Nine SSPs issued for Quetiapine tablets
In response to significant ongoing disruption to the supply of some Quetiapine tablets, the Department of Health and Social Care (DHSC) has issued nine new Serious Shortage Protocols (SSPs). The nine new SSPs, introduced with immediate effect, allow community pharmacists to consider different options to enable continued supply of quetiapine tablets to mitigate the ongoing supply disruptions affecting certain quetiapine tablet strengths.
Depending on the prescribed quantity of the affected quetiapine tablet, the protocols allow pharmacists to either supply a reduced quantity of the same quetiapine tablet, or substitute with a alternative strength, or provide a reduced quantity of a specific alternative product. For each SSP, DHSC has included specific patients counselling points which must be taken into account when deciding whether supply in accordance with an SSP is suitable for a patient. Pharmacists will need to call on their clinical expertise to determine which SSP is the most appropriate to use in each scenario and to counsel patients on any changes made to their treatment and what it means for their medicine regimen.
All SSPs are currently set to expire on 13 September 2024.
Pharmacy teams are advised to read the documentation in full for all SSPs published on the NHSBSA’s website and implement the protocols with immediate effect. DHSC have confirmed that the endorsement guidance for the new SSPs is currently being developed and will be added to the NHSBSA’s website shortly.
Quetiapine SSPs
For three strengths of quetiapine tablets affected by ongoing supply disruptions, a total of 9 individual SSPs have been issued by DHSC which allow either:
- Restriction of the quantity supplied – where a prescription has a duration of more than one month and supplies are available, an equivalent of one months’ supply will be permitted in accordance with the SSP for the prescribed medicine; or
- Substitution with a specific alternative product – where the prescribed duration of treatment is three months or less and supplies are unavailable, a pharmacist can supply a specific alternative product sufficient to provide a reasonable estimate of the prescribed duration of treatment, if deemed clinically appropriate; or
- Substitution with a specific alternative product AND restriction of the quantity supplied – where a prescription has a duration of more than one month and supplies are unavailable, the SSPs will allow pharmacists to provide one months’ supply of specific alternative product.
A summary breakdown of SSPs available for each strength of quetiapine tablets is listed below.
| Drug name | SSP | ||
| Substitution with a specific alternative quetiapine strengths | Restriction of the quantity supplied | Substitution with a specific alternative product AND restriction of the quantity supplied | |
| Quetiapine 150mg tablets |  SSP062 |
SSP063 |
SSP064 |
| Quetiapine 200mg tablets | SSP065 |
SSP066 |
SSP067 |
| Quetiapine 300mg tablets | SSP068 |
SSP069 |
SSP070 |
Pharmacists are required to read and comply with the requirements outlined within the individual SSPs and supporting guidance as published on the NHSBSA website for the quetiapine tablets listed above.
Where a prescription has a duration of more than one month and supplies are available, three of the SSPs for quetiapine enable community pharmacists in the UK to restrict the quantity supplied to an equivalent of one months’ supply.
No prescription charge is payable if a patient receives a smaller quantity of the medicine than the quantity originally ordered on the prescription if it was supplied in accordance with an SSP for reduced quantity.
| SSP number | Quetiapine product | SSP Expiry | Supporting Information | Patient charge |
| SSP063 | Quetiapine 150mg tablets | Friday 13 September 2024 | SSP063 guide | No |
| SSP066 | Quetiapine 200mg tablets | Friday 13 September 2024 | SSP066 guide | No |
| SSP069 | Quetiapine 300mg tablets | Friday 13 September 2024 | SSP069 guide | No |
Where the prescribed duration of treatment is more than one months and supplies of the prescribed treatments are unavailable, three SSPs for quetiapine tablets enable community pharmacists in the UK to substitute with specific alternative strengths quetiapine tablets to provide a reasonable estimate of the prescribed duration of treatment.
As there is no quantity restriction for the SSPs allowing substitution only, patients who pay for their prescriptions will continue to pay prescription charge(s) for all chargeable items including any quetiapine tablets supplied in accordance with such SSPs.
| SSP number | Quetiapine product | Substitute medicine | SSP Expiry | Supporting Information | Patient charge |
| SSP062 | Quetiapine 150mg tablets | For every quetiapine 150mg tablet, the following quantity must be supplied (listed in order of preference) in accordance with this protocol: 1 x 100mg and 1 x 50mg quetiapine tablet |
Friday 13 September 2024 | SSP062 guide | Yes* |
| SSP065 | Quetiapine 200mg tablets | For every quetiapine 200mg tablet, the following quantity must be supplied (listed in order of preference) in accordance with this protocol: 2 x 100mg quetiapine tablets |
Friday 13 September 2024 | SSP065 guide | Yes* |
| SSP068 | Quetiapine 300mg tablets | For every quetiapine 300mg tablet, the following quantity must be supplied (listed in order of preference) in accordance with this protocol: 3 x 100mg quetiapine tablets |
Friday 13 September 2024 | SSP068 guide | Yes* |
*where a patient does not hold a valid exemption.
Where the prescribed duration of treatment is longer than one month and supplies of the prescribed treatment are unavailable, three of the SSPs for quetiapine tablets enable community pharmacists in the UK to provide one months’ supply of specific alternative strengths of quetiapine tablets.
No prescription charge is payable if a patient receives a smaller quantity of the medicine than the quantity originally ordered on the prescription if it was supplied in accordance with an SSP for substitution AND reduced quantity
| SSP number | Quetiapine product | Substitute medicine | SSP Expiry | Supporting Information | Patient charge |
| SSP064 | Quetiapine 150mg tablets | For every quetiapine 150mg tablet, the following quantity must be supplied (listed in order of preference) in accordance with this protocol: 1 x 100mg and 1 x 50mg quetiapine tablet |
Friday 13 September 2024 | SSP064 guide | No |
| SSP067 | Quetiapine 200mg tablets | For every quetiapine 200mg tablet, the following quantity must be supplied (listed in order of preference) in accordance with this protocol: 2 x 100mg quetiapine tablets |
Friday 13 September 2024 | SSP067 guide | No |
| SSP070 | Quetiapine 300mg tablets | For every quetiapine 300mg tablet, the following quantity must be supplied (listed in order of preference) in accordance with this protocol: 3 x 100mg quetiapine tablets |
Friday 13 September 2024 | SSP070 guide | No |
Support on implementation
Only one SSP can be used against an individual prescription. Therefore, in each scenario, the pharmacist will need to consider both the pharmacy’s stock levels of different quetiapine tablets strengths and the patient’s circumstances and before determining which of the SSPs is most appropriate to use. Depending on the SSP used, the change in supply may require additional counselling to ensure that the patient is confident to take their medication.
Endorsement Guidance
Due to the number of different quetiapine tablet SSPs available for each affected quetiapine tablet strengths, pharmacists must ensure that they follow the correct endorsements requirements as per the supporting guidance published for each SSP on the dedicated page of the NHSBSA’s website. Incorrect endorsements will affect pharmacy payments.
Reimbursement
Reimbursement is for the medicine supplied in accordance with the SSP and not the originally prescribed medicine i.e. in this instance contractors will be reimbursed for the quetiapine tablets supplied. The reimbursement price will account for VAT payment. Supply in accordance with the SSP will result in the following fees being paid to the contractor:
- One Single Activity fee (currently £1.27)
- One SSP fee (£5.35)
Useful resources
PSNC Briefing 023/19: Serious Shortage Protocols – A guide for community pharmacy teams
