Creon 10,000 and 25,000: Quantities to be dispensed limited to one month
The Department of Health and Social Care (DHSC) has introduced two new Serious Shortage Protocols (SSPs), SSP060 and SSP061, in response to the current shortage of pancreatic enzyme replacement therapies (PERTs). The SSPs relate to Creon 10,000 and Creon 25,000 capsules. They are valid from 24/05/2024 until 22/11/2024.
Both SSPs indicate that where supplies are available, but the prescription is for more than one month’s supply, the total quantity that may be supplied against the prescription is to be limited to the equivalent of one months’ supply of the prescribed medicine. They also place an obligation on the dispensing pharmacy professionals to make the patient/carer aware that in accordance with this SSP, no further supply can be made from the same prescription above the one-month quantity. In other words, the pharmacy must supply and claim for a maximum of one month’s supply, but cannot generate an “owing” for the patient to collect the balance the following month.
Background
As per Community Pharmacy England, the supply disruption of Creon® capsules is due to limited availability of active pharmaceutical ingredients and manufacturing constraints to produce the volumes required to meet demand. Alternatives such as Nutrizym 22 capsules and Pancreas V are either out of stock or not expected to support an uplift in demand.
- Creon® 10,000 and 25,000 capsules are in limited supply until 2026.
- Nutrizym® 22 capsules are out of stock until mid-August 2024.
- Pancrex V® capsules and powder remain available but are unable to support an increase in demand.
The supply disruption for Nutrizym® 22 capsules has been caused by a manufacturing issue and increased demand because of the Creon® supply issue.
PERT is indicated for the treatment of pancreatic exocrine insufficiency such as in cystic fibrosis, pancreatic cancer, and pancreatitis. There is no clinical alternative to PERT.
Implications for Pharmacy Professionals in General Practice
Pharmacists and pharmacy technicians in general practice will likely get one or both of the following queries over the immediate future:
- Requests for alternatives from frustrated patients who have not been able to obtain PERT from their pharmacy
- Complaints over limitation of supply to one month by dispensing pharmacies.
As usual, exercising empathy and good consultation skills in this situation is paramount. It is vital to support frontline fellow professionals working in community pharmacy. At the same time, the following advice from Community Pharmacy England will go a long way in guiding clinicians to minimise the development of such problems:
If you would like information on other SSPs, please click here.
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