“英国脱欧让我们变得更加脆弱，因为我们不再能使用欧盟的药品储备。” 读者来信：若药品价格被压得过低，将导致药物短缺。阿曼达·科尔（Amanda Cole）表示，政府需要权衡药品成本与短缺对英国国家医疗服务体系（NHS）及患者造成的损害。如果没有果断的政府行动，报道中医院出现的药物短缺将只是冰山一角（英格兰的医院遭遇扑热息痛等常用药物短缺，9月29日）。
‘Brexit has made us even more vulnerable as we no longer have access to EU medicine reserves.’Medicine shortages will result if drug prices are driven too low Amanda Cole says the government needs to weigh the cost of medicines against the damage that a shortage can cause to the NHS and patients Without decisive government action, the reported medicine shortages in hospitals will only be the tip of the iceberg ( Hospitals in England hit by shortages of common drugs such as paracetamol, 29 September ).
药品的供应链复杂且全球化，存在多个潜在的故障点，对地缘政治冲击尤为敏感。英国脱欧让我们更加脆弱，因为我们不再能获得欧盟的药品储备，跨境物流也变得更加复杂。
Medicine supply chains are complex and global, with multiple points of potential failure that are especially sensitive to geopolitical shocks. Brexit has made us even more vulnerable, as we no longer have access to EU medicine reserves and cross-border logistics are further complicated.
研究表明，这些短缺往往集中在（专利期已过的）非专利药（仿制药）和生物类似药市场。诚然，非专利药的低价格对于节省医疗系统开支和提高可负担性非常重要。问题在于，当价格被压至不可持续的低位时，制造商会退出市场，导致供应商过少，面对任何供应链中断或需求激增时都极其危险地暴露在风险之中。当短缺发生时，NHS将承担代价，表现为价格上涨、昂贵的替代品，以及在应对紧急采购甚至配给时沉重的人员负担。患者则以延误治疗和更差的疗效付出了最高昂的代价。
research shows that these shortages tend to be concentrated in (off-patent) generic and biosimilar markets. It’s true that low prices for off-patent medicines are important in driving health system savings and promoting affordability. The problem is that when prices are driven an unsustainable low, manufacturers exit, leaving markets with too few suppliers and dangerously exposed to any supply disruption or demand spike. The NHS bears the cost when a shortage does occur, in the form of higher prices, expensive substitutes and a heavy staff burden in managing emergency procurement and, sometimes, rationing. Patients pay the highest price in delayed treatment and worse outcomes.
政府需要权衡价格管制与药物短缺可能造成的惨重损失。解决之道在于利用监管、定价和审批决策来鼓励竞争并培育供应商的抗风险能力。在药品的可负担性与安全性之间，必须找到一个关键的平衡点。健康经济学办公室主任
The government needs to weigh pricing controls against the costly damage that a drug shortage can cause. The answer lies in using regulatory, pricing and approval decisions to encourage competition and nurture supplier resilience. There is a critical balance between affordability and medicine security that needs to be struck. Director, Office of Health Economics