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Pharmacies across Northern Ireland are in financial turmoil, reporting that they are dispensing prescription medicines at a loss due to inadequate reimbursement from the Department of Health (DoH). This crisis has led to the closure of almost a dozen pharmacies over the past 18 months, with many others struggling to stay open. Siobhan McNulty, who runs Melvin Pharmacy in Garrison, County Fermanagh, described the dire situation. "We're dispensing medicines at a loss," she said. "The reimbursement rates don't match the cost of the drugs, and we're left to cover the gap." McNulty relies on sales of non-pharmaceutical products to keep her business running.

Pharmacists working in Northern Ireland think the retention fees are too high, and most would prefer to pay in instalments, if that option is available, amid the increased living costs, a new survey has found. 97 per cent of the respondents to the survey, conducted by the Pharmacists' Defence Association (PDA) of its Northern Irish members, felt the fees were too high. Four in five said they would opt to pay in instalments if this option were available to them in light of the challenges of significant one-off payments. On average, the fees accounted for 23 per cent of a pharmacist's take-home pay for one month, and 98 per cent did not see any value added to their professional standing for the sum, according to the survey. The PDA said the respondents also reported feeling disadvantaged among their colleagues in terms of how fees are collected, with many also wondering why the registration fee was not offset for those on maternity leave or working reduced or flexible hours.

Almost nine in ten community pharmacists in England say they have patients who sometimes go without prescription medicines because they cannot afford the prescription charge levied by the government. Sixty-eight per cent of pharmacists in a National Pharmacy Association (NPA) survey, conducted via email in June 2022, said this has become more frequent in the past year - suggesting that the rising cost of living could be leading more people to miss out on vital medicines. While prescription charge does not apply in Scotland, Wales and Northern Ireland, in England an NHS patients needs to pay £9.35 per item. For patients who need multiples medicines the cost could be exponential and virtually unaffordable amid rising inflation and higher cost of living. The survey found that 89 per cent of pharmacies in England have patients who sometimes go without prescription medicines due to cost. For most pharmacists (74 per cent) this happens one to five times a week. Fifteen per cent said they see such patients from six to 20 times a week.

The result from the Royal Pharmaceutical Society (RPS)'s survey showed that pharmacists witnessed 'the cost of living is having an impact on whether people can afford prescription medicines in England'. RPS has long campaigned to remove prescription charges for people with long-term conditions in England because they create a financial barrier to patients receiving the medicines needed to keep them well. The charge currently stands at £9.35 per item prescrib9ed and an annual rise usually occurs in April. Prescriptions are free for people in Scotland, Wales and Northern Ireland. One in two pharmacists who responded to the survey said they've seen an increase in the last six months in patients asking them which medicines on their prescription they can 'do without' due to affordability issues. One in two pharmacists had seen a rise in people not collecting their prescription, whilst two out of three pharmacists reported an increase in being asked if there was a cheaper, over-the-counter substitute for the medicine they had been prescribed.