Wednesday, August 01, 2018

Insulin supplies - the facts.

A few days ago the chairman of the Medicines and Healthcare products Regulatory Agency, Sir Michael Rawlins, spoke in a "personal capacity" to the Pharmaceutical Journal and his interview included the following:

We make no insulin in the UK. We import every drop of it. You can’t transport insulin around ordinarily because it must be temperature-controlled. And there are 3.5 million people [with diabetes, some of whom] rely on insulin, not least the Prime Minister.

This was repeated on social media by the head of operations at Channel 4, doubtless in good faith - if the chairman of the regulatory agency for drugs makes a comment like that even in a personal capacity it's a legitimate news story - and over the weekend a number of people got very heated about it on social media.

In fact Sir Michael was exaggerating when he said that Britain imports every drop of insulin - one of the two suppliers which was being quoted by outraged Brexit supporters as manufacturing insulin here, Wockhardt UK, does indeed produce animal-based insulin at its site in Wrexham. They supply porcine and bovine insulin made in this country, although the former product is in the process of being withdrawn. (The other supplier which some people suggested at the weekend was making insulin here, Lily, told Channel 4 Factcheck that they import it.)

Sir Michael's statement was not quite correct and he was extremely ill-advised to overstate the case and thereby pump yet more anger and hysteria into a debate which was already replete with both, but he wasn't overstating it by much - certainly not by the standards of debates about Brexit.

I've seen an analysis which estimates that Wockhardt UK's insulin accounts for 0.3% of the insulin prescribed in the UK and that the other 99.7% is imported. It certainly appears that more than 99% of insulin used here is indeed imported.

Which raises the question of whether a no-deal Brexit is a threat to insulin supplies.

Channel 4 factcheck have done an analysis on this - and before anyone else points out that a senior executive at their own news channel was in the firing line on this issue, it is quite clear from the measured nature of their response, including pointing out that the statement their colleague repeated was not, strictly speaking, quite true,  that the fact-checkers at Channel 4 were not influenced by that.


Soon after the referendum in 2016, the Healthcare Distribution Association (HDA UK), which represents medical suppliers in the UK, wrote an open letter to the government, warning of the “significant consequences for the NHS medicines supply chain” if Brexit negotiations weren’t handled properly.

However, the current view of the industry is that this issue is being addressed. A spokesperson for HDA UK told Channel 4 FactCheck on Monday that: “we are aware of proposals by the government and manufacturers to develop plans for stockpiling medicines of all types as abuffer stockin the event of ano deal Brexit’.”

He added: “The UK medicines supply chain has an inbuilt resilience and flexibility, which is now being supported by the plans for abuffer stock’”, which he described as “sensible planning”.

Individual suppliers are quoted by Channel 4 factcheck as making similar comments.

After his interview on Friday, Mr Rawlins issued a further statement acknowledging that his comments were made before the health secretary, Matt Hancock, announced the government’s contingency plans. Those plans include securing insulin supplies.

Mr Rawlins said that “the Department of Health and Social Care is working to make sure the health sector and industry are prepared and that people’s health will be safeguarded.”

You can read the Channel 4 factcheck article in full here.

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