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‘Frustrating’: DH 'imposed' atorvastatin 20mg and 80mg concessions, says CPE

The pharmacy negotiator has said that two new price concessions for shortage-hit drug atorvastatin were “imposed” by the government, as contractors decry cash losses caused by the crisis.

Community Pharmacy England (CPE) has said that July concessionary prices for 20mg and 80mg preparations of atorvastatin were “imposed” by the Department of Health and Social Care (DH) in an update posted on its website yesterday (August 1).

The negotiator said that final concession prices for 10mg and 40mg atorvastatin tablets - £1.65 and £2.25 respectively - were “high enough” to cover purchasing costs for “the vast majority” of pharmacy contractors that report prices to CPE.

But it added that “despite the improvements, we could not agree the prices for 20mg and 80mg, and these were imposed by the DH, based on the data it has gathered”.

Read more: ‘Four-figure loss’: Pharmacy contractors rage at atorvastatin crisis

The final atorvastatin price concessions for July, issued late on Monday (July 31), were:

  • Atorvastatin 10mg tablets (28) at £1.65
  • Atorvastatin 20mg tablets (28) at £3.38
  • Atorvastatin 40mg tablets (28) at £2.25
  • And atorvastatin 80mg tablets (28) at £3.45

CPE said that the DH concessions update came after “strong representations” and putting “weekly evidence from pharmacy owners” to the government over “several weeks”.

Read more: Atorvastatin: DH ‘closely monitoring’ situation amid 'supply constraints'

The industry negotiator added that while some of the DH’s new concessions were “improvements” on its original offers, it was “frustrating” that some were “imposed” and the update was announced “very late in the month”.

CPE is “deeply concerned about the impact that medicines supply issues are having on pharmacy teams and how this affects patients”, it said.

 

Next steps

 

CPE said that following a negotiating team meeting to consider the “critical medicines supply situation” yesterday morning, it will continue to press the DH for an “uplift to the £800m margin” from which community pharmacies can earn as well as an uplift to total funding.

It added that it had made “an exceptional request” to the DH for “a back-dated uplift” on the prices for 80mg atorvastatin and “two other concession lines” for July. 

Read more: Prescription costs up 8% to over £10 billion in England, NHSBSA reveals

CPE said that it had also asked the department to publish guidance for GPs to be “more accommodating” and instead prescribe “other available strengths/statins”, as well as guidance explaining the issues to patients.

It added that the DH had not issued any “central communications or Serious Shortage Protocols (SSPs)” to help pharmacies.

But the negotiator said that the DH had responded to say it was “worried” that guidance could lead to stockpiling or “potentially worsen the supply situation”.

 

“Unacceptable”

 

Suraj Shah, CPE’s drug tariff and reimbursement manager, said that the negotiator’s “clear position” is that making a loss from dispensing is “unacceptable”.

Mr Shah added that there had been “some clear improvements” to the concession price system after a review conducted with the DH in 2022.

These included removing discount deduction from concession products, rolling over products ordered later in the month and “a retrospective correction mechanism” when prices were later shown to have been wrong, he said.

“This was a step in the right direction, but more is needed,” he added.

Read more: Atorvastatin most-dispensed drug in community for second year running

David Broome, CPE committee member, said that “all pharmacy owners are stuck with the daily headache of trying to obtain medicines affected by supply disruptions or shortages”.

The situation is “now simply impossible” for many contractors and their patients and “it must be resolved”, he added, saying that the negotiator will “continue to fight for” protection from the “ongoing volatility in the market” through “all possible channels”.

CPE has also announced a concessions webinar in September, with community pharmacy owners and DH representatives both invited to take part.

 

DH “closely monitoring the situation”

 

 

A DH spokesperson reiterated that it is “aware of supply constraints affecting atorvastatin tablets and [is] working with wholesalers and all suppliers to understand what steps can be taken to improve the situation”.

Deliveries are continuing to be made and the department is “closely monitoring the situation”, they told C+D today (August 2).

“We have well-established processes to manage and mitigate the small number of supply problems that may arise at any one time including issuing a medicines supply notification or SSP, where appropriate,” the spokesperson said.

Read more: Feeling the pinch: How funding cuts are leaving contractors out of pocket

They added that CPE “is able to submit requests for concessionary prices at any point during the month” and that “volume and selling price information” from manufacturers and wholesalers is used to support the concessionary price setting mechanism.

It comes after C+D today revealed the results of a poll which found that half of responding contractors were facing losses of more than £1,000 from dispensing atorvastatin in July.

An SSP was most recently issued for atorvastatin in November 2022, but this was withdrawn on January 27 this year.

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