1. Medicines Distribution Crisis: December in Scotland The Pharmacists Experience : Alex MacKinnon Scotland

2. Background Scotland December 2010 saw the worst snowfall in Scotland since 1963. Widespread travel chaos across the Central Belt. Anecdotal evidence from phone calls to the Scottish Directorate of the Royal Pharmaceutical Society suggested medicine supplies to pharmacy became very poor during this period. RPS Scotland ran an online survey in January 2011 to measure the extent of the problem. 256 responses were received, nearly all from the community sector, and representing every part of Scotland. We present this data in order to facilitate working towards finding solutions to prevent similar difficulties happening in the future.

3. Scotland How would you rate the service you received from your distributors? Earlier research has shown that many pharmacists believe there are fundamental issues with the medicines distribution system. This research suggests that despite that perception the system was nevertheless seen to be satisfactory to a clear majority. But during the period of extreme weather and its aftermath the service pharmacists received clearly became much worse, especially in the Central Belt. Results

4. Scotland

8. Commonly mentioned medicines that were hard to source Many of the responses we received to questions about which medicines were most difficult to source just said all of them, usually the ones on quota or any from sole distributor agents. But those named individually most often were: ZyprexaLilly Lipitor Pfizer FemaraNovartis ArimidexAstraZeneca NeurontinPfizer PentasaFerring Novo InsulinsNovo Nordisk KeppraUCB Pharma Perstantin RetardBoehringer Ingelheim Cymbalta Lilly SpirivaBoehringer Ingelheim CipralexLundbeck Humulin InsulinsLilly MicardisBoehringer Ingelheim XalatanPharmacia SymbicortAstraZeneca CarduraPfizer Scotland

9. Commonly mentioned distribution networks Alliance/Unichem were easily mentioned the most often. AAH and Phoenix were mentioned as well, but less frequently. Indeed, some pharmacists recognised the efforts these companies made to try and restore a normal service. Rowlands (assume Phoenix) were only mentioned for doing well. Scotland

10. Commonly mentioned manufacturers Pfizer were mentioned the most often due to their products being distributed through Alliance Lilly and Novartis were also mentioned frequently Other pharmaceutical manufacturers were rarely mentioned The issues created by the severe weather meant our members were more concerned with disruption caused by the weather rather than older issues surrounding medicines distribution and the supply chain. As a result the overall number of times a pharmaceutical company was named was much smaller than the number of times a medicines distributor was mentioned Scotland

11. Conclusions Pharmacists believe the distribution system is too fragile to maintain reasonable service during prolonged periods of poor weather. The weaknesses of the current supply chain were confirmed. Our members do recognise that some distributors were innovative in trying to overcome the difficulties created by the snow in December. There was real frustration with Alliance who appeared overwhelmed by the situation. We all need to work now to agree some contingency planning measures for periods of severe weather? We need to work together to make medicine distribution more robust in order that the system delivers for patients. Scotland

12. What can we do to improve the system? Scotland