THE turning point was the Brexit referendum. Before voting to leave the EU in June 2016, medicine shortages were not something the UK often had to worry about.

But once the votes had been ­counted, the UK Government ­realised that it may have an issue on its hands. As well as urging ­pharmacists to stockpile a six-week supply of key medicines ahead of the transition ­period ending, Whitehall also started to keep a close eye on drug shortages and supply.

“A lot of the measures for ­medicine shortage were brought in as the ­Government in London tried to ­prepare for Brexit and anticipated, probably correctly, that it would have a really big effect on medicine ­supplies,” Mark Dayan, the Brexit Programme Lead at the Nuffield Trust told the Sunday National.

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And issues with medicine supply in the UK didn’t start with the end of the transition period. They began almost as soon as the 2016 referendum results came in. And there is one measure which predates Brexit which highlights this: UK Government-approved price concessions for ­imported medicine.

These concessions have an immediate knock-on impact on an already over-stretched NHS budget. The more the health service pays for medicine, the less it has to spare elsewhere.

Before the referendum in June 2016, the Department of Health and Social Care had never needed to issue more than two dozen at a time.

Since mid-2016, the number of ­concessions being issued has climbed higher and higher. After the impact of Liz Truss’s disastrous mini-Budget – which saw the pound sterling hit ­record lows against the US dollar – the UK was forced to issue around eight times more concessions than it ever had before the Brexit vote.

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These price concessions are ­“really an indicator of shortage or ­pressure on supplies”, Dayan explains. ­Worryingly, the low numbers being approved before the 2016 vote have not been seen again since.

The UK’s decision to exit the EU ­impacted immediately on medicine supply and cost concessions through the devaluation of the sterling. Exit polls predicting a Leave victory saw the pound slump to a three-decade low from which it has never ­recovered.

The NHS has to spend more of its pounds to get the same amount of medicine as it had before “because of perceptions about what Brexit would mean,” Dayan says.

He adds that while medicine ­shortages are a global issue at the ­moment, “there is evidence that ­aspects of this in the UK have been exacerbated by Brexit”.

A weakened pound is not the only way in which leaving the EU looks to have impacted on medicine supplies and prices in the UK. “Bureaucracy and barriers at the border” may also have added to prices, leading to more concessions having to be made.

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“Particularly for generic medicines which are not expensive [and not] high-end products where extra transport costs can be soaked up,” Dayan says. “They’re price-competitive, bulk, commodity products. A change in transport costs could have an effect.

“In many cases they would have been supplied on a whole-Europe basis before [Brexit]. Some will be shipped straight to the UK, but many will be shipped to Rotterdam or ­Hamburg etcetera.”

And looking to the future, the UK may find itself outside of key ­measures to combat medicine shortages being looked at by the EU.

On Thursday, the Financial Times reported that the ­European ­Commission was looking to ­tackle problems it is facing through ­stockpiling drugs and obliging ­manufacturers to guarantee supplies.

Dayan warned that the UK may need to look at taking such policy moves on, as it will “not be part of EU anti-shortage measures”.

“If the EU does stockpile a lot of these common medicines for example for infectious diseases, the UK will be out of that,” he says. “It may have to consider stockpiling for itself again.”

A surge in Covid, cold, and flu cases – especially in children – across the northern hemisphere has left some basic medicines in short supply. But soon the issue could be elsewhere.

“Crises tend to jump from one [drug] to the other,” Dayan says.

“At the moment the UK, and ­actually many countries, are in a ­really difficult situation with ­medicine shortages and it’s gotten much, much worse in recent years.”