The British Generic Manufacturers Association (BGMA) said it cannot comment on the “pricing of individual products” but understands that there have been global active pharmaceutical ingredient (API) issues and higher demand for sertraline than usual over the past 12 months, a spokesperson told C+D yesterday (June 15).

According to prescription cost analysis data for 2020/21, released by NHS Business Services Authority (NHS BSA) last week (June 10), sertraline hydrochloride cost the NHS almost £168 million in 2020/21.

This is a 307% increase on the 2019/20 total cost for sertraline hydrochloride, which was £41.2m.  

Meanwhile, the average cost per item increased by 275% from £2.37 in 2019/20 to £8.89 in 2020/21.

Cost “halved and stabilised” since April 2021

The NHS BSA outlined in its analysis that the presentation “with the largest absolute increase in cost” between 2019/20 and 2020/21 at £78.9m was sertraline 100mg tablets, from £21m to £99.9m.

Sertraline 50mg had the third-highest absolute change in cost during the same time, at £46.7m.

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However, from April this year, the prices of both strengths “halved and stabilised”, according to the BGMA.

Drug tariff prices for sertraline 100mg and 50mg decreased to £4.32 and £2.78 respectively in April, and both strengths maintained the same costs in the May and June drug tariffs.

“The drug tariff price is made up [of the] manufacturers’ selling prices, as well as the margin for wholesalers and pharmacy, dispensing,” the BGMA spokesperson explained.

“Shortage of the API”

Several factors can influence the price of a medicine, such as “market size, raw ingredients and supply chain reliability”, a spokesperson from Accord Healthcare – which manufacturers sertraline 100mg and 50mg – told C+D earlier this week (June 14).

“We can confirm that we experienced a shortage of the API [for sertraline]. The shortage was compounded by increased logistical challenges presented by the pandemic and we were in regular dialogue with the Department of Health and Social Care (DH) throughout,” the spokesperson added.

“The supply of sertraline has stabilised in a relatively short period and is now back to usual stock levels,” they said, but added that the manufacturer cannot predict how future events will impact the supply of this medicine.

Teva also manufacturers the 50mg and 100mg strengths and a spokesperson told C+D that both are currently in stock and “with no major supply issues on the horizon”.

A spokesperson for Viatris – which manufacturers a generic version of sertraline in strengths of 50mg and 100mg and a branded version under the name Lustral in strengths of 50mg and 100mg – told C+D yesterday (June 15) that it does not anticipate supply interruptions “based on current predicted demand”.

Dr. Reddy's Laboratories also produces both strengths, which a spokesperson told C+D on June 14 are currently out of stock.

Price concessions were granted by the DH for sertraline  50mg and 100mg tablets between April and October 2020.

Pharmaceutical Services Negotiating Committee director of pharmacy funding Mike Dent told C+D last week (June 11) that “when drugs such as sertraline are only available at inflated prices, our Dispensing and Supply Team analyses the data from contractors and, where appropriate, seeks reflective concession prices to be granted”.