respond to this unprecedented increase in demand as best and as efficiently as possible. This includes working hard to manage supply, consistently releasing stock weekly at average demand levels to supply the wholesalers. We expect continued stock deliveries over the coming weeks and months, and we have good stock levels of all our products. We can confirm that production of all our products continues uninterrupted at all of our manufacturing sites.’

MIMS reports that it is not just Chiesi inhalers that are affected – Ventolin Evohaler, Kelkale, Qvar, Soprobec, Flixotide, Fostair and Seretide also seem to be in short supply.

NHS England has written to primary care teams asking prescribers not to over order/over prescribe, but sadly, the message doesn’t seem to be landing.

The key advice to give patients is to:

  • Avoid over-ordering repeat prescriptions, and
  • Avoid ordering inhalers before they are actually needed.