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Dispensing at a loss is absurd – enough is enough

It’s becoming increasingly difficult to stay afloat while the dysfunctional medicines reimbursement system remains in force, says contractor Olivier Picard

Pharmacies like mine provide a crucial service to patients and the entire community, giving healthcare advice, vaccinations, health checks and a great deal of other support besides. 

Plus, of course, dispensing medicines, which is the service upon which many others are built.

Through effective medicines procurement, pharmacies have helped the NHS save billions of pounds over the years – driving down the cost of medicines for the health service. 


So, it seems very unfair that, for many pharmacies, this is increasingly a loss-making exercise.


Pharmacists spend a lot of time sourcing medicines and frequently, these days, pay inflated prices to wholesalers to obtain stock promptly. We are reimbursed by the NHS at a set price, which is very often below the cost price to us.


As an example, there’s a drug for bipolar disorder that my pharmacy used to pay under £2 per packet for. We now have to pay nearly £45 per box. But the government is still paying me less than £2 per box.


Read more: PSNC: Review of price concessions ‘the priority’ for pharmacy contractors


Many other drugs like common antibiotics and indigestion medicines have also gone up in price recently. While the government has increased the reimbursement payment for some of these medicines, I am no longer able to generate any profit from them and therefore my ability to generate an income has been completely eroded.

Small, independent pharmacy businesses are the worst affected because we are at the mercy of local changes. ‘Averaging’ out across the country doesn’t help us in the slightest.

We get given very little market information from wholesalers; I could go to bed one evening with a medicine being widely available and priced in pennies and wake up the next morning to discover that the same medicine is only available at highly inflated prices, if at all.

I understand that wholesalers put their prices up like in any other business to absorb inflation. But I cannot change my prices to reflect this. My ability to generate an income has been capped for years because of this, but I am still paying more for medicines, staff, utilities, and everything else from computers to refuse collection.

Read more: BGMA: NHS must complete drug reimbursement reforms or face higher bill

Pharmacists have always put the needs of patients first, even when it means our businesses lose money. We don’t want to let down our patients with mental illness, epilepsy, gastric problems, or any other medicinal need.

But this state of affairs can’t continue. As a recent National Pharmacy Association (NPA)-commissioned report showed, the sector’s finances are not in a fit state to survive such nonsense as dispensing at a loss.

We’re working hard and still losing money – it’s a ridiculous situation and members of the public agree. 

A public opinion poll commissioned by the NPA in August found that 81% think it is unfair that pharmacies are sometimes paid less by the NHS for prescription medicines than the cost at which they buy them.

I’m genuinely worried about my business going forward. I know there are many others in a similar position.

We are all wondering about when to say enough is enough with this crazy system that relies on us losing more money the harder we work for our patients.

Olivier Picard is an NPA board member and owner of Newdays Pharmacy in Berkshire

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