Notification and Management of Medicines Shortages
DH/ ABPI Best Practice Guidelines

PRO-FORMA FOR NOTIFICATION OF PRODUCT SHORTAGES

Information required

Company details

Company name:……………………………………………………..

Company contact:…………………………………………………..

Contact telephone number:…………………………………………

Contact fax number:……………………………………………….

Contact e-mail address:……………………………………………

Product details

Product name:………………………………………………………..

Licensed/ unlicensed uses:…………………………………………….

Presentation:………………………………………………………………

Presentations remaining:……………………………………………………

Reason for shortage

Manufacturing difficulties (yes/ no)

Regulatory problems (yes/ no)

Raw material problems (yes/ no)

Other (yes/no)

Further details of shortage
…………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Expected duration of shortage:

…………………………………………………………………………………………

Steps taken/ planned to address shortage:

…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..

Licensing Authority advised (yes/no)

Form completed by:                                                  Date:

Contact details
 
Department of Health
F.A.O. Mrs Isabelle Izzard         
Principal Pharmacist
Medicines, Pharmacy and Industry Group
456D Skipton House
80 London Road
London SE1 6LH

Tel:   020 7972 2913
Fax:  020 7972 2932

E-mail: isabelle.izzard@dh.gsi.gov.uk	
Mailbox: Brandedmedicineshortages@dh.gsi.gov.uk

In addition, for products affecting secondary care contract items:

NHS Purchasing and Supply Agency
F.A.O. Howard Stokoe
Principal Pharmacist
Premier House
60 Caversham Road
Reading RG1 7EB

Tel: 0118 980 8850
Fax: 0118 980 8853
E-mail: howard.stokoe@dh.gsi.gov.uk