Community Pharmacy Scotland has warned of possible further disruption in the supply of Clexane (enoxaparin 40mg strength) in late November.
Two biosimilars of Clexane (enoxaparin) are due to launch this autumn, which should provide support during the on-going Clexane supply constraints.
If there are supply problems, Sanofi has agreed to protect dispensary supplies in line with historical demand. If it proves impossible to source Clexane from wholesalers, practices should be ready to counsel patients who self-inject as there are differences in device design between the reference product and biosimilars.
In the interim, if a generic prescription for enoxaparin is received, the dispenser should confirm which brand the patient has been receiving, dispense this brand and endorse the prescription accordingly to ensure correct payment.
A biosimilar medicine is a biological medicine that is similar to another biological medicine which has already been granted a marketing authorisation. Although biosimilars and their reference biologic share a generic name, they are not presumed to be identical in the same way as generic non-biological medicines. To support pharmacovigilance and to ensure any switching between brands is authorised by the prescriber, the MHRA advise that biological medicine (including biosimilars) should be prescribed by brand name. Currently a high proportion of prescriptions for enoxaparin in primary care are issued by generic name and do not specify a brand. Work is underway across Scotland to transition across to branded prescribing.