NHS drug shortages have one cause

Almost 400 medicines are vulnerable to shortages in the UK, according to a new list produced by NHS England and Medicines UK. Among the drugs on the list are treatments for blood clots, stroke, and several cancers.

The medicines were identified as at-risk because they have either a single supplier, or no supplier at all. Often, drug companies stop producing specific medicines because they no longer see them as commercially viable.

Having identified this vulnerability, NHS England and its partner organisations are taking steps to mitigate the problem. They’re calling the initiative ‘Project Revive’, providing incentives for drug companies to manufacture the medicines on the list.

Whilst undoubtedly an important step towards ensuring the resilience of the medical supply system in the UK, this is a treatment for a symptom, rather than a cure.

We’re in this mess in the first place because we treat drug manufacture as a commercial market, where companies can compete, patent, price gouge, and drop drugs when they stop making money. That commercialisation of healthcare costs lives.

NHS shortage of ‘products of critical priority’

In total, NHS England identified 378 drugs on its list of vulnerable medicines. Of these, around 80 no longer have a supplier at all, meaning that the currently existing supply is all that remains.

The medicines on the list include bendamustine, a chemotherapy drug used for several cancers; flupentixol, which is used for schizophrenia; and urokinase, a treatment for pulmonary embolism. The prices that the UK pays for these drugs could soar if demand starts to outpace supply.

NHS England produced its list alongside Medicines UK, a trade body representing manufacturers of generic medicines. Mark Samuels, Medicines UK’s chief executive, said:

The list includes products of critical priority and the ambition is to target those medicines representing the most serious risk to supply resilience, which could lead to shortages affecting patient care.

Drugs which have faced shortages across the UK in recent years include estradiol, an element of hormone replacement therapy; lisdexamfetamine, an ADHD medication; and Creon, which is used to treat cystic fibrosis.

Project Revive

However, NHS England, Medicines UK, and the Medicines and Healthcare Products Regulatory Agency (MHRA) plan to tackle the problem of shortages through ‘Project Revive’. This scheme will provide incentives like fast-tracked license approvals to enable manufacturers to supply the 378 drugs on the list.

The pilot of Project Revive will run for 12 months. Then, in 2027, coordinators plan to instate a long-term iteration of the same scheme. Samuels explained that:

We have long stated that medicine shortages cannot be solved in isolation, and this project shows what can be achieved by working together. By working with NHS England and MHRA, we hope that this new model provides more certainty to enable companies to produce and supply medicines for use in the NHS.

Fiona Bride, interim chief commercial officer for NHS England, echoed that sentiment:

Ensuring a resilient and stable supply of medicines is fundamental to delivering patient care, with pharmaceuticals being the most common healthcare intervention in the NHS, and this collaborative pilot initiative aims to strengthen that supply chain by incentivising more companies to become NHS suppliers, or deepen existing partnerships.

Treating the symptom

The news of Project Revive comes after medicine pricing issues hit the headlines last year. Several of the world’s biggest drug manufacturers announced that they were ditching their UK projects.

Critics from within the industry blamed uncompetitive prices for new medicines, low levels of government investment, and Trump’s tariffs adding to supply prices.

Then, in September 2025, science minister Patrick Vallance argued that the NHS would have to pay higher prices for medicines to prevent pharmaceutical investors from abandoning the UK.

This is a problem inherent to introducing a profit motive to any aspect of healthcare, all across the world. Treating medicine as a capitalist exercise creates a host of problems for patients, who should always have been the center of the issue.

Meanwhile, the global pharmaceutical industry has raked in profits at higher margins than practically any other sector.

Profit over patients

As NHS England showed in the Project Revive research, drug companies can cease supply of individual medicines if their profits aren’t high enough. This can leave patients without crucial medications that they need.

Likewise, manufacturers can also raise their prices artificially if they aren’t faced with competition from other companies, or if other countries are willing to pay higher prices. Patents and intellectual property rights for individual drugs can also allow companies to create artificial scarcity.

Even beyond this, the profit motive causes problems with the development of new medicines. Companies aim to develop medicines in profitable sectors, particularly cancer and rare diseases. This, in turn, sees less-profitable diseases neglected in terms of research and development.

Likewise, even the idea of curing a disease can be anathema to a profit motive. In a choice between being paid once to cure a patient, or being paid again and again to treat a disease without curing it, the latter is the profitable choice. For example, one damning Goldman Sachs report stated that:

The potential to deliver ‘one shot cures’ is one of the most attractive aspects of gene therapy, genetically-engineered cell therapy and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies…. While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow.

Project Revive looks like an important step towards strengthening the UK’s drug supply chain. However, it’s a band-aid on a problem which will take far more work to heal.

In the UK, we fear the loss of socialised healthcare through the NHS, but the private sector already has its hooks in the system at every level.

There’s no easy fix for the problem of private profiteering in medicine. Capitalism itself is an enemy of good healthcare. It sounds glib, we know, but it’s also true. Failing to recognise that fact will mean that we’re trapped in a cycle of treating the symptoms, whilst neglecting their cause.

Featured image via the Canary