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Pharmacies in the UK say they are being forced to stock up on antibiotics to treat strep A infections as wholesale prices are hit hard, as health chiefs deny there is a shortage.
An unprecedented surge in group A streptococcus, mainly among school children, has fueled demand in recent days for penicillin and amoxicillin, the main antibiotic treatments, adding to pressure on already stretched pharmacies.
A total of 851 strep A cases were reported by the UK Health Security Agency in the week ending November 20, compared to an average of 186 during the same period in recent years. The bacterial infection, which usually causes mild symptoms including a sore throat or skin rash, has killed 16 children across the UK, according to the UKHSA.
In response to the outbreak, health officials have lowered prescription thresholds for penicillin and amoxicillin, and are also considering allowing close contacts of infected individuals to be given prophylactic antibiotics, which has led to increased demand.
As a result, pharmacies have reported struggling to get supplies of drugs from wholesalers and, on the rare occasions antibiotics were available, said the wholesale price exceeded the reimbursement they received from the NHS, meaning they were losing money on each prescription.
“All these things that were taken as a given — that you push a button, order amoxicillin, it arrives the next day, the pharmacy makes some money, and the patient gets their medicine — that’s all gone,” Olivier said. Pickard, Managing Director of Newdays Pharmacy and Board Member of the National Pharmacy Association (NPA). He added that many parents told him they had called more than a dozen pharmacies and failed to find antibiotics in stock.
Layla Henbeck, chief executive of the Association of Independent Multiple Pharmacies, said the situation was unsustainable. “We need better visibility on supply from wholesalers and manufacturers, and we need pharmacists to be adequately compensated for these drugs because they cannot dispense them at a loss.”
Health officials insist there is an adequate supply of antibiotics but admit they are taking time to get to pharmacies.
“We have plenty of antibiotics,” NHS medical director Stephen Powis told the BBC. “Obviously we’re asking people to prescribe them a bit earlier, that means pharmacies need extra supply so the government is working with wholesalers to make sure that supply comes out.”
Three pharmacies told the Financial Times they paid a minimum of £5 for amoxicillin or penicillin liquid solution last week, more than double the amount they would receive in reimbursement under the NHS drug tariff scheme.
Alliance Healthcare, a wholesaler, declined to comment. Phoenix and AAH did not respond to requests for comment.
Sigma Pharmaceuticals briefly set its wholesale price for amoxicillin liquid solution at more than £19, almost 10 times the reimbursement price paid to pharmacies by the NHS. Sigma chief executive Hatul Shah blamed the high cost on “IT glitches”. “It was a complete mistake,” he told the FT. “We resolved the issue within a few hours and no one was charged this price.”
The chairman of the NPA, Andrew Lane, urged the Department of Health and Social Care to update its relief prices for amoxicillin and penicillin “as quickly as possible” so that pharmacies do not have to “foot the bill” for strep A outbreaks.
If a drug is added to the list of concessions, pharmacies are reimbursed for any price increase.
The November concession list had a total of 158 drugs, indicating a shortage of drugs. Pharmaceutical Services Negotiating Committee chief executive Janet Morrison, who negotiated the concession list with the Department of Health, said pharmacies were at “breaking point”.
She said they are “helping against market forces that are working against them, and they need urgent government assurances that all medicines will be available, and not at wildly inflated prices”.
The health department did not respond to a request for comment.
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