UK pharmacies say they are being forced to dispense Strep A antibiotics at a loss

Pharmacies in the UK say they are being forced to dispense antibiotics to treat strep A infection at huge losses due to rising wholesale prices, as health chiefs denied there were any shortages.

An unusually early rise in group A strep, mainly among schoolchildren, has raised demand for penicillin and amoxicillin, the main antibiotic treatments, in recent days, putting pressure on already overburdened pharmacies.

The UK Health Security Agency recorded a total of 851 cases of strep A in the week ending November 20, compared with an average of 186 over the same period in recent years. The bacterial infection, which usually causes mild symptoms such as a sore throat or rash, has killed 16 children across the UK, according to the UKHSA.

In response to the outbreak, health officials lowered the prescription threshold for penicillin and amoxicillin, and even considered allowing preventative antibiotics to be given to close contacts of infected people, prompting a surge in demand.

Consequently, pharmacies reported difficulties in obtaining supplies of the medicines from wholesalers and, on occasions where antibiotics were available, said the wholesale price exceeded the compensation they received from the NHS, meaning they were losing money with each prescription.

“All these things that were taken for granted, that you push a button, you ask for amoxicillin, it comes the next day, the pharmacy makes a little money and the patient gets his medicine, all of that is gone,” Olivier said. Picard, managing director of Newdays Pharmacy and a board member of the National Pharmacy Association (NPA). He added that several parents had told him they called more than a dozen pharmacies and found no antibiotics in stock.

Leyla Hannbeck, executive director of the Association of Independent Multiple Pharmacies, said the situation was untenable. “We need better visibility into supply from wholesalers and manufacturers, and we need pharmacists to be adequately reimbursed for these medicines as they cannot afford to distribute them at a loss.”

Health officials and wholesalers insist there are sufficient supplies of antibiotics, but acknowledged they were taking time to reach pharmacies.

“We have a lot of antibiotics,” Stephen Powis, the NHS’s chief medical officer, told the BBC. “Clearly, we have been asking people to prescribe them a little earlier. That means pharmacies have needed extra supplies, so the government is working with wholesalers to make sure those supplies get out.”

Three pharmacies told the Financial Times that the minimum they had paid for amoxicillin or penicillin liquid solution from wholesalers including Alliance Healthcare and AAH in recent days was £5, which is more than double the amount they will receive. in compensation under the NHS drug. tariff scheme.

Martin Sawer, chief executive of the Healthcare Distribution Association, which represents wholesalers, said the higher price directly reflected the amount wholesalers had to pay manufacturers. He denied there was a shortage, but said the supply chain had to adjust to the “sudden increase in demand.”

Sigma Pharmaceuticals has apologized for setting its wholesale price at more than £19 for amoxicillin liquid solution, almost 10 times the cost of reimbursement paid by the NHS to pharmacies, blaming the error on “IT glitch”.

NPA Chairman Andrew Lane urged the Department of Health and Social Care to update its concession price for amoxicillin and penicillin “as soon as possible” so that pharmacies do not have to “foot the bill” for the Strep outbreak A.

If a drug is added to the concession list, pharmacies are reimbursed for any price increases.

A total of 158 drugs were on the November concession list. Janet Morrison, executive director of the Pharmaceutical Services Bargaining Committee, which negotiates concession lists with the health department, said pharmacies were at a “breaking point.”

He said they were “helpless against the market forces that are working against them, and urgently need government guarantees that all drugs will be available, and not at grossly inflated prices.”

The health department said there was “no shortage of providers,” explaining that “prices may fluctuate” due to increases in demand for certain antibiotics. “But no company should use this as an opportunity to exploit the NHS.”