The cost of antibiotics used to treat infections including strep A have risen more than tenfold in the UK in recent weeks, pharmacists have said, with many facing continued difficulties in sourcing supplies.
Cases of scarlet fever and strep A have increased earlier in the season than usual: last Thursday the UK Health Security Agency said that since mid-September there had been 60 deaths from invasive strep A infections across all age groups in England, including 13 children.
Many pharmacists have been experiencing difficulties in obtaining antibiotics such as penicillin and amoxycillin which are used to treat strep A and other infections. And parents have reported having to try a number of pharmacies to obtain medications prescribed for their sick children.
Now pharmacists have said the cost of many drugs has risen sharply, including antibiotics used to treat strep A.
“In the current market, antibiotic costs have increased nearly 10-20 times of what they were a couple of weeks ago,” said Sri Kanaparthy, who operates three pharmacies in County Durham and one in Barrow-in-Furness.
The situation has caused concern because the NHS reimburses pharmacists for the medicines they buy according to a set tariff.
“Irrespective of the price we are having to pay, the NHS will only pay us a set amount,” said Kanaparthy, noting that while a bottle of penicillin containing 125mg/5ml dose was normally £1.30 for a pharmacy to buy, some suppliers were now charging £14.95.
Dr Leyla Hannbeck, the head of the Association of Independent Multiple Pharmacies, said pharmacies were making huge losses on antibiotics.
“The prices are completely crazy compared to how they were,” she said. “A pack of amoxicillin, instead of being £2, we are buying [it] for £15 and basically we’ll be losing about £13, because you only get reimbursed for £2.”
Hannbeck said price increases could be reported to the government so that it could look at issuing a price concession, but the process could take a long time. “In the meantime, pharmacies keep losing money – money that they actually don’t have.”
She said that while increased costs for products such as shampoo could be passed on to the consumer, that was not the case for medicines as it may mean people cannot afford them.
Suraj Shah, a drug tariff and reimbursement manager with the Pharmaceutical Services Negotiating Committee (PSNC), said the impact of Brexit, the war in Ukraine, the Covid pandemic, rising inflation, high demand and suppressed drug tariff prices had all contributed to the reimbursement prices of many drugs not keeping pace with market prices.
“For antibiotics, it is the sudden spike in demand that has contributed to the increased prices,” he said, adding that demand had been triggered by a lowering of the threshold for prescribing antibiotics to children presenting with symptoms associated with strep A.
“There is a question as to whether manufacturers and wholesalers are profiteering from strep A,” he said, and called for the Competition and Markets Authority or the Department of Health and Social Care (DHSC) to investigate.
Fin McCaul, an independent community pharmacy owner in Prestwich, Manchester, and a PSNC committee, said he was struggling to obtain certain amoxicillin products and liquid penicillin, and costs were also a concern.
“Most suppliers are now above tariff, so I’m having to pay more than I would normally pay for it. And at the minute the [DHSC] will not confirm what we’re going to be renumerated at,” he said.
On Monday, the DHSC issued a medicine supply notification for antibiotics for the treatment of strep A. “Supplies of antibiotics for the treatment of group A strep have seen a surge in demand and may be temporarily in limited supply at certain wholesalers and pharmacies,” it said. “Supplies are available with manufacturers, and deliveries into wholesalers and pharmacies are being expedited and are expected in the coming days.”
A DHSC spokesperson said: “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.
“Where companies are found to be abusing their dominant position by charging excessive and unfair prices, the Competition and Markets Authority can take action against businesses and individuals engaged in anti-competitive conduct.”
