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There has been a lot of coverage in the national and pharmaceutical press of the prices being charged to pharmacy owners for certain medicines. Leaving aside the reasons for steep price rises, I have been asked on social media and elsewhere whether pharmacy owners can refuse to supply prescribed medicines if they would make a significant financial loss. Legal obligation The first thing to point out is that the National Health Service Act 2006 imposes a legal duty on the Secretary of State and NHS England to make arrangements for people to receive sufficient prescribed drugs. These arrangements involve the publication of the Drug Tariff. The Drug Tariff includes reimbursement prices or a method for determining prices. Various factors can be taken into account in determining reimbursement prices. The Drug Tariff does not provide a pound for pound reimbursement for medicines that pharmacies supply on NHS prescriptions.

From over-the-counter flu tablets to crucial antibiotics and antidepressants, medicines are running scarce in UK pharmacies this year, causing concerns among patients, the government, and the wider pharma industry. Drug shortages have accelerated over the past year due to a clutch of problems including the after-effects of the pandemic on supply chains, the war in Ukraine, and soaring input costs weighing on manufacturers. More recently, a sudden spike in respiratory infections - another by-product of Covid-19 that neither pharma companies nor the government were able to predict - has deepened the crisis, with 70 commonly taken drugs out of stock in Britain as of February. The problem is not unique to the UK. In a recent survey of groups representing pharmacies in 29 European countries, three quarters said shortages were worse this winter than a year ago, with a quarter reporting more than 600 drugs in short supply. The US is also facing significant shortages of popular prescription drugs like amoxicillin and Adderall, an ADHD medication. To some extent, the current disruption is laying bare wider challenges facing the industry for several years that were only exacerbated by the pandemic. The over-reliance on foreign suppliers for most active pharmaceutical ingredients (APIs) is one of them. This model has left companies more susceptible to supply shocks, which have in turn increased in frequency and severity due to pandemic lockdowns, the war in Ukraine and other issues such as the shortage of shipping containers. Pharma's long and opaque supply chains, alongside regulatory complexities, also mean it is taking longer for drugmakers to reconfigure manufacturing and distribution in times of additional need.

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General practitioners (GPs) across England have made a resolute stand against proposed alterations in the 2024/25 national GP General Medical Services (GMS) contract put forth by the Department of Health and Social Care (DHSC) and NHS England. This firm opposition coincides with the declaration of an extended six-month strike by 33,869 junior doctors within the NHS, advocating for full pay reinstatement and reforms in the pay recommendation process. The latest survey conducted by the British Medical Association (BMA) has revealed that an overwhelming 99.2% of GPs in England are against any changes to the existing contract. The proposed amendments, slated for implementation from April 1st, 2024, encompass a meagre national practice contract baseline funding uplift of just 1.9%, notably falling short of recent inflation rates. This corroborates with GP Online poll that recently unveiled widespread GP dissatisfaction with proposed changes to the national GMS contract. 83% of GPs in favour of strikes cite pay and funding concerns, while burnout, high workloads, and patient safety also fuel discontent.