Update on supplies of riluzole

Wednesday 21 February 2024

While we have seen a reduction in the number of reports from people who have struggled to have their prescriptions fulfilled, suggesting the situation is improving, we are also aware it remains an issue for a small number of people.

The manufacturing and supply chain of riluzole is complex. We have been made aware that manufacturers struggled to source the active pharmaceutical ingredient to make riluzole, and some pulled out of the UK market so reducing availability of the drug.  

Having been in touch with manufacturers and wholesalers, the Department of Health and Social Care (DHSC) has assured us there is now sufficient stock available. We have also received a response from the Minister of State for Health and Secondary Care, Rt Hon. Andrew Stephenson CBE MP to our letter, dated 11 December 2023. He also assured us there are sufficient supplies of riluzole and pharmacies should be able to order stock from their normal wholesalers.  

However, we believe there may be challenges sourcing the drug at community pharmacy level. We are continuing to work with Community Pharmacy England and, until we are confident everyone with MND can easily access the medication they have been prescribed, we won’t stop pushing for a resolution.

Of course, we need to ensure this won’t happen again as well. Riluzole is the only treatment available for people with MND so it is vital that supplies are always available. We will continue to explore the lines of enquiry available to us and share our findings with all relevant organisations, departments and teams.

We will also continue monitoring the situation and taking account of any further reports we receive from people with MND or Care Centres and Networks to report to the DHSC. 

Thursday 25 January 2024

We are aware some people with MND are still having issues with accessing riluzole. We know this is worrying.
We met with representatives from Department of Health and Social Care this week. We are calling on the Government to take decisive action to identify the causes of the current shortages and resolve them as soon as possible.
We will continue to engage with them – this includes a further meeting next week. We will continue to prioritise this issue until everyone can easily access their prescribed medication.

Monday 8 January 2024

As you know, over the last three months the MND Association has been receiving reports from our community about difficulties having their prescriptions of riluzole fulfilled. 

Since then we have had a number of conversations with medicine supply agencies and the Department of Health and Social Care (DHSC) as well as raising our concerns through the All Party Parliamentary Group for MND, submission of a Parliamentary Question and by writing directly to the Secretary of State for Health and Social Care, Victoria Atkins. We have also worked with the media to highlight the issue. While we have received some reassurances from supply agencies, unfortunately we have continued to receive reports that people with MND are having difficulties accessing their medication. We are collating these reports as evidence and sharing them with the relevant agencies and authorities.

We are currently awaiting a response from the Department of Health and Social Care for further questions we asked on 20 December. 

Our next steps are:

• To follow up with the Secretary of State for a response to our December 2023 letter.
• Continue to share evidence of shortages with DHSC Medicines Supply Team.
• Continue to engage with Community Pharmacy England to understand community pharmacy challenges in accessing riluzole.

We are urging anyone experiencing problems accessing riluzole via their pharmacy to contact their GP or neurologist to ask them to prescribe an alternative riluzole preparation. 

Thursday 14 December 2023

Our Chief Executive Tanya Curry is awaiting a response to her letter of 8 December to the Secretary of State for Health and Social Care Victoria Atkins urging her to act fast to resolve the reported shortage of riluzole.

In her letter Tanya called for the Department to clarify in detail:

• what steps it has taken to understand the causes of the supply issue and to ensure the restoration of supply immediately
• why there continues to be no stock available to order, despite the assurances evidently given to the Department by suppliers
• when supply will be fully restored.

She also asked, on behalf of the whole MND community, that ‘the Department of Health and Social Care takes urgent steps to ensure that in cases where generic riluzole is not available, patients are given access to a branded alternative version of the drug’.

We have chased the Secretary of State for a reply. In the meantime, we are continuing to hear from members of our community of ongoing challenges with access to riluzole tablets.

As a reminder, if you are experiencing problems please contact your GP or neurologist to explain that the pharmacy could not dispense the prescription requested and ask them to prescribe an alternative riluzole preparation.

Riluzole is the only treatment currently available for people with MND and we feel strongly that healthcare providers should be doing everything possible to make alternative preparations available while work continues to resolve the issues of supply and distribution of riluzole tablets as a matter of urgency.

We know the situation is causing problems for our MND community and feel duty bound to share what information we can. 
 

Tuesday 5 December 2023

We have received a response from the Department of Health and Social Care to our written parliamentary question:

On 24 November, we asked the Secretary of State for Health and Social Care, Victoria Atkins, what steps her Department is taking to tackle shortages of Riluzole; and whether she plans to issue guidance to (a) local NHS Trusts and (b) prescribers to help ensure patients are able to access treatment for motor neurone disease.  

We received the following response on 30 November: "We are aware that one of the suppliers of riluzole 50 milligram tablets is experiencing a supply issue. However, alternative suppliers have stock available. We are working closely with all the relevant manufacturers to expedite deliveries, where possible, to ensure supplies remain available for patients in the United Kingdom.

We have well-established processes for managing and mitigating medicine supply issues, which involve working with the pharmaceutical industry, the Medicines and Healthcare products Regulatory Agency, NHS England, the devolved governments and others operating in the supply chain to help ensure patients have access to the treatments they need."

Despite these reassurances, we are aware some people with MND are continuing to experience challenges in accessing riluzole. We have shared that evidence with the team at DHSC and requested an urgent meeting to discuss this further.

Thursday 30 November 2023
 
On Friday 24 November, we were informed that an alternative riluzole supplier had been sourced. This response suggested the situation with riluzole supply seemed to be improving.

Over recent days, however, the MND Association has continued to receive reports from people with MND, doctors and regional care teams that riluzole supply is still a problem. 

It is clear this is a complicated and mixed picture and we have not yet received satisfactory information that reassures us the situation is being effectively addressed. We are continuing to discuss this with a number of stakeholders and have urgently requested a meeting with the Department of Health and Social Care (DHSC) to ensure the situation is resolved as soon as possible. We have also raised our concerns through the All Party Parliamentary Group for MND and are expecting a response to a Parliamentary Question.

We will update you when we know more about this ever-changing situation. 

In the meantime, we are keen to continue to monitor and understand the scale and extent of the problem. Please share your experience with your Area Support Coordinator or Service Development Manager. 

We know this is a worrying time for many people. Please be reassured we are doing everything we can to resolve the issue, this includes liaising with MND Care Centres and Networks impacted by the shortages. It is not acceptable that people with MND are facing challenges sourcing riluzole, the only approved medication for people with the disease. We will not stop until we know new stocks of medication have reached pharmacies for people with MND to access. 

Tuesday 14 November 2023

Since our last update, people with MND in certain areas of the country have continued to face challenges accessing riluzole. This is despite reassurances we received from the Department of Health and Social Care (DHSC) medicines supply team that stocks would be replenished during the week commencing 30 October. 

In some circumstances people have had to travel to several pharmacies, while some have had to request an alternative riluzole preparation.  
We recognise this is worrying for people. Riluzole is the only licensed medication for people with MND and it is vital people are able to access it easily in the formulation they are comfortable with. 

We have been in regular contact with the DHSC but unfortunately haven’t received the information we need. 
As a result, we will now be raising the issue with Government representatives this week to escalate our concerns and achieve a resolution. 
In the meantime, if you face any challenges with accessing riluzole please speak to your neurologist or GP. 

Alongside concerns about riluzole, we have also been made aware of an issue with the supply of suction tubing used for secretion management. We have been told by NHS England supply chain teams this is a global supply challenge caused by a manufacturer ceasing business. A process has been introduced to manage the demand and supply of the tubing to ensure it remains available to those who need it.  
Other manufacturers are now scaling up production and it is expected that the full supply chain will be operating as usual by March next year. 

Thursday 26 October 2023 

Today (26 October) we have been informed by the Department of Health and Social Care (DHSC) that stocks of riluzole will reach UK wholesalers next week (week commencing 30 October). The MND Association will continue communicating regularly with the DHSC for further updates and to find out what has caused the shortages.  

Tuesday 24 October 2023

The MND Association has been working with medicine supply agencies and MND Care Centres and Networks since receiving reports of a shortage of riluzole, currently the only treatment available for people with MND. 

We have been assured by the Department of Health and Social Care (DHSC) medicines supply team that new stocks of the medication will be distributed to pharmacies this week (week commencing 23 October)*. 

Shortages of the generic tablet form of the medication have been reported at pharmacies in central, west and south east of England over the last month. 

Our MND Connect helpline has received a number of calls and emails from people with MND whose usual pharmacy hasn’t been able to fulfil their prescription. We have been advising people to contact their GP or neurologist directly to request an alternative riluzole preparation. 

As soon as we became aware of the issue, the Association raised the shortage as a matter of urgency with the Department of Health and Social Care medicines supply team and has been in regular contact since. 

We have also been in communication with the 22 MND Care Centres and Networks, which we help support with funding, to advise them of the situation, let them know what guidance we are giving people with MND and keep them updated on our dealings with the DHSC.  

The Association’s Acting Director of Care Improvement Sally Hughes said: “This is very worrying for those people with MND who have been struggling to find a pharmacy to provide them with riluzole. Our understanding is that people have been supported by their clinicians to find alternative pharmacies or been prescribed a different form of the medication.  

“Of course the ideal situation is that everyone is able to source exactly what they have been prescribed with minimal effort. The DHSC has assured us stocks will be replenished this week – we will continue to liaise with them until we are confident that is the case.”