Antibiotic supply and pricing issues: Steps taken this week

Following on from our update about antibiotic supply and pricing issues on Friday 9th December, we wanted to share some recent developments.

HDA statement

The Healthcare Distribution Association (HDA), whose member companies distribute over 90% of prescription medicines on behalf of the NHS, has issued a lengthy statement regarding the availability of Strep A treatments.

According to the HDA, the sudden spike in demand for antibiotics used for the treatment of Strep A has meant that there is not enough of these medicines in the supply chain currently to meet this increased demand. As a result, wholesalers are working extremely hard with manufacturers to increase the supply of antibiotics.

The HDA goes on to say:

“As regards pricing, the prices charged to pharmacies by HDA wholesale distributors will directly reflect the increase in prices wholesalers are having to pay for these medicines from manufacturers at the moment, in order to be able to continue supplying these medicines to pharmacies. This will be the case until supply and demand are more in sync.”

In their statement, the HDA has also requested that NHS England and the Department of Health and Social Care (DHSC) issue urgent communications requesting that all those involved in medicines supply do not hoard, stockpile or over-prescribe Strep A antibiotics.

Read the HDA Statement re Strep A treatment availability

Managing supply

To help ensure the continued supply of medicines to meet the needs of UK patients, DHSC has now added the following products to its list of medicines which must not be parallel exported from the UK:

• Amoxicillin;
• Cefalexin;
• Phenoxymethylpenicillin (Penicillin V); and
• Azithromycin oral suspension.

Hoarding or exporting a medicine on the list is considered a breach of regulation 43(2) of the Human Medicines Regulations 2012 and a contravention of the wholesale dealer licence and may lead to regulatory action by the Medicines and Healthcare products Regulatory Agency (MHRA), which could include immediate suspension of the wholesale dealer licence.

Antibiotic pricing

PSNC continues to hear from contractors who are paying inflated prices for antibiotics used for the treatment of Strep A and who are rightly concerned about the lack of certainty around the final reimbursement prices for these medicines.

With this in mind, we welcome the news being reported today that the Competition and Markets Authority (CMA) is investigating the price of antibiotics.

PSNC’s view

Whilst the above measures are steps in the right direction, PSNC continues to warn DHSC about the very serious impact the shortage of Strep A antibiotics is having on pharmacies and to press them 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)).

We have also been clear that more communications are needed to reassure patients and to protect pharmacy staff from the abuse that they are reporting.

The DHSC is considering our applications for price concessions this month and we are continuing to stress the urgency of this.