More than six in 10 pharmacists fear the shortage of medicines is affecting the health outcomes of some patients – with particular concern around people with diabetes and epilepsy.

The survey by the Irish Pharmacy Union (IPU) comes amid a worsening in the shortage of a range of medication, including some key drugs which are rationed between pharmacies.

And patients who would normally be reimbursed for a drug are having to pay out of pocket for unlicensed alternatives which are needed to fill the gap.

Dermot Twomey, president of the IPU, said the survey found 65pc of the 249 pharmacists questioned believe supply difficulties are having an effect on patient outcomes.

He told a panel discussion in Dublin, which included stakeholders and experts, that as an example he recently had to give a medicine in liquid form to a patient with epilepsy who normally takes capsules to prevent seizures. This required a lot of time and work with colleagues to ensure the correct dose was achieved.

“Almost every pharmacist in Ireland has felt medicine shortages significantly increase this year,” said Mr Twomey. Other pharmacists have cited a shortage of Ozempic which is used to lower blood sugar in type 2 diabetes and is difficult to get hold of for regular patients.

Thyra de Jongh, the main author of a recent European Commission report on medicine shortages, told the meeting that pricing is a “short-term solution that should be considered to ease medicine shortages”.

“Shortages are caused by a mismatch between demand and supply,” said Ms De Jongh.

“I am hopeful we may be able to get the demand side under control a bit better because we are currently experiencing surge demand for certain products in part because of seasonal epidemics. But that does not change the reality on the supply side.

“Pricing-related factors are quite specific to older off-patent and generic medicines because those types of medicines actually don’t have very high profit margins.

“We think of medicines as outrageously expensive products, but for most of the over-the-counter generic medicines that you can get at the pharmacy, the margins are in the magnitude of [a few] cent.

“If the costs are going up, those margins will quickly evaporate. The prices on generics cannot just be raised because of the pricing policies on these medicines.

“There is a necessity on the part of purchasing authorities to meet in the middle and raise prices. However, the systemic factors will need solutions with a longer-term span.”

Some countries are paying up to four times more for the older, widely used drugs – leaving Ireland at a disadvantage on price and volume.

Sandra Gannon, chief executive of Azure Pharmaceuticals, which is involved in the supply of some of the older off-patent medicines, said three million packs of unlicensed medicines were used here to cover shortages last year, which undermines the regulatory process.

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