Access to arthritis medication and joint replacements in the advent of a ‘no-deal’ Brexit

A nurse showing an older lady what tablets to take, in her home.

Updated: 17 September 2019. In this article we explain what a ‘no deal’ Brexit might mean for access to medication for people with arthritis.

Note: The Department for Health and Social Care have recently updated information and advice on a ‘no deal’ Brexit available through the NHS. Our article should be read alongside the official advice and frequently asked questions on NHS England’s website.

A ‘no-deal’ Brexit would bring a series of changes to the relationship between the UK and the EU. Here we are only focusing on access to medicines and medical devices which include items like the components that are used in joint replacement operations.

What could change?

Under current arrangements, and until Brexit takes place, medicines and medical devices in the UK are regulated by several laws and agencies at the EU level. These provide a single system across the EU to test, approve and monitor the safety of new and existing treatments and devices.

In the event of a no-deal Brexit, the Medicines and Healthcare products Regulatory Agency (MHRA) will take on responsibility for this type of regulation, including how medicines and medical devices are made, imported, supplied and sold.

The MHRA have developed detailed plans to ensure medicines and medical devices would remain approved and available for patients in the UK for a limited period. This guidance also covered plans to ensure EU-backed clinical trials taking place in the UK can continue, and that importing experimental medicines for trials will continue to be allowed.

Update: The NHS has assured us that it is continuing to work with organisations that run clinical trials to ensure research continues as normal in the coming months. If you are taking part in a clinical trial, the NHS advises that you speak to the organisation that is hosting the study if you have any concerns.

How has the Government prepared for this situation?

Update: The Department for Health and Social Care have issued new information to highlight the contingency measures they have put in place to make sure medicines are still available, even in the event of a ‘no deal’ Brexit. This includes:

  1. Increasing UK stocks of medicines
  2. Ensuring medicines are a priority on transport links between the UK and the EU
  3. Working with suppliers to prepare them for new border and customs controls
  4. Ensuring flexible regulation so EU approved medicines can continue to be used in the UK

The UK Government has put in place a series of measures in order to prevent any short-term interruption to the supply and availability of medicines in the event of a no-deal Brexit, including ‘fast-tracking’ several necessary changes to UK law.

As part of its preparations, the Government has worked with pharmaceutical companies to identify medicines which are currently imported from the EU. It has asked these companies to stockpile an additional six weeks supply to reduce the impact of any potential delays on imports to the UK. For medicines with a short shelf-life that can’t be stored for long periods, the Government has asked UK suppliers to ensure plans are in place to air freight these products into the country. Plans have also been put in place so medications and medical devices are prioritised as part of additional shipping capacity between the EU and UK.

While most arthritis medication, including painkillers and biologic drugs, have a shelf-life longer than six weeks, it should be noted that drug suppliers have raised concerns with Parliament about the logistics and implementation of these plans.

For medical devices, which can include hip, knee and other joint replacements, the Government has convened a working group with industry and trade associations to test its contingency planning, so these can still be imported to the UK following Brexit. Most recently, the Department of Health and Social Care has set-up an emergency ‘hotline’ for NHS suppliers to use if they experience any disruption to deliveries as a result of Brexit, and the Department is also working with their counterparts in Scotland, Wales and Northern Ireland to support them in any preparations.

What might this mean for you?

Update: The Government has issued further information about the impact of temporary disruptions in supply of medicines. Their guidance states:

In the unlikely event your medicine is temporarily unavailable, the NHS will work with you to prescribe the best alternative. This could typically be a different brand of medicine or perhaps lower strength medicines to make up the same dose. On rare occasions it may mean a different medicine to do the same thing, but you will make the decision with your prescriber who will be provided with all the necessary information on how best to do this. This will ensure your treatment continues as normal. The NHS, through your local GP surgery, pharmacy and/or hospital, will help you to stay informed if there are any changes.

If you are concerned, please speak to your doctor or pharmacist.

The Secretary of State for Health and Social Care, Matt Hancock, has asked clinicians in the NHS to advise patients not to store additional medicine at home (PDF, 396 KB). People should continue to obtain prescriptions and use their medicines in the normal way.

In addition, the Government has unilaterally offered that it will continue to pay for any healthcare costs for current or former UK residents who are living, working in, or visiting the EU in the event of a no deal Brexit until the end of December 2020. Some EU countries, such as Spain, have already committed to ensuring access to healthcare for UK nationals and the UK Government will also fund, for up to one year, healthcare for UK nationals who have applied for, or are undergoing treatment in the EU before the UK leaves.

However, alongside the above information, the Government has also made it clear that it may not be able to guarantee access to healthcare abroad in a no-deal scenario, and continues to advise UK residents to take out travel insurance for any overseas travel.

Update: The Government has updated its guidance for UK nationals travelling to the EU, and for UK nationals living in the EU after Brexit.

What next?

In the short term, it is very difficult to fully understand the potential impact of a no-deal Brexit and how it might affect the availability of medicines and access to surgery like joint replacement. However, we will continue to monitor the ongoing situation to ensure that the needs of people with arthritis are considered.

If you would like to speak about any concerns about access to treatments please call our free helpline on 0800 5200 520. Our lines are open from 9am-8pm Monday to Friday.