Drug firms could be investigated by the Government’s watchdog for ‘price gouging’ – inflating the cost of vital medication needed by millions of Britons – amid concerns they may profit from the Covid-19 pandemic.
Prices paid by NHS chemists for antidepressants and a breast cancer treatment have soared by more than 800 per cent in recent weeks, The Mail on Sunday can reveal.
And dozens of other commonly taken drugs have seen extraordinary price increases during the pandemic. These include painkillers such as ibuprofen and co-codamol, antibiotics, and even medication to treat overactive bladders.
While some pharmacies have paid over the odds in order to meet patient needs, others have been unable to – meaning that thousands of Britons may have faced delays or struggled to get the treatment they need.
Prices paid by NHS chemists for antidepressants and a breast cancer treatment have soared by more than 800 per cent in recent weeks (stock photo)
Some chemists say that due to shortages, they have at times not been able to give heart patients aspirin, which is prescribed as a blood thinner to prevent heart attacks.
Companies that supply the drugs claim price hikes are due to increased demand, lockdowns causing hold-ups in production and problems getting products from India and China, where most medicines are made.
But Government officials are also concerned that ‘a minority of bad apples’ may artificially inflate prices during the pandemic to make money.
Other examples of price gouging, investigated by consumer watchdogs in recent months, include high-demand products such as hand sanitiser, bleach and baby formula.
Experts are also warning that if a second wave of coronavirus hits in the winter, when demand for medicines is typically higher, there could be further cost increases and shortages.
‘When there are shortages, a pharmacist will do whatever they can to source that product,’ says Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies.
‘If they can’t get hold of it, patients will sometimes be switched on to similar-acting medicines. But with some antidepressants, for example, it’s not very easy to just switch a patient from one medicine to another – and if someone suffers from anxiety and depression, not having their medicine will make them more anxious.
‘Shortages of cancer drugs are also particularly difficult.
‘In a lot of instances, patients are put on drugs for specific reasons and it’s difficult to just substitute them for something else.’
The process of making and distributing prescription drugs is complex. Firstly, the raw ingredients that make them work, known as active pharmaceutical ingredients, need to be manufactured.
While some pharmacies have paid over the odds in order to meet patient needs, others have been unable to – meaning thousands of Britons may have faced delays (stock photo)
These are then transported to factories where they are made into tablets or prepared for injections into the patient. The finished products are traded between wholesalers until they are sold to pharmacies and hospitals, which dispense them to patients.
Today, the majority of generics – cheap, unbranded versions of commonly taken drugs – are imported from abroad. Just 20 to 25 per cent of those supplied to the NHS for use in pharmacies and hospitals are made in the UK.
About a quarter come from India, and India gets 70 per cent of its raw ingredients from China.
‘We are at the end of a very long supply chain for some drugs,’ says Dr Andrew Hill, honorary senior visiting research fellow in the Institute of Translational Medicine at the University of Liverpool.
‘If anything breaks down, then we are in trouble.’
In February, some factories in China ceased production as Covid19 spread. And in March, India introduced restrictions on the drugs it would export, so it could meet its own demand for medicines. The effects of the disruption caused to the supply chain are still being felt in the UK.
Fin McCaul, who has owned and run a pharmacy in north Manchester for nearly 40 years, says two wholesalers he uses regularly have been recently out of stock of aspirin.
‘We have been spending a lot of time trying to source appropriate products, and working with GPs to find alternatives that patients can switch to,’ he says.
Shortages of prescription drugs can also be costly.
‘Medicines are subject to supply and demand,’ explains Martin Sawer, executive director at the Healthcare Distribution Association, which represents wholesalers.
‘If there is plentiful supply, then the price comes down. If supply can’t meet demand straight away, then the prices go up. These prices change on a daily basis.’
The NHS reimburses pharmacists for prescription drugs they dispense, paying a set price known as a drug tariff. But when there are problems and a drug is in short supply, pharmacies may end up paying above the listed price to get hold of it.
WHAT’S THE DIFFERENCE BETWEEN COLITIS AND CROHN’S DISEASE?
Both are common types of inflammatory bowel disease – where an over-reaction of the immune system causes severe inflammation within the digestive system.
Symptoms of both include acute abdominal pain, urgent diarrhoea and, often, blood in the stools. However, with Crohn’s disease, any part of the digestive tract can be affected – from the mouth to the back passage.
Inflammation in colitis, known medically as ulcerative colitis, is contained to the large bowel, with only the inner lining affected.
Colitis also often results in ulcers forming between the colon and the back passage.
If this happens, the Department of Health will meet the higher price and pay back pharmacies – this is called a concession.
The list of concession prices, published by the Pharmaceutical Services Negotiating Committee, gives a good indication of drugs which are in short supply. A total of 43 items were listed in March, but this grew to 74 in April and 80 in May.
Figures from May suggest the price of antidepressant sertraline was up by 823 per cent, with the NHS reimbursing £14.32 for a pack of 100mg tablets, instead of its usual £1.55. Exemestane, a hormone therapy used to treat breast cancer in post-menopausal women, soared in price by 827 per cent.
A 30-pack usually costs the NHS £6.64, but in May the concession price was £61.57.
The Government’s Competition and Markets Authority has said it will investigate price rises throughout the supply chain during the Covid-19 pandemic and take action against any increases which it considers to be ‘unjustifiable’.
Warwick Smith, director-general of the British Generic Manufacturers Association, says: ‘If manufacturers increase prices for no good reason, then we will be the first to criticise them.’
As the UK prepares for a possible second wave of Covid-19, some experts argue that the supply chain must be strengthened to ensure patients have access to essential, life-saving drugs.
Shortages so far have not just been limited to pharmacies, Dr Hill warns. ‘I’ve spoken to doctors who ran out of certain drugs in intensive care,’ he says.
He believes the Government must now consider how it will source drugs and the ingredients to make them to avoid similar problems for pharmacies and hospitals in the future. ‘At the moment, if China goes down, we don’t have another option,’ he says. ‘The key is to have at least a Plan B, if not a Plan C. As a last resort, we should have the ability to make drugs within the UK.’
For patients worried about shortages, the advice is clear. ‘Order your medicine seven days before you run out,’ pharmacist Fin McCaul says. ‘If there is an issue, this gives us time to source the medication, or speak to your GP about finding an alternative.’
A Department of Health and Social Care spokesman said: ‘Fluctuations in price for generic medicines are normal, but companies must not capitalise on the pandemic by charging unjustifiably high prices.
‘The Competition and Markets Authority has set up a taskforce to investigate reports about businesses behaving unfairly, and can take action if necessary.’