Pharmacists have hit back at claims that they are involved in a "prescription pricing scandal", in which prescribed supplements are supplied at inflated costs to the NHS, and have warned that flaws in pharmacy's remuneration system could be fuelling the alleged practice.  

The Daily Telegraph accused pharmacists on Monday (July 15) of hitting the taxpayer with bills for as much as £80 for prescription products that could be supplied over the counter for as little as £2. But pharmacists told C+D that it was "unfair" to condemn the profession over the supply of a few products when it was faced with "unprecedented supply problems" and pressure on profit margins.

The newspaper reported that pharmacists were supplying some supplements, including vitamin E, evening primrose oil and zinc sulphate, on prescription when they were "freely available" as OTC products. This was because of a loophole in the rules that "allows chemists to select suitable products from drug companies and bill the taxpayer", the Telegraph claimed. 

The Telegraph accused pharmacists of charging patients around £80 for prescription products, such as cod liver oil, that could be supplied over the counter for as little as £2	More on prescription pricing Pharmacy Voice calls for major reform of script       pricing system NHS BSA pledges greater transparency over       prescription pricing errors Numark slams £310,000 underpayment 'debacle' MORE NEWS
	The newspaper said that pharmacists were dispensing 500mg capsules of cod liver oil from pharmaceutical company Ennogen at an NHS price of £87.20 for packets of 30, while a similar Seven Seas product was available for an NHS price of £2.08 for 30.

Ennogen Healthcare told C+D that its cod liver oil and zinc sulphate products "often operate in niche markets" of which the company had a "very small share". All its products were subject to competition which "allows the NHS to achieve good value for money," a spokesperson said. 

PSNC chief executive Sue Sharpe said that, if the prescriber did not specify the brand name for products such as cod liver oil, pharmacists were "free to select an appropriate product".

However, she could not think of a "reasonable justification" for pharmacists to claim for a product at a premium over the prevailing price.

Mike Hewitson, owner of Beaminster Pharmacy, Dorset, said he did not condone the alleged practice and branded it unethical. However, it was a "symptom of a wider problem", as pharmacists were dispensing prescriptions for branded medicines at a loss. "The reimbursement system is not really working," he argued.

Numark managing director John D'Arcy said pharmacists were working against a set of payment rules that are "as complex as they are opaque". Pharmacists were dispensing prescriptions against a backdrop of supply problems and a climate characterised by doing "more for less".  They were dispensing around 35 per cent of prescriptions for branded medicines at a loss, he added.

Essex LPC chief executive Ash Pandya said he was angry that pharmacists were continually being picked on for "small specifics rather than a bigger picture".

"I think it is unfair to blame pharmacists on small specific items they are supplying that may be subject to quite large fluctuations of price," he argued. "I think generally pharmacists do a very good job for the NHS by providing best value and saving £1 billion for the NHS."

The Department of Health told C+D that the government was working on how the NHS could "get a better deal" on medicines that were not proving to be good value for money.

The number of prescription items dispensed for cod liver oil in England fell from 66,000 to 44,500 between 2010 and 2012, according to NHS figures. The cost of the supplements increased from £1.99 to £4.26 per item over the two years.

Last month, the Telegraph took aim at pharmacists with allegations that they were colluding with specials manufacturers to secure extra NHS payments.

Is the Telegraph right to attack pharmacy over prescription pricing? Comment below or email us at [email protected] You can also find C+D on Twitter, LinkedIn and Facebook