What to Do When Your Usual Pharmaceutical Supplier Can't Supply a Medicine

A supplier telling you that a medicine is unavailable does not necessarily mean the medicine cannot be sourced.

It means your usual supply route has failed.

For pharmacy procurement teams, the next step is to establish whether the issue is local to that supplier, part of a wider UK shortage, or evidence that the licensed product is genuinely unavailable across the market.

From there, there may be several options: alternative wholesalers, different presentations, mutual aid, alternative licensed medicines or, where clinically appropriate, an imported unlicensed medicine.

The key is to move quickly while keeping the requirement precise.

If your usual supplier cannot supply a medicine, Alcatia Pharma can investigate alternative sourcing options.

First: establish exactly what "unavailable" means

Not every failed order represents a national medicine shortage.

A supplier may be unable to fulfil an order because:

• its own stock has been exhausted;
• stock has been allocated;
• the manufacturer has restricted distribution;
• a particular pack size or presentation is unavailable;
• there is a temporary wholesaler issue;
• demand has increased unexpectedly;
• the manufacturer has experienced a supply disruption; or
• the product has been discontinued.

Manufacturers have a legal obligation to notify the Department of Health and Social Care of medicine shortages and discontinuations that meet the relevant reporting criteria. DHSC and NHS England then assess notified supply issues and determine what action may be required.

For a procurement team, however, the immediate question is simpler:

Can the medicine still be sourced somewhere else?

Step 1: Confirm the requirement

Before contacting alternative suppliers, make sure you know exactly what you need.

Record:

• medicine or active ingredient;
• brand, if clinically relevant;
• strength;
• pharmaceutical form;
• pack size;
• quantity required;
• current stock position;
• expected usage;
• required-by date; and
• whether alternative presentations can be considered.

This prevents a common problem during shortages: searching for a product name without defining which characteristics are genuinely essential.

For example:

"We need 50 packs of Drug X"

is considerably less useful than:

"We require 50 packs of Drug X 500 mg tablets, ideally 28 tablets per pack, required within seven days."

The second request gives a sourcing team something actionable.

Step 2: Check whether the problem extends beyond your normal supplier

Your first supplier being out of stock does not automatically mean all UK supply has disappeared.

Depending on your organisation and procurement arrangements, it may be appropriate to investigate:

• other contracted wholesalers;
• alternative authorised wholesalers;
• the manufacturer;
• specialist pharmaceutical suppliers; or
• other established supply routes available to your organisation.

Availability can differ between suppliers because different businesses have different stock holdings, allocations and distribution arrangements.

The objective at this stage is to establish whether licensed UK stock remains available elsewhere before moving to more complex alternatives.

Step 3: Check whether there is an official supply issue

If the problem appears wider than a single supplier, establish whether the medicine is affected by a recognised shortage.

In England, DHSC and NHS England manage national medicine supply issues, and information for healthcare professionals may be communicated through Medicine Supply Notifications (MSNs) and the NHS Medicines Supply Tool hosted by Specialist Pharmacy Service.

These communications can provide important information such as:

• expected duration of the shortage;
• products affected;
• remaining availability;
• alternative products;
• clinical management recommendations; and
• whether additional sourcing routes are being used.

For secondary care NHS pharmacy procurement teams, SPS also publishes specific guidance on navigating potential supply issues before escalation to regional procurement teams.

An official shortage notice can therefore change the sourcing strategy considerably.

Step 4: Establish how much stock you actually need

During a shortage, it is important to distinguish between the amount you would normally order and the amount you actually need to protect patient supply.

Ask:

How much stock is currently available?

What is the normal daily or weekly usage?

How many patients depend on the medicine?

How long will the existing stock last?

When is the next normal delivery expected?

This allows the team to calculate the genuine supply gap.

If you normally purchase 200 packs per month but currently need only 30 additional packs to bridge a two-week disruption, a smaller alternative source may be sufficient.

That can materially increase the number of viable sourcing options.

Step 5: Consider alternative presentations of the licensed medicine

Sometimes the shortage affects only one presentation.

Depending on the medicine, there may still be availability in:

• another strength;
• another pack size;
• another pharmaceutical form;
• another licensed brand; or
• an alternative manufacturer.

Whether any of these products are clinically interchangeable is a decision for the appropriate pharmacy and clinical teams.

From a procurement perspective, however, identifying what is available can help those teams assess the options.

This is another reason sourcing enquiries should clearly distinguish between essential product characteristics and preferences.

Step 6: Consider an alternative licensed medicine

A shortage may sometimes be managed using a different licensed medicine.

National supply guidance may provide recommendations for clinically appropriate alternatives, and more significant shortages can result in additional national actions such as Serious Shortage Protocols. DHSC states that SSPs may be used where an alternative medicine or quantity can be supplied by a pharmacy under the relevant protocol.

This is not primarily a procurement decision.

The appropriate clinical, medicines information and pharmacy teams should determine whether an alternative therapy is suitable.

Procurement can then establish whether adequate supply of the recommended alternative is available.

Step 7: Consider mutual aid where appropriate

For NHS hospital pharmacies, mutual aid can sometimes help when conventional supply routes cannot provide medicine quickly enough.

SPS describes this as the transfer of medicines between NHS hospitals in circumstances including national shortages, sudden increases in demand or urgent requirements for medicines that are not normally stocked.

However, mutual aid is intended for exceptional circumstances rather than as an alternative routine supply chain. SPS advises that normal supply options should be exhausted first.

For NHS secondary care organisations, regional SPS procurement teams can help assess whether mutual aid is appropriate and may have visibility of stock held by other trusts.

This can be particularly useful where only a small quantity is required urgently for a specific patient.

Step 8: Investigate international supply

If licensed UK stock cannot be obtained, there may still be commercially available stock elsewhere in the world.

A medicine unavailable in the UK might still be routinely marketed in:

• Europe;
• North America;
• Asia;
• Australia;
• or another regulated pharmaceutical market.

This is where specialist sourcing companies can become particularly useful.

Instead of a pharmacy procurement team contacting individual overseas suppliers, a specialist importer can investigate markets, manufacturers and authorised distribution channels to determine whether a viable product exists.

The first objective is simply to answer:

Does an appropriate product exist, where is it available and how quickly could it reach the UK?

Step 9: Consider whether an unlicensed import may be appropriate

If the licensed UK medicine is unavailable and an appropriate product exists overseas, unlicensed importation may sometimes be relevant.

Under Regulation 167 of the Human Medicines Regulations 2012, an unlicensed medicine may be supplied where no available licensed medicine can meet the clinical needs of an individual patient. The clinical need is determined by the responsible prescriber.

An overseas medicine may therefore be:

• commercially manufactured;
• licensed in its home market;
• routinely used in that country; but
• considered unlicensed when supplied in the UK.

This does not make unlicensed imports a general substitute for licensed UK medicines.

They are a regulated route intended to address a genuine clinical requirement where available licensed options cannot meet that need.

Step 10: Use an appropriately licensed importer

A pharmacy should not simply locate an overseas website or wholesaler and arrange for medicine to be shipped into the UK.

Unlicensed medicine importation is regulated by the MHRA.

Depending on the source country, an importer requires the appropriate Manufacturer's "Specials" Licence or Wholesale Dealer's Licence, and the MHRA must be notified of the intention to import the unlicensed medicine before the import takes place.

The notification process requires supporting evidence concerning:

• appropriate manufacturing and distribution standards; and
• the special clinical need for the medicine.

Using a specialist importer therefore provides a structured route for investigating international availability while meeting the relevant regulatory requirements.

What information should you ask an alternative supplier for?

Finding someone who says "we can source it" is only the beginning.

Before proceeding, procurement teams should understand exactly what is being offered.

Ask for information including:

Exact product

Confirm:

• active ingredient;
• strength;
• pharmaceutical form;
• brand or manufacturer;
• pack size; and
• presentation.

Regulatory status

Establish:

• whether the product is UK licensed;
• whether it is licensed in another market;
• or whether it would be supplied as an unlicensed medicine.

Source

Ask:

• where the medicine is manufactured;
• where the stock is currently located; and
• through which supply chain it will reach the UK.

Quantity

Confirm how much physical stock is actually available.

"There is availability" is not the same as confirmation that your required quantity can be supplied.

Shelf life

Shortage stock can sometimes come from limited international inventories, so remaining shelf life should be established before purchase.

Lead time

Ask for a realistic estimate that takes account of:

• supplier preparation;
• transportation;
• regulatory processes;
• customs;
• cold-chain requirements where relevant; and
• final UK delivery.

Continuity

If the UK shortage is expected to last several months, ask whether further quantities are likely to be available.

A source that resolves today's requirement but cannot support subsequent demand may still be useful, but the limitation should be understood.

Avoid one of the biggest shortage procurement mistakes

When supply becomes difficult, there is an understandable temptation to ask every potential supplier:

"How many can you get?"

A better question is:

"We need X quantity by Y date. What viable options can you identify?"

This matters because pharmaceutical sourcing is not simply a stock search.

Different options may involve different:

• manufacturers;
• countries;
• pack configurations;
• licence status;
• lead times;
• shelf lives;
• prices; and
• regulatory requirements.

Giving the supplier a defined requirement allows them to find the best route for the actual problem rather than simply quoting whatever stock happens to be available.

What should you send Alcatia when your supplier cannot supply?

You do not need to conduct an international search yourself.

Send us the requirement.

At minimum, provide:

Medicine or molecule
The product you are trying to source.

Strength
For example, 500 mg or 10 mg/ml.

Form
Tablet, capsule, vial, ampoule, oral solution, injection or other presentation.

Quantity
How much you need.

Required-by date
When the medicine needs to arrive.

It is also useful to tell us:

• your organisation;
• the normal product or manufacturer;
• pack size;
• whether this relates to a known shortage;
• whether alternative presentations can be considered;
• minimum shelf-life requirements;
• storage requirements; and
• any previous sourcing attempts.

You can select licensed, unlicensed or unsure when submitting the enquiry.

You do not need to determine the sourcing route before contacting us.

What happens after Alcatia receives the requirement?

We can investigate the available supply options based on the information provided.

Depending on the product, this may involve examining:

1. available licensed supply;
2. alternative UK supply channels;
3. specialist pharmaceutical sources;
4. international availability;
5. potential unlicensed imports; and
6. realistic lead times.

If a potential product is identified, we can provide relevant information for your procurement and pharmacy teams to assess.

That may include:

• manufacturer;
• source market;
• strength and presentation;
• pack size;
• available quantity;
• shelf life;
• regulatory status;
• pricing; and
• indicative delivery time.

Availability can change quickly, particularly when multiple healthcare organisations are responding to the same shortage.

The earlier the enquiry is submitted, the more time there is to investigate alternatives.

Your usual supplier being out of stock is the start of the investigation, not necessarily the end

Medicine supply chains are complex.

A failure through one route can sometimes be resolved through another licensed supplier. In other circumstances, the solution may involve another presentation, mutual aid or a clinically appropriate alternative.

And when the licensed UK market cannot meet the requirement, specialist international sourcing may provide another option.

The important thing is to define the requirement accurately and start investigating before local stock reaches a critical level.

Can't source a medicine through your normal supplier?

Tell Alcatia:

What you need.
How much you need.
When you need it.

We'll investigate the available sourcing options.

This article is intended to provide general information for healthcare procurement and medicines-supply professionals. It does not constitute clinical, legal or regulatory advice. Decisions concerning alternative products or unlicensed medicines should be made by appropriately authorised professionals in accordance with current MHRA and NHS guidance and local governance procedures.