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Unpaid NHS medicines bills have reached around £43m, Alex Williams, chief executive of the Healthcare Distribution Association (HDA), has told The Pharmaceutical Journal.
Speaking to The Pharmaceutical Journal on 19 June 2026, Williams said: “NHS overdue debt … is a particular concern for our members [wholesalers]. We believe that NHS hospitals owe our members around £43m in overdue debt; that’s debt where the product has been received but the invoice hasn’t been paid.”
This represents a £3m increase in the past two years, when Martin Sawer, previous chief executive of the HDA, identified the debt as close to £40m in 2024.
The HDA represents the interests of UK medicines wholesalers.
“Frankly, the NHS does need to get better at paying its invoices, and we have written to NHS England on that matter, and that overdue debt is an issue both in primary care and in secondary care,” Williams said.
He also said that the issue “varies by trust and it varies by time of the year”, adding that unpaid invoices had “a big capital cost” for wholesalers.
“They’ve purchased the medicines, they’ve delivered them, but they haven’t received the funding for them,” Williams continued.
He noted that in “very rare circumstances”, wholesalers were forced to “place a trust on stop and say that no further medicines are going to be delivered until the bills are paid”.
“Our members are doing their utmost to make sure that medicines continue to be delivered, and it’s incredibly rare for them to [do that], they really do not want to do that, but … sometimes they have to, and our experience is that when they do that, bills get paid within 24 hours,” Williams added.
He said the issue of unpaid bills was also affecting other sectors that supply to the NHS.
“It is fairly common knowledge that our sector is not the only part of the supply chain that is experiencing this. It has been identified that other suppliers are also awaiting payment from the NHS, and I suspect there is an issue with cashflow within the NHS, but that’s not something I’m personally party to,” Williams said.
Responding to the comments, a spokesperson for NHS England told The Pharmaceutical Journal: “NHS organisations have a duty to meet their financial commitments, and boards must ensure suppliers receive payments within contracted timeframes.
“Cash levels have actually increased between the end of the 2024/2025 and 2025/2026 financial years, reflecting the overall improvement in the health of NHS finances that has been possible through the hard work and disciplined approach of colleagues up and down the country.”
In primary care, price concessions for medicines dispensed by community pharmacies have reached a fourth consecutive month of record high levels.
James Davies, director of research and insights at Community Pharmacy England, said the issue was a sign of “a medicines pricing system under sustained pressure”.
“Pharmacy owners tell us month after month that they are having to spend significant time and personal money sourcing medicines above Drug Tariff prices, impacting their ability to provide patient care,” he added.
“The unrelenting price increases are creating serious cashflow challenges at a time when the sector is already under strain.”
