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Supply Disruption Alert – Priadel

UK Healthcare professionals have been notified that Priadel® (lithium carbonate) 200mg and 400mg modified-release tablets are being discontinued in the UK and remaining supplies of both strengths are expected to be exhausted by April 2021.

The Department of Health & Social Care (DHSC) Medicines Supply team, the Royal College of Psychiatrists and the UK supplier of Priadel, Essential Pharma, have provided strong reassurance that NO problems with supply of Priadel are anticipated ahead of the planned cessation of supplies of Priadel to the UK market in APRIL 2021. Nonetheless, GPs and NHS pharmacists have reported some early and unexpected issues with supply of Priadel to community pharmacies. NECS MO are NOT aware of any problems with supply to patients.

NECS MO have investigated the reported issues with Priadel supplies and have ascertained the following:

  • Essential Pharma have put in place monthly wholesaler quotas for Priadel in order to protect supplies from stockpiling
  • Quotas are based on historical demand (possibly with some margin for fluctuation etc.)
    • DHSC are in discussions with Essential Pharma senior managers about the stock situation and the quota system and the quota for next month is likely to be increased
  • Quota for Priadel tablets for current period has been EXCEEDED much earlier than expected
  • It is likely that the quota has been exceeded because some (or many) pharmacies (in both community & MH sector) HAVE done exactly what the senior managers at Essential Pharma anticipated – i.e. ordered extra to safeguard supplies for THEIR patients
  • As the quota has been exceeded, supplies of Priadel to wholesalers have been suspended
  • AAH & Alliance have now run out of Priadel 400mg and cannot currently supply
  • AAH can supply Priadel 200mg
  • Call handlers @ AAH & Alliance do not know when the manufacturer will re-supply – the information is NOT on the IT system they use when fielding enquiries from potential purchasers in community pharmacy – thus, the message to a community pharmacist calling to find out what is going on will be ‘computer says no – manufacturer cannot supply’ – and that message is likely to have been passed on
  • New quota will kick in for September – i.e. next week. So, pharmacies WILL be able to order more Priadel from wholesalers once Essential Pharma deliver & it gets out through the distribution system (maybe end next week?)
  • This situation is likely to feed and provoke the sort of stockpiling behaviour that the quotas were intended to guard against – those pharmacists that did NOT order extra after receiving the attached letters will probably do so as soon as there is more stock available
  • WRT the important bit – i.e.: ensuring continuity of supply for patients – it is UNLIKELY that patients will have problems with supplies overall, but there may be localised issues – the amount of stock in the entire system is in line with historical usage (+ possible comfort margin) – but ALL of it is in pharmacies, with none at wholesalers – reducing the flexibility and resilience of the system – and some of it may be in the wrong places and moving it between pharmacies if there are local issues could be difficult
  • There is a potential workaround (for some pharmacies)
    • Essential Pharma are still supplying Priadel to Movianto to fulfil  ‘urgent’ orders
  • But….
    • Not all pharmacies have a contract with Movianto – and not all chains will allow individual branches to open accounts or order directly from Movianto
    • There may be additional costs for such urgent orders – which may be passed on to the NHS as out of pocket expenses