Pharmacies are losing thousands of pounds a month on commonly prescribed medicines because NHS reimbursement prices fall short by up to £75 a pack, according to a National Pharmacy Association analysis.

The NPA’s research compared supplier prices in early October with September Drug Tariff concessionary prices.

In the worst case the NPA uncovered, the NHS September concessionary price for a 56-tablet pack of amantadine 100mg tablets was £18.06. But, claims the NPA, the market cost was £94.05 per pack, meaning a pharmacy would lose £75.99.

Its analysis compared the prices of 15 commonly dispensed items on October 7 from two major wholesalers with the September Price Concessions published by Community Pharmacy England.

The final list of October price concessions, to which the October supplier prices should be more properly compared, will not be published until the end of the month.

Although the NPA notes that prices can vary between pharmacies and fluctuate throughout the month, it highlights other ‘underpayments’ from its snapshot of prices as:

• ·       The September concessionary price for escitalopram 5mg (28 tablets) was £1.72, while the supplier price in early October was £9.08
• ·       The concessionary price for lorazepam 1mg (28 tablets) was £3.16, while the supplier price was £10.75
• ·       Etoricoxib 60mg (28 tablets) had a concessionary price of £6.75 but cost pharmacies £19.47 to buy in.

The analysis comes as the NPA is balloting members for the first time on whether to take collective ‘work to rule’ measures if the funding situation does not improve.

“It is nothing short of a national scandal that pharmacies have to dig deep into their own pockets just to cover the cost of basic medicines that they dispense. No other health professional would be asked to subsidise a key NHS service,” said Paul Rees, NPA chief executive.

“The system for funding the medicines upon which millions of patients rely is utterly broken. We share the government’s ambitions to expand the role of pharmacies, but this cannot happen while they are being forced to closing in record numbers by chronic underfunding.”

CPE reaction

Mike Dent, CPE’s director of pharmacy funding, said: “Community pharmacy teams work extremely hard to procure medicines cost effectively, but recent volatility in medicines pricing and availability is having a detrimental effect on this important part of their role.

Our 2024 Medicines Supply Report found that medicines purchasing costs are one of the two biggest drivers for cost increases for pharmacies. There is simply not enough funding in the contract sum, with a margin component that has remained flat for a decade.

“Significant increases in dispensing volume and pricing issues mean retained margin is spread much more thinly, further intensifying existing financial challenges that pharmacies are facing and effectively forcing them to subsidise the NHS medicines bill.

“CPE has called for a full review of the medicines supply market to address issues such as under-funding and price concessions, as well as a comprehensive review of medicines margin. A full review could consider outcomes such as benefit sharing and relief mechanisms.”

September concessionary prices of 15 products that the NPA compared with the supplier price in early October.