Brexit could mean delays for cancer treatments and less safe medicines

BMJ 2017; 359 doi: (Published 07 December 2017) Cite this as: BMJ 2017;359:j5685
  1. Adrian O’Dowd
  1. London

Patients could face delays in receiving lifesaving treatments and their medicines may be less safe if the UK does not secure a good post-Brexit deal and transitional arrangements, experts have warned MPs.

Speaking at an evidence session of the parliamentary health committee on 5 December for its inquiry into the potential effects of Brexit on the supply chain of medicines, medical devices, and other medical products, witnesses warned of the dangers of disrupting drug supply chains between the UK and the EU after Brexit.

MPs asked witnesses what a realistic worst case scenario could be after Britain leaves the EU. Martin Sawer, executive director of the Healthcare Distribution Association, which represents the UK’s major drug distributors, warned that medicines could become less safe for patients.

“The worst case scenario from our perspective is that we do not have any guidelines and rules against which we can operate, so if there is not common regulation with either the EU or the other countries which at the moment exists because of the EU, then medicines will become less safe for UK patients in the long run,” he said.

Sawer added, “The beauty of the EU system as a single market is that there are 28 countries all operating in the same way with the same wholesaler deals in operation and a product can be moved around, but also there’s a central database against which you can check the origin of those medicines.

“That type of patient safety issue is very important to us and guarantees that what we are handling are kosher medicines.”

Jeanette Dickson, vice president of the faculty of clinical oncology at the Royal College of Radiologists and a fellow witness, added her concerns over the potential impact on patient care. The UK currently imports about 80% of the medical radioisotopes used in diagnostic equipment, she told MPs, and around 700 000 of the one million diagnostic and therapeutic procedures carried out every year rely on imports.

“The facility to manufacture them in the UK does not exist at the present time,” said Dickson. “You can do some substitution, but the capacity there is limited to increase the amount of radioisotopes, and the costs of those isotopes are much more than the ones that we import.

“You are talking about a significant proportion of patients with cancer, heart disease, bone disease, thyroid disorders, not having rapid access to diagnostic imaging, and not having an assured diagnostic pathway.”

Treatment could also be affected, she warned, saying, “If we talk about the treatment of cancer, which is done by unsealed sources—medical radioisotopes that you either ingest or we inject—these cure patients with predominantly thyroid cancers. If we don’t have an ensured supply of those, the reduction in the rate of cure means more people are going to die of their thyroid cancer.

“Whatever happens, we need to be able to assure the supply as quickly and as efficiently, with no disruption, as we do now.”

MPs also asked what the impact might be for patients if the UK were to diverge from EU regulations covering the safety of blood, tissue, and organs. Ian Bateman, director of quality at NHS Blood and Transplant, said, “We’ve got a very strong framework of regulation across Europe and in the UK. The aim is to transpose the regulations through the Withdrawal Bill in a like-for-like basis.

“It’s important we maintain the strength of that regulatory framework as we transition across.”

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