Britain's government watchdog says there's still a "significant amount" of work to do to make sure the country has an adequate supply of licensed drugs in case of a no-deal Brexit.
In a report issued Friday, Britain's National Audit Office said additional shipping capacity chartered by the U.K. for sending goods across the English Channel might not be operational until the end of November — one month after the Oct. 31 deadline for Britain to leave the European Union. Of the more than 12,300 medicines licensed in the U.K., about 7,000 arrive from or via the EU, mostly across the Channel.
Meg Hillier, who chairs a committee overseeing the audit office, called the findings "deeply concerning." She said she had seen "countless examples" of the British government missing deadlines, but that this one was particularly striking.
"If the government gets this wrong, it could have the gravest of consequences," she said.
Alan Boyd of the Academy of Medical Royal Colleges said people with epilepsy were a particular concern in the event of any drug shortages, noting that "one seizure can have a life-changing impact."
According to the British government's "reasonable worst-case" scenario, the flow of goods could be cut by half on Day One of a no-deal Brexit and could take a year to recover. It said time was "extremely limited" if the shipping issues were to be resolved by the end of October.
'Troubling, reckless'
Dr. David Nicholl, a neurologist who helped draft the U.K.'s no-deal Brexit planning and went public with his concerns this month, said he felt vindicated by the audit office report. He said during his work consulting for the government, there were concerns about adequate supplies for treatments for conditions including epilepsy, Parkinson's disease, diabetes and certain cancers including leukemia.
"It's incredibly troubling and reckless," he said. "I don't think there's any evidence that we're in any better situation than we were before."
Nicholl said British politicians were still refusing to honestly acknowledge the harm that would be caused to patients in Britain by a no-deal exit. He predicted there would be a spike in illness and deaths if Britain does leave Europe without a divorce deal.
In early September, Nicholl publicly raised the issue of drug shortages on a London radio show when he pointedly asked Jacob Rees-Mogg, the leader of the House of Commons, what level of excess deaths he would be willing to accept in a no-deal Brexit. Mogg dismissed Nicholl's warnings and later compared him to the disgraced researcher Andrew Wakefield, who published a now-discredited paper linking a childhood vaccine to autism. Mogg later apologized for the comparison.
"It's completely surreal," Nicholl said, describing how politicized the situation has become. "I still don't think there's been an honest conversation about the harms that will be caused by a no deal."
Precautions, stockpiles
Britain's department of health said it has taken measures to prepare, including ordering six weeks of extra medicine stocks across the country and securing specialist courier services to deliver products with a short shelf life.
But not everyone was convinced by the moves.
"One thing is clear about a no-deal Brexit and that is that no amount of preparation can fully eradicate the risks it presents to patient safety," said Donal O'Donoghue of the Royal College of Physicians. "It is impossible for me and my colleagues to reassure patients that their health and care won't be negatively impacted by the U.K. leaving the EU without a deal."
Steve Bates, CEO of U.K.' s Bioindustry Association, said that unlike the last Brexit deadline — March 31 — the government has given companies much less information about alternative routes in case a no-deal Brexit results in jammed ports.
"Last time, we knew which ferry services had been commissioned on alternative routes with pharmaceutical companies encouraged to book space to ship their products," he told reporters last week. "But the same approach has not been adopted this time."
The audit report released Friday also said there was "incomplete information" about the levels of medicine stockpiling but that levels were increasing daily. As of Sept. 20, suppliers reported that 72% of medicines had a six-week stockpile.
Boyd said drug shortages already happen every month even without Brexit and the department of health typically issues a list of affected medicines and, in some cases, suggests possible alternatives. He said the group was also concerned that a no-deal Brexit would mean that Britain would be kicked out of a Europe-wide program to identify counterfeit medicines.
"The department of health will put its own system in place, but that will likely take a few years before it's up and running," he said.
