"Selected" pharmacies in NHS Greater Glasgow and Clyde have been involved with providing the treatment to eligible infected patients since December 22 last year, a spokesperson for the health board told C+D last week (January 14).

“The community pharmacy network remains a vital part of our continued delivery plan moving forward,” they added.

C+D has approached all 14 health boards in Scotland – of which nine responded in time for publication – to ask if they are currently involving pharmacies in this service or whether they are planning to do so in the future.

 

Pharmacies in more areas could come on board

 

Scotland’s chief pharmaceutical officer Alison Strath wrote that not all health boards may decide to ask pharmacies to supply COVID-19 antivirals in a circular published last week (January 13).

NHS Ayrshire and Arran does not currently supply molnupiravir via community pharmacies.

However, the health board said that it “will explore the potential for and logistics of community pharmacy supply of antivirals for non-hospitalised COVID-19 patients”.

Similarly, a spokesperson for NHS Lothian said it does not currently distribute molnupiravir via community pharmacies, although it is “actively considering this as an option”.

 

Pharmacies’ involvement under review

 

NHS Forth Valley is currently utilising the Forth Valley Royal Hospital’s pharmacy department to dispense the antiviral, a spokesperson told C+D.

At present, Forth Valley does not need to involve community pharmacies to facilitate the supply of molnupiravir, according to the spokesperson.

However, the health board “will continue to review the potential need for community pharmacists to be involved in the supply of these treatments on an ongoing basis,” they added.

NHS Lanarkshire primary care chief pharmacist George Lindsay told C+D today (January 17) that the board “would consider moving to a community pharmacy supply” if it needed to do so.

“As we work closely with community pharmacy colleagues across Lanarkshire, we would be able to change our model speedily if and when required,” Mr Lindsay added.

NHS Shetland told C+D today that it currently has “no plans” to distribute molnupiravir through community pharmacies because “it would not necessarily be the most efficient way of distributing the very limited stock we have available at the moment”.

However, the health board will “keep this under review as the situation evolves”, it said.

There are “no plans” to utilise pharmacies for this service in NHS Tayside, NHS Borders, and NHS Fife, the respective spokespersons have told C+D.

 

Service fees and specifications

 

In her circular, Ms Strath released the details of the fees payable to pharmacies involved with the supply of the antiviral treatments to COVID-19 positive patients.

Where pharmacies are commissioned to supply the antivirals, the Scottish Government has agreed to pay them a fee of £45 per dispensed item.

Pharmacies that are also delivering the treatment to the patient’s home will be paid a delivery fee of up to £12 depending on mileage, according to the circular.

Meanwhile, NHS England and NHS Improvement told pharmacies in England last month (December 9) that they would not be stocking molnupiravir “and therefore patients will not be supplied with the medicine”.

Instead, pharmacies were asked to advise patients with a positive PCR test to stay at home and call their GP to be referred to a COVID-19 Medicine Delivery Unit, “who can assess eligibility and arrange treatment”.

The antiviral Lagevrio (molnupiravir) was the first to be approved by the Medicines and Healthcare products Regulatory Agency (MHRA) on November 4 last year.

On December 31, 2021, the MHRA approved another COVID-19 antiviral treatment – called Paxlovid – after it determined that it could reduce the “risk of hospitalisation and death in people with mild to moderate COVID-19 infection who are at an increased risk of developing severe disease”.