Pharmacy negotiator tells government it is ‘increasingly concerned’ over medicines supply

The Pharmaceutical Services Negotiating Committee (PSNC) is calling on the government to improve the price concessions process owing to the “serious impact” that medicines shortages are having on community pharmacy teams.

In a statement, published on 20 July 2022, the PSNC said it was becoming “increasingly concerned” about the sustained pressures on medicines supply and that it had “escalated the situation” and its concerns with the Department of Health and Social Care (DHSC).

“As we move into the second half of the year, we are asking contractors and their teams to continue using our regular reporting tools to help us to demonstrate the scale of the problems to the Department of Health and Social Care (DHSC) and to support escalations as needed,” the PSNC said.

It added that there had been “more than 100 concessions” granted in some months in 2022, and that it was aware that many pharmacies were now in “a critical situation trying to source medicines in [a] timely manner” and facing significant financial risk owing to the uncertainty around expected reimbursement prices.

Concessions are issued by the government to reimburse pharmacies when the price of a particular medicine increases sharply.

“We know that some concessions being imposed by the DHSC do not match contractors’ experience on the ground, and we would ask all contractors to continue reporting pricing issues to us on a regular basis to support our representations,” the PSNC said in the statement.

Gordon Hockey, director legal at the PSNC, said that the “currently volatility” and pricing issues in the medicines supply chain were “extremely concerning”.

“We know that they are having a very negative impact across the sector, often on a daily basis,” he said.

“It is also particularly concerning to hear from pharmacy teams who report that some patients are showing aggression to pharmacy teams as a consequence of these sustained issues.

“We are continuing to seek price concessions from DHSC on a monthly basis, alongside escalating this within the DHSC.”

Ade Williams, superintendent pharmacist at Bedminster Pharmacy and pharmacist prescriber at Broadmead Medical Centre, in Bristol, said he was seeing an “increasing list” of common generic medicines being either unavailable or available at prices well above the drug tariff.

Giving the examples of citalopram and alendronic acid 70mg tablets, Williams said that “some filter back in at significantly higher prices”.

“A system to communicate shortages in a manner that enables alternative switches in an organised manner would be ideal.

“[This is] all creating patient anxiety [and] wasting everyone’s time.”

On 14 July 2022, the PSNC issued a medicines supply notification, saying that alendronic acid 70mg tablets were out of stock until “late August 2022”.

It said that risedronate sodium 35mg tablets (weekly) and ibandronic acid 150mg tablets (monthly) remained available.

“Where these are not suitable, unlicensed supplies of alendronic acid 70mg tablets may be sourced, lead times vary,” the notification added.

The DHSC has so far granted 45 price concessions in July 2022. In the latest price concessions update, the PSNC said it was still working with the DHSC to agree further concessionary prices on other drugs reported to be unavailable at the stated July 2022 Drug Tariff price.