Free Content Treatment interruptions and inconsistent supply of anti-tuberculosis drugs in the United Kingdom

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Abstract:

SETTING: National Health Service (NHS) centres treating tuberculosis (TB) in the United Kingdom.

OBJECTIVES: To describe NHS TB treatment centres' experience of obtaining anti-tuberculosis drugs to treat drug-susceptible and drug-resistant TB between 2007 and 2009. In particular: 1) any difficulties experienced in obtaining different drugs; 2) resulting interruptions or alterations in the prescribed regimen; 3) availability of paediatric formulations; and 4) resources available to identify and manage drug shortages.

DESIGN: Questionnaires were sent to pharmacists at 168 treatment centres.

RESULTS: Of the 77 (46%) treatment centres that responded, 63% (48/77) reported difficulties in obtaining anti-tuberculosis drugs. Consequently, 27% had to interrupt the prescribed treatment regimen at least once, whilst 19% had to alter the regimen. Of 55 centres treating multidrug-resistant tuberculosis, 36% reported difficulties obtaining second-line drugs, 16% had to interrupt the prescribed treatment regimen at least once and 5% had to alter the regimen. A lack of licensed liquid formulations for children resulted in 26% of treatment centres using unlicensed, variable-strength liquids and locally prepared suspensions.

CONCLUSIONS: Difficulties obtaining drugs to treat both drug-susceptible and drug-resistant disease are common in the UK. There are particular risks for children. Our data identify an urgent need for national strategic guidance to ensure a consistent and reliable supply of anti-tuberculosis drugs.

Keywords: United Kingdom; drugs; essential; health resources; tuberculosis

Document Type: Regular Paper

DOI: http://dx.doi.org/10.5588/ijtld.10.0568

Affiliations: 1: Pharmacy Department, St James's University Hospital, Leeds, UK 2: All-Party Parliamentary Group on Global Tuberculosis, London, UK 3: HIV and Respiratory Medicine, Department of Thoracic Medicine, Royal Free Hospital, London, UK

Publication date: June 1, 2011

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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