Medicine shortages are becoming more frequent, impacting patients everywhere.

The Royal Pharmaceutical Society (RPS) has stated that “Medicines shortages impair patients’ access to treatment, causing frustration, anxiety and in some cases worsening health”.1

The RPS report also highlighted “There is a growing consensus that the increase in medicines shortages that the UK and other countries are experiencing is becoming a ‘new normal’ of frequent disruption to medicines supply”, which was referenced from the same Nuffield Trust report which states that “Multiple indicators show that the past two years have seen constantly elevated medicines shortages, in a new normal of frequent disruption to crucial products”.

These views are undoubtedly correct, and the impact of shortages is obvious: patients losing access to medicines.

“Ensuring continuity of treatment requires the ability to source medicines through different routes when primary supply channels are disrupted” — Royal Pharmaceutical Society, 2024

Addressing shortages is the challenge that Smartway’s import strategy has been addressing for many years, with great effect, particularly with the increased financial pressures on healthcare systems. The continuation of parallel imports as a response to this emerging issue is helping patients throughout the UK.

Smartway uses its import capacity to help hospitals, pharmacies and healthcare systems, including the NHS, optimise their medicine procurement strategies, fill gaps in supply and provide continuity of care to patients. This helps every part of the health system, from NHS to private care.

What Are Parallel Imported Medicines?

Parallel imported medicines are pharmaceutical products/medicines sourced from one country and imported into another. The product is authorised by the regulatory authority in its origin country, and the repackaged product is nationally authorised by the authority in the destination country to ensure the appropriate, equivalent safety and efficacy standards are met. Parallel imported medicines are therapeutically equivalent∗.

For Smartway, this typically means importing from countries in the European Economic Area (EEA) under UK authorisations that Smartway holds for those products∗∗.

Once a medicine is placed on the market in an EEA member state (e.g. Sweden), it can be supplied into the UK, provided all requirements for packaging and quality assurance are met. This is regulated by the Medicines and Healthcare products Regulatory Agency (MHRA).

Parallel distribution can also apply between EEA member states when they are authorised by the European Medicines Agency (EMA).

Cost containment and supply resilience are also a natural result from the competitive market dynamics created by parallel imports, making them an important part of the pharmaceutical landscape.

Parallel imports are the same authorised medicines, identical in active ingredient, strength, dosage form, and therapeutic effect, but sourced through alternative, often more cost-effective, supply routes from countries within the EEA.

Parallel imports are different from unlicensed imports, which are addressed further below. These typically involve importing medicines which do not have local authorisations, though they may well be authorised in other countries.

Read here for an example of when Smartway imported an unlicensed medicine to give a patient much-needed relief from menstrual pain.

How parallel imports help health systems

With global supply chains facing increasing strain from manufacturing disruptions, medicines shortages and freight delays, parallel imports help ensure that treatment continuity is maintained, operating within a well-regulated environment. Smartway has for decades imported medicines into the UK to address a shortage of medicines on the local UK market.

The importance of parallel imports has grown as medicine shortages become more frequent and healthcare budgets more constrained. In 2017, the Nuffield Trust found that parallel imports result in “passing on some savings to the health service”2. This is because pricing variations across different markets caused by various factors play out. Parallel importation enables healthcare providers to procure the same medicine often at a lower cost. This offers significant savings to public health systems like the NHS, as well as private healthcare providers, without compromising on quality or efficacy.

It is thought that parallel imports accounted for around 9% of the medicines dispensed in pharmacies in England in prior years, valued at ₤750m. The NHS is estimated to save hundreds of millions of pounds each year due to parallel imports according to a report in 20203.

Parallel imports also account for a significant proportion of medicine supply in many other European markets, delivering billions in savings to healthcare systems annually.

For procurement teams, wholesalers, and healthcare organisations, parallel import sourcing is a strategic tool to enhance availability, manage costs and protect patients from the risks of supply disruption.

How Smartway helps health systems

At Smartway, parallel importation of medicines is one of the many tools we use to help improve and empower patient access, helping build a more resilient global medicine supply chain. We work closely with our partners in Europe, including suppliers and manufacturers.

We are routinely engaged by the NHS and independent providers during periods of shortage to maintain continuity of treatment, whether licensed parallel imported medicines, or unlicensed imports.

With decades of experience, we support NHS Trusts, GP surgeries, pharmacy chains, private hospitals, and other healthcare providers through:

  • Strategic Global Sourcing: Our extensive partner network across the EU and beyond ensures access to a wide range of medicines, even during shortages. Smartway holds a resilient portfolio of products suitable for parallel import.
  • Supply Continuity: We help healthcare providers respond rapidly to disruptions, ensuring treatments remain available.
  • Regulatory Excellence: Every product meets regulatory and safety requirements. This means the medicines are safe and effective.
  • Market Insight: We provide actionable data and guidance to support strategic procurement decisions, often helping us address shortages at the first opportunity.

Our expertise in imports from the EU and further afield, combined with our commitment to quality and compliance, makes Smartway a trusted ally for those in healthcare systems seeking cost-effective, reliable, and patient-focused supply solutions.

The future for parallel imports

As the healthcare landscape continues to evolve, the role of parallel imported medicines will increase in the UK. They are a strategic necessity for healthcare systems striving to balance affordability, quality, and supply resilience, for the benefit of patients.

“Parallel imports strengthen access, maintain quality and support continuity of patient care. As supply challenges increase, our responsibility is to ensure healthcare providers can rely on safe, compliant, and consistent medicine access.” — Dhruv Patel, Chief Operating Officer

At Smartway, we have embedded parallel imports as part of our offering - ensuring that no patient is left without access to the medicines they need, wherever they are in the world.

Smartway imports medicines from outside of the EEA under separate authorisations and licences. These are unlicensed medicines that are also an effective weapon against shortages and you can read more about how here.

Sign up to receive regular updates on medicine shortages, or get in touch to request a medicine which you are struggling to obtain at: [email protected]

∗Prescribers will assure continuity of treatment for certain conditions in line with usual prescribing guidance
∗∗Product licences held by Smartway can be verified here:
https://products.mhra.gov.uk

References:

  1. 1.  Medicines Shortages: The Future for Health After Brexit (2024) ( www.nuffieldtrust.org.uk/sites/default/files/2024-04/Health%20after%20Brexit_WEB.pdf )
  2. 2.  How will our future relationship with the EU shape the NHS? (2017) ( www.nuffieldtrust.org.uk/sites/default/files/2017-11/1509990492_nt-future-relationship-with-eu-after-brexit-web.pdf )
  3. 3.  Institute of Economic Affairs ( iea.org.uk/publications/parallel-universe/ )