Pregabalin entered category M in August, two months after NHS England announced the drug should be prescribed “in accordance with normal practice”.

Pregabalin prices in the drug tariff currently range from £1.87 for a pack of 56 25mg capsules to £4.17 for a pack of 56 300mg capsules. But contractors have told C+D they are being forced to pay almost £20 per pack by wholesalers.

PSNC director of pharmacy funding Mike Dent told C+D that when a category M reimbursement price for a particular product is reduced, it may take time and “sustained pressure from pharmacies for wholesale prices to respond.

“There have been a number of examples where manufacturers' prices were below the drug tariff price, but a product could not be obtained at the drug tariff price from a number of wholesalers,” Mr Dent told C+D today (August 3).

“During this period, it is essential that contractors exert maximum pressure on wholesalers,” Mr Dent said.

“Ridiculous” prices

A Cheshire contractor – who requires “around 200” boxes of pregabalin a month – told C+D he was not able to order any stock last month, as the prices “were ridiculous”.

“Yesterday I bought pregabalin at £19.32 a box. In the drug tariff, the box is £4.17. I’ve just lost £15 on that,” said the contractor, who wishes to remain anonymous.

“All the wholesalers seem to be quoting the same price across the board, it’s so unusual,” he said.

Describing the situation as “totally unsustainable”, the contractor said that as soon as pregabalin went off patent, some wholesalers refused to supply the generic in sufficient quantities.

“When I struggled to get hold of stock, I knew something was up,” he added.

“Contact PSNC immediately”

Numark said it is encouraging its members to “immediately contact PSNC” and alert the negotiator about the raised purchasing price of pregabalin.

“We have picked up news that the price of pregabalin is in some cases higher than the tariff,” Numark marketing director Mandeep Mudhar told C+D.

“This is not unusual with molecules where there is sometimes a shortage in the market – wholesalers have to pay more for a limited amount of stock.”

The drug tariff price “does not quickly respond to pricing fluctuations”, he added.

C+D has approached wholesaler representative body the Healthcare Distribution Association for comment.