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The Pharmaceutical Services Negotiating Committee (PSNC) has raised concerns over the impact that high medicine price rises are having on contractor. Recently, the Department of Health and Social Care (DHSC) has granted the final list of price concessions for December 2022. The latest additions bring the total number of concessionary prices granted for the month of December to 198, surpassing the previous record of 159 granted in September 2022. PSNC has heard from hundreds of community pharmacy contractors who are paying inflated prices for antibiotics used for the treatment of Strep A and who have rightly been concerned about the lack of certainty around the final reimbursement prices for these medicines. It added: "We welcomed the involvement of the Competition and Markets Authority (CMA) to look into the pricing of antibiotics. But the number of reports we are getting from contractors about medicines price rises are just not acceptable and this goes far beyond the antibiotic crisis."

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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.

The Department of Health and Social Care (DHSC) has redetermined the December 2023 concessionary prices for four medicines following requests made by Community Pharmacy England (CPE) on behalf of community pharmacy owners. For Ezetimibe 10mg tablets (pack size 28), the price has been fixed at £17.78, up from £9.44. Other drugs included in the list are Aripiprazole 5mg (£8.52), Digoxin 125microgram (£3.70) and Digoxin 250micrgram (£3.70) tablets. Contractors would be reimbursed at the new prices only for prescriptions submitted for payment for the dispensing month of December 2023. CPE said they are still working with DHSC to agree price concessions for January. Check the final the December 2023 price concessionary here. Additionally, DHSC on Friday confirmed that there's now sufficient stock of Clarithromycin 125mg/5ml oral suspension to meet normal demand, and the Serious Shortage Protocol (SSP), SSP053 for the antibiotic expires on 12 January 2024.

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Britain's competition watchdog has fined pharmaceutical companies Pfizer and Flynn £63 million and £6.7 million respectively for allegedly breaking competition law and illegally profiting from the sale of an anti-epilepsy drug. The Competition and Markets Authority (CMA) found that the two companies colluded to sell phenytoin sodium capsules, previously known as Epanutin, at "unfairly high prices" for over four over years between 2012 and 2016. The annual costs of the capsules for the NHS increased from £2 million in 2012 to approximately £50 million the following year. CMA has accused Pfizer of charging, over four years, prices between 780 per cent and 1,600 per cent higher than what was fixed previously for the medicine used to prevent life-threatening epileptic seizures. Pfizer supplied the drug to Flynn, which then sold the capsules on to wholesalers and pharmacies at a price between 2,300 per cent and 2,600 per cent higher than the prices previously charged by Pfizer.

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The Department of Health and Social Care have retrospectively granted a concessionary price for Isocarboxazid 10mg tablets for the months of May and June 2021. While the reimbursement price had previously been £217.75, a concessionary price of £249.10 has now been granted. The NHS Business Services Authority confirmed that payment for the difference - £31.35 for every pack of 56 claimed - will be adjusted accordingly for the mentionedtime period where contractors have submitted claims in those months. This adjustment will be paid on 31 December 2021 in the next Schedule of Payments.

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