Pharmacists should be able to refuse to dispense prescriptions if shortages worsen when Britain leaves the European Union (EU), the Pharmaceutical Services Negotiating Committee (PSNC) has said.

In a letter sent last week (7 December) to the Health and Social Care Committee, PSNC chief executive Simon Dukes urged the Government to ‘relax’ the NHS terms and conditions for pharmacies, allowing them if necessary to refuse to dispense a prescription in the event of post-Brexit medicines shortages.

Last week, the Government told The Pharmacist that it is consulting on enabling pharmacists to ‘provide an appropriate alternative should there be a shortage of certain types of medicines.’


Relaxing pharmacies obligations


Mr Dukes said that the Government should ‘relax the NHS terms of service obligation on pharmacists’, allowing them to use ‘appropriate professional discretion’ and refuse the supply of medicines if deemed necessary.

He wrote: ‘This would allow pharmacies to avoid dispensing drugs at a significant loss and incurring costs that their business could not survive.

'It would also allow pharmacies to refuse to dispense complete prescriptions where, for example, patients were seeking several months’ worth of a medicine at once, or where they already had sufficient stock from a previous prescription.’

In September, the negotiator’s director of pharmacy funding, Mike Dent, told The Pharmacist that PSNC had been lobbying the Government to enable pharmacists to dispense a ‘therapeutically equivalent generic’ as an alternative to a branded version prescribed by the GP.

Mr Dukes said that this option would allow pharmacists to better manage the demand for medicines and prioritise stock for patients who need it most in a shortage situation.


‘Fragile’ reimbursement system at risk


Mr Dukes also argued that the Government needs to review the ‘fragile medicines pricing and reimbursement systems’ to ensure these are not ‘destabilised’ when the UK is expected to leave the EU in March 2019.

At the moment, pharmacies often purchase medicines at a higher price than the drug tariff. PSNC estimated that there were 72 price concessions in November alone – a number set to be higher in December, it said.

Mr Dukes said: ‘For some medicines, pharmacies have to contact up to seven or eight wholesalers and they are increasingly reporting that none have stock available of products at the drug tariff price or even at the concessionary prices.

‘If medicine prices increase significantly post Brexit, there could be a huge impact on individual pharmacies that dispense large volumes of any affected lines, particularly where the difference between purchase price and concessionary price is significant.’