By Neil Trainis

National Pharmacy Association board member Sanjeev Panesar has urged wholesalers and manufacturers to work together to ensure pharmacies are given accurate stock information and immediately alerted if any problems with supply arise.

Panesar told the Healthcare Distribution Association’s conference in London last week that pharmacies already stretched to the limit by the rising price of medicines and inadequate funding are having to deal with "turbulence in the supply chain," leading them to spend significant time chasing suppliers when they could be serving patients. The HDA represents pharmaceutical wholesalers. 

"Operationally, we have lots of time-robbing activities that financially affect our businesses and clinically affect the care we give to our patients," he said, insisting the issue of shortages was "highlighted more perfectly than ever before" when antibiotics reportedly went short towards the end of last year. 

"As extreme as this shortage was, this issue is something we’ve been experiencing for many, many years, with now more than 200 commonly prescribed medicines in short supply. For years, community pharmacies have spent endless hours trying to source medicines for patients that are in short supply.

"This often involves searching all the various supply portals for stock updates, ringing around suppliers and wholesalers and manufacturers to determine when things will be back in stock or what the issues are, contacting nearby pharmacies to see if they have stock and, if all else fails, finding a solution for the patient (such as) finding out if an alternative medicine can be prescribed, checking that has no supply issues itself and finally contacting patients or GP surgeries to explain the issue and request a new prescription.

"This process takes a huge amount of time, especially when you consider the number of patients, the number of surgeries each pharmacy deals with and the number of commonly prescribed medicines currently in short supply."

Panesar called for a "more reliable and consistent supply of medicines in the supply chain" and an equal distribution of products "to pharmacies across the country." He urged supply chain players to ensure "accurate stock information and prompt update" is communicated to "all the relevant stakeholders in the supply chain as soon as issues come to light."

"The quicker this information reaches the various stakeholders, the quicker we can respond, get alternatives and reduce disruption to pharmacy teams, surgeries and patients," he said.

The HDA executive director Martin Sawer said his members were working hard to ensure medicines reach pharmacies.

Panesar also expressed concern over the government’s failure to fix a broken price concession system and insisted community pharmacies needed "more consistent, reliable pricing." He said he did not "know any other business that procures blind and in the dark without knowing what they will be reimbursed and with so many price fluctuations occurring on a daily basis."

"Many pharmacists are making losses on supplies of medicines that are above their drug tariff reimbursement value. Even if a medicine is added on to the price concession list, prescriptions can only be submitted for reimbursement once the patient collects their medication," he said.

"If a patient collects their medication a month after a price concession is permitted, the pharmacy may still make huge losses."

Panesar said there needed to be more "transparency and communication on pricing schemes and consistency across wholesalers and prescribing habits across the country."

He suggested many pharmacists, particularly "the younger generation," would not necessarily be aware of or understand what schemes such as reduced wholesaler agreements and DTP models "mean." 

"All of the above can introduce pressures and financial burdens into the system and into pharmacy businesses. Pharmacy teams need to understand why they’re in place, how these schemes work and how it affects them," he said.

"They also need to understand why surcharges are triggered and what they can do to avoid them."