Adrenaline auto-injectors (AAIs) – A shortages case study
What are AAIs?
that people carry with them in case there is an emergency, such as a
potentially life-threatening allergic reaction to stings or certain foods (e.g.
What was the issue? A shortage of one
particular brand led to increased demand for other AAIs, which coincided with
the seasonal increase in demand for all AAIs linked to the seasonal vaccination
and back-to-school periods. This led to supply constraints for AAIs in the
second half of 2018.
What was the benefit of the multi-stakeholder
The HPRA, in
collaboration with the other AAI suppliers and healthcare professionals,
were able to respond quickly and establish the potential gap in supply as
soon as the potential shortage was identified. This allowed a number of
actions to be taken prior to the seasonal increase in demand.
suppliers were advised of the anticipated increased demand for their
products in advance so that they could increase production and supply to
Ireland to fill the gap left by the shortage. This communication continued
during the period of supply constraints to ensure mitigation of the
The HPRA liaised
with the pharmacy regulator, hospital pharmacy medication safety networks
and the community pharmacy representative body to provide information on
the supply issues so that appropriate guidance and information could be
disseminated to pharmacists to ensure a pragmatic response to the
maintained regular communication with specialist prescribers who provided
clarification to colleagues on appropriate prescribing of AAI strengths.
As some patients
may have received an alternative AAI that they may have been previously
unfamiliar with, communications highlighted that patients and their carers
should become familiar with the new device and that pharmacists could
provide advice in this regard at the point of dispensing.
section of the HPRA website was updated regularly with information on the
supply and became a ‘go-to’ site for information to patients and
Was Ireland the only country impacted?
The supply constraints
were a global issue that impacted many countries, including the USA and the UK.
Whilst the supply situation in Ireland was challenging, the actions taken
ensured that a suitable AAI was available to dispense to patients at all times
which is in contrast to the situation observed in other countries.