Further increases in the cost of medicines are ‘just not acceptable’, Janet Morrison, chief executive of the Pharmaceutical Services Negotiating Committee (PSNC) has said, as contractors report they are paying well above the reimbursement price for antibiotics.

Amid high levels of Strep A infections, GPs have been advised to ‘have a low threshold’ for prescribing antibiotics to children presenting with symptoms associated the infection.

But pharmacy contractors have reported that they are having difficulty ordering antibiotics, which are frequently showing as ‘out of stock’, and when they are able to place an order are paying as much as five or six times the reimbursement set by the Department of Health and Social Care (DHSC).

In a statement released by PSNC, Ms Morrison said that the high price rises that contractors were reporting to the negotiator were ‘just not acceptable’, adding that ‘this goes far beyond the antibiotic crisis.’

‘We expect to see a record number of concessions granted this month which is yet more proof that this system is simply not coping with the current medicines market,’ she said.

On Twitter, advanced clinical practice pharmacist at Manchester Pharmacy and Health Clinic, Zeshan Rehmani, said that he had had to order penicillin liquid at £11.78 per bottle, nearly six times the reimbursement price of £2.08.

He tweeted that he was ‘now completely out of certain antibiotics’ and ‘having to turn unwell children away’.

Meanwhile, superintendent pharmacist at Community Pharmacy of Saltdean, Dervin Gurol, shared a screenshot on Twitter showing out-of-stock antibiotics, with prices listed as much as £14.95 a bottle. ‘Community Pharmacy cannot carry on like this, we are at a breaking point!’ he wrote in the Tweet.

Ms Morrison said that she would be meeting with government ministers this week and would take the issue to them, while ‘continuing to press for a fairer and more timely system to protect pharmacies from these devastating price rises’.

She added: ‘Government and the NHS have squeezed pharmacies dry financially, and now they want us to pay their NHS drugs bill as well: it just cannot carry on. The Department, NHS and Government need to hear and understand that we are on our knees and cannot continue to pay for the mess that a combination of Brexit, Covid, inflationary pressures, war in Ukraine and other factors has caused.’

Information provided by pharmaceutical wholesalers to GP practices last week appeared to confirm widespread antibiotics shortages, but a DHSC spokesperson said that there was ‘no supplier shortage of antibiotics’, only difficulties caused by ‘increased demand’.

Martin Sawer, executive director of the Healthcare Distribution Association (HDA) which represents pharmaceutical wholesalers, told The Pharmacist that wholesale distributors had been ‘forced to cap orders’ to ‘even out distribution’.

He said that HDA believes that there has been 'a huge and very sudden spike in demand - for example, one large pharmacy group ordered one normal month's worth of Strep A-related antibiotic products in one day last week'.

He added that 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'.

He added: ‘The supply of generics is a ‘commodity-based’ market, where manufacturers are free to price based on demand and competition – right now there is too much demand for products and not enough competitive products being made available to buy from the manufacturers.’

A DHSC spokesperson told The Pharmacist that ‘there is no supplier shortage of antibiotics available to treat Strep A’, saying: ‘We rely on competition to drive down the prices of generic medicines which generally results in lower prices for the NHS – this means prices can fluctuate, but no company should use this as an opportunity to exploit the NHS.’

They added: ‘Where companies are found to be abusing their dominant position by charging excessive and unfair prices, the Competition and Markets Authority (CMA) can take action against businesses and individuals engaged in anti-competitive conduct.’

DHSC confirmed that where market prices increase significantly and rapidly, concessionary prices can ensure that pharmacy contractors are paid fairly and can access medicines for their patients, but it could not confirm at this stage which medicines would appear on the next price concessions list.

Mr Sawer called for ‘robust communications’ from NHS England and DHSC to ask ‘all players involved in medicines supply to not over-prescribe, hoard or stockpile’.

He also questioned why players within the medicines supply chain weren't communicated with in advance of the lowering of doctors’ prescription thresholds for antibiotics.

Mark Samuels, Chief Executive of the British Generic Manufacturers Association (BGMA) said that via competition, generic medicines competition save taxpayers £15billion every year, meaning that the UK has the lowest medicine prices in Europe.

He said that amid the 'high demand for antibiotics' caused by concerns about Strep A, BGMA members were working with supply chain partners and the Government to ensure stock is made available.

'The actual selling prices of manufacturers is just one element of the cost of medicines received by community pharmacies. All manufacturing selling prices are made available to DHSC, alongside those of the wholesalers, and the Government can intervene if it finds excessive pricing is taking place in any point of the supply chain,' he added.

Pharmacy wholesalers have said the supply of antibiotics should improve soon as more stock is being delivered ‘on a daily basis’.

But contractor Sri Kapanarthy told The Pharmacist that wholesale drug prices overall have been above drug tariff price for a long time, with the situation becoming ‘really, really bad’ in the last six or seven months.

Last month, DHSC told The Pharmacist that it is working PSNC ‘at pace’ to review the drug price concessions system.