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COVID-19: The pharmacy losing money from dispensing sertraline

Mohammed Faisal Din says he has struggled to source Clenil inhalers
Mohammed Faisal Din says he has struggled to source Clenil inhalers

One pharmacy in Manchester has been dispensing sertraline at a “massive loss” since the outbreak of COVID-19

Pharmacies across the UK have been handling an unprecedented surge in demand during the COVID-19 outbreak. At Windmill Pharmacy in Denton, Greater Manchester, staff are emerging from an overwhelming few weeks, contractor Mohammed Faisal Din tells C+D.

“The main thing that we’ve had to deal with is the panic,” says Mr Din. “People have been wanting their prescriptions early and bulk buying.”

Windmill Pharmacy’s delivery service has seen a boom in demand of up to nine times the usual daily requirement. They normally complete between 10 and 15 deliveries a day but some days in March they were doing 90. “We’ve been a bit overwhelmed,” Mr Din says, although the requests have since calmed down.

Inhaler shortages

The worst part of the pandemic for Windmill Pharmacy’s patients has been stock shortages, Mr Din says.

The pharmacy team have struggled to get hold of many medicines, especially ones related to respiratory conditions. Drugs it could not get over the last few weeks include prednisolone steroid tablets, Fostair inhalers, and hormone replacement therapy (HRT) treatment.

Mr Din says Clenil inhalers in 50, 100 and 200 mcg strengths were unavailable from the end of March until early April. “People are panicking because this virus affects your lungs,” he says.

“A massive loss”

The pharmacy has been forced to dispense at a loss on some items, only adding to their problems. The drug tariff price for one 28-tablet box of sertraline 100mg is £1.55, but Mr Din says he has been charged £14.99 for each pack by some wholesalers. “That’s a massive loss,” he says.

Other unprofitable drugs include the pharmacy’s “bread and butter” medicines like aspirin dispersible 75mg tablets and paracetamol, Mr Din says.

The losses were offset slightly by the surge in demand from patients for over-the-counter items in the first few weeks of the crisis, but that has since trickled away, Mr Din continues.

He wants more support with this issue from the government. Wholesalers are “allowed to charge whatever they want”, he says. Mr Din says he has repeatedly seen hikes during the COVID-19 outbreak and would like to see healthcare authorities put more pressure on wholesalers to keep prices reasonable.

“Who is responsible?”

The pressure on pharmacy teams can be exacerbated by staff members having to self-isolate because they suspect they may have symptoms of COVID-19. As with other parts of the healthcare system, this problem would be alleviated by testing to determine who has the virus.

The Pharmaceutical Services Negotiating Committee (PSNC) said in March that pharmacy teams in England would be tested for COVID-19 for free if they are showing symptoms, but the tests have yet to materialise.

Windmill Pharmacy has taken an innovative approach to staffing in a bid to avoid closing due to absences. It’s split the team in two, with Mr Din heading up one group and his co-owner Rachel Potter the other. If one gets infected with COVID-19 there will still be enough staff to open the pharmacy.

“It’s a bit intense because you’ve not got the full staffing, but it means you’ve got backup. Some staff have been off ill, but we’ve not been able to test if they have COVID-19, which is a bit of a worry,” Mr Din says.

“We’re only human”

The plight of pharmacy has not gone unnoticed, but professionals say more needs to be done. The government announced that £300 million of “advance funding” would be made available to community pharmacy in England – although this is will need to be paid back at a later date. Steps to ease the demand for medicines deliveries have been taken through a national deliveries service and help from NHS volunteers.

However, pharmacy professionals are still calling for the government to support the sector directly with new funding to cover the rising costs COVID-19 is bringing.

In the meantime, Mr Din says continuing is a struggle, but the team carries on because they must. “We are obviously trying our best to help all the patients that we can, but we’re only human and we can only do what we physically can do,” he says.

“It’s always in the back of your mind – have I provided the right medicine? That’s the way it is.”

17 Comments
Question: 
How has your pharmacy been affected by COVID-19?

Lucky Ex-Locum, Superintendent Pharmacist

And our contract with the NHS says we HAVE to do this. What other profession would have a contract which EXPLICITLY states that you cannot refuse to do something even if it makes you a loss? This just proves that pharmacy is dead and I do not give a flying f if I get accused of being a troll by certain people on here who haven't the slightest idea of the real world.

Sanjay Shah, Community pharmacist

Unfortunately government will take no notice until the local village and town pharmacies start going out of business and the community they serve suffer as a result

Lucky Ex-Locum, Superintendent Pharmacist

I'm afraid you're wrong here. They won't take any notice even then because that is basically their stated intent. They have no regard for genuine community pharmacy at all. 

N O, Pharmaceutical Adviser

Many TROLLS have suggested that we leave this profession and do something else, not just here but on many other threads.

For them -- Please stop doing it.

Why did we study so hard? if all we had to do was to open a grocer or be a plumber or a truck driver or whatever. Even if we now move to those areas, don't you think it will be over crowded? And how much work do Plumbers/ Gardners etc get anyway?

Of course there will be trolls like these over here posting in their forums asking them to quit and seek help from Govt (doles)

So please stop suggestiing what people should do with their life and get on with yours.

Lucky Ex-Locum, Superintendent Pharmacist

Hope you aren't accusing me of being a troll. I and the vast majority of people on here are merely telling the truth. I have thirty years experience of pharmacy and used to love my job. I now loathe it because of what it has been turned into. Try actually DOING the job. I don't think a 'pharmaceutical adviser' whatever the hell that is, is qualified to criticize an actual pharmacist.

George Ibrahim, Locum pharmacist

Bruh

Industry Pharmacist, Head/Senior Manager

It's not about trolling. It's about facts. Pharmacy is almost dead, and the lack of Government financial commitment and the behaviour of the pharmacy regulators show that they do not care about the future of pharmacy. So there is no point in crying and protesting about cuts and price hikes....deal with being in dead end job and quit complaining, or move on.

N patel , Non Pharmacist Branch Manager

psnc never really cared for contractors.. 

Ahmed Patel, Community pharmacist

Not the only pharmacy that’s is dispensing items at a loss - we all are and it's unacceptable that we have had to deal with this along with all the other issues currently and before the pandemic 

A.S. Singh, Community pharmacist

I have posed this question with the PSNC during last nights webinar. They were too busy answering questions about PPE and the 300 million advance payment rightly. Fair reimbursement for dispensing medicines should be the main discussion point from PSNC to NHS England. Regardless of what we think and 'how well we are placed' in the community to provide extra services which we have no time for, more people listen to Boris when he said 'we dispense medicines and give assurance'. PQS must also be reviewed for this reason. 

Keith Mitchell, Community pharmacist

You're wasting your time there. I was at a PSNC / LPC meeting once where the PSNC CEO (Suzi Blunt (sic)) famously spouted "You don't have a God-given right to make a profit from dispensing". I don't think much has changed in the past ten years or so, has it?

Suleman Adam-Gavar, Pharmacy Area manager/ Operations Manager

I was there & I remember the comment, also I'm jealous I didn't come up with that name lol.... and it's so obvious as well.

Chris Locum, Locum pharmacist

Your comment sums up exactly why many community pharmacies in the independent category will not survive. I am sure she wasn't 'working' for free while propagating that comment.

Khalid Ahmed, Community pharmacist

An absolutely dispicable statement from that women! Its like telling a baker you are
not allowed to make money on bread! The poor baker cant even bake anything else because the machinery in not geared for much else to make it worthwhile.

John Boey, Community pharmacist

She really said that? Clearly only thinks that every penny above cost goes to making contractors even fatter cats, never to paying your OBLIGATIONS like your staff wages, overhead, loans, bills beforehand.

*This comment has been edited to comply with C+D's community principles*

A.S. Singh, Community pharmacist

Thanks for the insight! Lets leave dispensing for the future magicicans then. The psnc did indicate that they did not want to go to the press for this in their webinar, but why? 

ABC DEF, Primary care pharmacist

Why bother doing a business when there is no profit? May as well shut it down and open up a grocery store, and you probably get less earaches and headaches from unreasonable customers/patients.

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