The Struggle to Get Hold of Medication in England Is Set to Get Worse

The struggle to get hold of medication – Chloe, a 29-year-old woman living with epilepsy, describes her current situation as “terrifying.” She suffers from panic attacks, which are compounded by her difficulty in securing the medication needed to prevent dangerous seizures. Her specific drug, based on Lamotrigine, is one of many everyday medications now in short supply across England. While she can easily access some of her other prescriptions, the one that enables her to maintain her independence and work is proving elusive. “In the past few weeks, I haven’t been able to get the right medication, and my seizures returned,” she explains. “I fell, hit my head, and now have a scar across my back from the impact.” This experience highlights the growing crisis in medication availability, which has reached its most vulnerable state in years.

“It’s just terrifying,” Chloe says. “I get panic attacks.”

Patients with a wide range of conditions, from heart disease to ADHD, are also facing similar challenges. Many rely on medications that are no longer consistently stocked, leaving them in a constant state of uncertainty. For those with chronic illnesses, this instability can disrupt their routines and even threaten their health. Chloe’s story is not isolated; it reflects a broader pattern of shortages that have left pharmacies nationwide unable to fulfill critical prescriptions.

The Funding System’s Role in the Crisis

The National Health Service (NHS) operates on a fixed reimbursement model, allocating a predetermined amount per medication dispensed. Pharmacies are then expected to source drugs at or below that rate. When prices soar above the NHS tariff, the government steps in with a price concessions list, which guarantees reimbursement at the new, higher cost. However, this system becomes problematic when market prices fluctuate rapidly. In April, the list expanded to 210 medications, a record high, but sudden spikes in costs often outpace these adjustments.

Pharmacy owners are left in a precarious position. If a drug’s market price exceeds the concession rate, they absorb the financial loss, which forces them to stock fewer items. This strategy, while necessary to stay profitable, increases the risk of shortages for patients who depend on these medications. Akash Patel, a pharmacist in Shepperton, Surrey, recently found himself unable to complete a prescription for a patient with epilepsy. “Some components are simply not available this month,” he says. “The pills I can provide will cost the pharmacy nearly £9 more than the reimbursement rate.” This financial strain is compounded by the fact that 27 pharmacies have closed this year alone, with 1,500 High Street pharmacies shuttering since 2017. The number of pharmacies in England has dropped to its lowest in two decades.

“It’s been getting worse in the last few years but now is the worst I’ve ever known it,” says Patel.

Global price increases are a key driver of this crisis. Energy and transportation costs have surged due to international tensions, and many medications depend on oil-based ingredients, which have become more expensive. At the same time, some manufacturers argue that the NHS’s reimbursement rates are too low to sustain production. This has led to shortages that further raise wholesale costs for pharmacies. For example, Venlafaxine, a widely used antidepressant, is on the concessions list, yet Patel can only purchase it for £5.25, £1.36 more than the government’s set rate. “It’s a significant loss-making drug, so we only order small amounts,” he notes.

Impact on Patients and Daily Life

The ripple effects of this system are felt by patients like Chris Henry, a 49-year-old man managing Parkinson’s Disease. His medication, Co Careldopa, is also on the concessions list, and he’s been left scrambling to secure his next supply. “After hearing about the shortages, I placed my order early, hoping the new medication arrives before I run out,” he says. The uncertainty has made his condition more challenging. “Managing Parkinson’s is already a nightmare, but the fear of a shortage adds an extra layer of anxiety,” he adds. Without his medication, his body control and dyskinesia become unpredictable, making it harder to maintain his responsibilities as a working parent.

“This is genuinely concerning,” he says. “Trying to manage medication for Parkinson’s Disease is a nightmare at the best of times, so thinking there is a shortage is incredibly worrying and scary. These medications make my life liveable.”

Such stories underscore the emotional and physical toll of the shortage crisis. Patients often spend hours waiting in pharmacies, or worse, leaving empty-handed. Chloe recounts how she sometimes sits on a bus for several hours, “going on patrol” to locate the medication she needs. For others, the situation is even more dire. The Epilepsy Society has documented three deaths in the past two years where a lack of essential drugs contributed to the fatalities. These cases highlight the potential consequences of prolonged shortages.

Experts warn that the problem is not just about current shortages but about a systemic breakdown in how medications are funded and distributed. The fixed reimbursement model, while designed to ensure affordability, creates a disconnect between what pharmacies can charge and what they are paid. This gap has led to a situation where pharmacies are forced to prioritize certain medications over others, often at the expense of patients’ health. The pressure is mounting, and the situation is expected to worsen as global supply chains remain volatile and manufacturing costs continue to climb.

Pharmacists are also struggling to keep up with the demand. Patel explains that the financial losses from dispensing high-cost drugs are forcing him to limit his stock. “If we don’t manage inventory carefully, we risk running out of critical medications for our patients,” he says. This balancing act is difficult, especially for those managing chronic conditions. The shortage of even a single drug can disrupt the delicate routines required to maintain health and independence.

As the crisis deepens, the emotional burden on patients is growing. The constant uncertainty about medication availability has become a source of stress for many. For Chloe, the anxiety of not having her seizure-preventing drug has turned everyday tasks into high-stakes situations. “I never know if I’ll be able to get my medication when I need it,” she says. This unpredictability is not just inconvenient—it’s life-threatening. With more pharmacies closing and supply chains under strain, the question is no longer whether patients will face shortages, but when.