Intended for healthcare professionals


Braced for Brexit

BMJ 2018; 363 doi: (Published 14 November 2018) Cite this as: BMJ 2018;363:k4724
  1. Nigel Hawkes, freelance journalist, London, UK,
  2. Jacqui Wise, freelance journalist, London, UK,
  3. Stephen Armstrong, freelance journalist, London, UK,
  4. Tom Moberly, UK editor, The BMJ
  1. Correspondence to: T Moberly tmoberly{at}

Availability of drugs—including blood products, insulin, and nuclear medicines—and treatment of rare diseases are some of the areas where uncertainty caused by UK-EU negotiations is increasingly concerning doctors, suppliers, and patients

Blood and insulin: a cold storage catastrophe?—Nigel Hawkes and Jacqui Wise

If the UK leaves the European Union without a deal in place, supplies of drugs could face “a catastrophic time,” according to Martin Sawer, executive director of the Healthcare Distribution Association.

Two types at particular risk are insulin and biological medicines, including those derived from blood plasma—because the UK relies on imported supplies. The six week buffer stock that health secretary Matt Hancock has asked drug companies to set up in case of short term border disruption is straightforward (if costly) for drugs with a long shelf life. It is trickier for those that need to be kept at a controlled, low temperature during transport and storage.

Mike Thompson, chief executive of the Association of the British Pharmaceutical Industry, told the Commons select committee no deal Brexit inquiry on 23 October1 that the government’s contingency plans were insufficient. There were no cold chain storage facilities at the ports in the event of delays and not enough medical cold stores generally in the UK, he said. “I think we’ve got to the stage of recognising that stockpiling won’t be enough and we need to put in the next phase of plans.”

In a last minute effort to close the gap, the Department of Health has issued tenders for additional cold storage—either newly built or, more likely, converted from facilities designed to store food. “I am confident this can be delivered by March next year when the UK leaves the EU,” Hancock told the committee. Others, including Thompson and Sawer, are not so sure. Sawer doubts there is now time to build new cold storage, which typically takes a year, …

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