Antibiotic Availability and Medicines Pricing: Update for contractors
Following on from previous information for community pharmacy teams about invasive Group A streptococcal (or Strep A) infections, we wanted to share a further update about antibiotic supply and pricing issues.
The Department of Health and Social Care (DHSC) has told PSNC this afternoon (9th December) that sufficient supplies of antibiotics used to treat Strep A are still available at manufacturer level.
But they said that as a result of the significant increase in demand there are still problems with getting it through to pharmacies. This is in line with the serious difficulties in obtaining stock that pharmacy contractors are reporting to us.
The DHSC Supply Team has been working closely with wholesalers and expect this to improve next week.
PSNC has warned DHSC about the very serious impact this issue is having on pharmacies who are having to chase stock, purchase without sight of any concession prices, and cope with increasing patient questions and abuse.
We have pressed the Department to think broadly about what measures could help to manage the current crisis, such as allowing pharmacists more freedom to change strengths or formulations without prescriber approval (outside of Serious Shortage Protocols (SSPs)), and also been clear that more communications are needed to reassure patients and to protect pharmacy staff from the abuse that they are reporting.
NHS information and guidance
NHS England has published the following documents in the past 24 hours:
Chief Pharmaceutical Officer letter : Group A streptococcus and antibiotic supply
Letter to community pharmacists, chief hospital pharmacists and regional chief pharmacists regarding Group A streptococcus and antibiotic supply, from David Webb, Chief Pharmaceutical Officer for England.
Guidance: Group A streptococcus communications to clinicians
Interim clinical guidance update aimed at clinicians involved in the diagnosis and treatment of children up to the age of 18 years.
Wholesale prices of many oral antibiotics have risen significantly owing to the surge in demand and the ongoing supply disruptions affecting these medicines.
As the majority of wholesalers are showing as out of stock on most lines, we are also hearing that some suppliers have significantly put up their prices this week for any oral antibiotics they do have in stock.
Due to pricing issues affecting several medicines including antibiotics, PSNC has applied for a record number of price concessions this month. We are very concerned that many contractors who are desperately trying to get hold of limited stock of antibiotics for their patients are paying inflated prices for these medicines without any certainty of their final reimbursement prices.
We have reiterated that the pricing situation is very serious and needs resolving urgently, and asked the Department to fast-track concessions for affected antibiotics this month.
Wider Medicines Market Issues
PSNC remains deeply concerned about the medicines supply market and the impact that unmanageable price rises are having on contractors.
This month we have made a record number of concessions requests to the Department. We are continuing to warn them that this is simply not sustainable or acceptable and are urging them to speed up implementing solutions to improve the price concessions system which is not coping. Pharmacies simply cannot afford to keep making purchases at prices higher than the Drug Tariff without knowing that they will be reimbursed fairly for obtaining the vital medicines that their patients need.
Janet Morrison, PSNC Chief Executive, said:
“The accounts we are getting from contractors about medicines price rises are just not acceptable and this goes far beyond the antibiotic crisis. We expect to see a record number of concessions granted this month which is yet more proof that this system is simply not coping with the current medicines market.
Government and the NHS have squeezed pharmacies dry financially, and now they want us to pay their NHS drugs bill as well: it just cannot carry on. The Department, NHS and Government need to hear and understand that we are on our knees and cannot continue to pay for the mess that a combination of Brexit, COVID, inflationary pressures, war in Ukraine and other factors has caused.
I will be taking all of this to my meeting with the Minister next week, and in the meantime we’re continuing to press for a fairer and more timely system to protect pharmacies from these devastating price rises.”