Treatment Interruptions and Inconsistent Supply of Anti-Tuberculosis Drugs in the United Kingdom

Int J Tuberc Lung Dis. 2011 Jun;15(6):754-60. doi: 10.5588/ijtld.10.0568.

Abstract

Setting: National Health Service (NHS) centres treating tuberculosis (TB) in the United Kingdom.

Objectives: To describe NHS TB treatment centres' experience of obtaining anti-tuberculosis drugs to treat drug-susceptible and drug-resistant TB between 2007 and 2009. In particular: 1) any difficulties experienced in obtaining different drugs; 2) resulting interruptions or alterations in the prescribed regimen; 3) availability of paediatric formulations; and 4) resources available to identify and manage drug shortages.

Design: Questionnaires were sent to pharmacists at 168 treatment centres.

Results: Of the 77 (46%) treatment centres that responded, 63% (48/77) reported difficulties in obtaining anti-tuberculosis drugs. Consequently, 27% had to interrupt the prescribed treatment regimen at least once, whilst 19% had to alter the regimen. Of 55 centres treating multidrug-resistant tuberculosis, 36% reported difficulties obtaining second-line drugs, 16% had to interrupt the prescribed treatment regimen at least once and 5% had to alter the regimen. A lack of licensed liquid formulations for children resulted in 26% of treatment centres using unlicensed, variable-strength liquids and locally prepared suspensions.

Conclusions: Difficulties obtaining drugs to treat both drug-susceptible and drug-resistant disease are common in the UK. There are particular risks for children. Our data identify an urgent need for national strategic guidance to ensure a consistent and reliable supply of anti-tuberculosis drugs.

MeSH terms

  • Antitubercular Agents / supply & distribution*
  • Antitubercular Agents / therapeutic use*
  • Cross-Sectional Studies
  • Drug Industry
  • Humans
  • Pediatrics
  • Pharmacists
  • State Medicine
  • Surveys and Questionnaires
  • Tuberculosis / drug therapy*
  • United Kingdom

Substances

  • Antitubercular Agents