Latest News

Addressing shortages of pancreatic enzyme replacement therapy (PERT)

There are problems with the supply of pancreatic enzyme replacement therapy (PERT) which has made it difficult to obtain for the last year and shortages are predicted to last until 2026.

What is pancreatic enzyme replacement therapy (PERT)?

Pancreatic enzyme replacement therapy (PERT) is a prescription medicine used to treat pancreatic enzyme insufficiency (PEI). PERT is a capsule taken with food to replace the enzymes your pancreas would normally make, helping you to digest food and absorb calories and nutrients.

PERT may be prescribed to people with cholangiocarcinoma who have an obstructed biliary duct or who have undergone a Whipple Procedure – a surgery also known as a pancreaticoduodenectomy which removes the head of the pancreas, a portion of the bile duct, gallbladder and the duodenum, usually with part of the stomach.

There are a few brands of PERT available in the UK:

  • Creon®
  • Nutrizym®
  • Pancrex®

More information about PERT can be found in the Nutrition section of the AMMF website.

Why is there a shortage of PERT?

Viatris, the company that produces Creon, has warned of a supply constraint due to high global demand and reaching maximum manufacturing supply output. Community Pharmacy England reports that supply is affected due to limited availability of raw ingredients and manufacturing capacity constraints.

The companies that make Nutrizym and Pancrex have also reported shortages as people have switched to their brands, but they are unable to fully cover the gap in supply.

The supply issues are intermittent, with some people experiencing trouble getting PERT or potentially running out. Supplies are being regularly restocked, so shortages may only last for a short time and may not affect all areas in the UK.

What should I do to manage my PERT prescriptions?

If you are concerned about your regular PERT prescription, it is recommended that you speak with your pharmacist. It is important to be aware that pharmacies can only provide a maximum of one month’s supply of PERT at a time, so that supplies last longer.

To give your pharmacist more time to get your PERT, it may help to put in your prescription request as soon as the pharmacy has provided your previous prescription. You may need to check with your GP surgery that the prescription request has been authorised because automated systems may reject repeat prescription requests that are placed too early.

If your normal pharmacy doesn’t have your PERT, you could ask them to call the wholesaler that supplies it to request a restock. You could also try calling other pharmacies in your area to see if they have PERT in stock – make sure you try several different chains of pharmacy because they may use different suppliers.

You may find it helpful to ask your GP for a separate prescription for PERT (i.e. without any other medicines included on it). This will make it easier to get the prescription fulfilled at other pharmacies if your usual one does not have it.

You can contact customer services at the companies that make PERT to find out which local pharmacies have recently ordered stock:

If your pharmacist cannot get the usual brands of PERT, they may be able to get other brands from overseas. These include PANCREAZE® and Zenpep®. Be aware that it may take a bit of time for these to be delivered. You would need to get your prescription changed for this – please speak to your GP or oncologist about this.

Where can my doctor, pharmacist and I go for further information and guidance?

Position Statements on the PERT shortage with advice for clinicians are available at https://www.psgbi.org/position-statement-pert-shortage/.

They contain advice for patients split into 3 phases:

  • Phase 1 – What to do when you have a supply
  • Phase 2 – What to do if you think you are going to run out
  • Phase 3 – What to do if you have run out

The Position Statement documents have been endorsed by the British Society of Gastroenterology; Pancreatic Society of Great Britain and Ireland, Pancreatic Cancer UK, GUTS UK, Cystic Fibrosis Trust, CF Medical Association, Pancreatic Cancer Action, Neuroendocrine Cancer UK and the British Dietetic Association.

March 2025