By Alexander Humphries*

As I write this I am sitting in my bunker surrounded by boxes of stock. I know we have been told not to stockpile but to my mind it is a case of ‘needs must’ for my patients

In this one room I have 74 boxes, to be exact. All sorts of stuff. Allopurinol? No problem. Furosemide 40mg? No sweat – although I am down to my last 800 packs, so I’m going to have to start rationing soon.

Matt Hancock told me not to do it. Local medicines management teams weighed in to wag the finger at pharmacists who were doing it. The Department of Health has threatened to investigate pharmacies doing it. So, after three months of furious, yes, stockpiling, what have I learnt and why did I do it?

Tricky time

The past 12 months have been a tricky time for the business. We have cut back on everything we can to the point where we are only going to be allowed to boil the kettle twice a day...

Things got a bit dicey, to be honest, so earlier this year the business refinanced its debt in order to free up some additional working capital. This has proved to be a good move (so far) as it has allowed us to be a lot more responsive to the market. As a result, in August, we began to increase our stockholding.

At the time the Government (aka Corporal Jones from Dad’s Army) was telling us not to panic about the risk of a nodeal Brexit, while making some dire predictions about what might happen in that very same scenario. Put simply, we took a punt.

Every day we have phone calls from suppliers telling us ‘product x is going up in price’ or ‘product y is going short’. Until now, I’ve tended to view these calls as high pressure tactics to shift more stock to improve their own profitability. However, with the potential risk of disruptions to supply in the event of Brexit (and possibly FMD as well) we were in the market to increase our generics stockholding of critical volume lines by around 10 times what we would normally hold. So we began to buy.

Two boxes became 10 boxes, which then became 30, and before you knew it you were sitting in your very own doomsday bunker making an igloo out of naproxen.

Begging

The things we were buying were what we use every day – the ones that get really annoying when you can’t get hold of them because you spend your life on the phone to surgeries begging them to change prescriptions. Or ringing up wholesalers who, last week, would have sold stock to you for 30p but now won’t take anything less than a tenner.

We had to do it because we had no faith in the concessionary pricing system, which takes far too long and often bares no resemblance to reality. The gamble wasn’t really a gamble at all as we will use the stock eventually – it just means a bit of extra cash is tied up at the moment.

This has worked out quite well, with a few key lines ‘paying’ for everything else we’ve bought. While not all the lines have made us money, we have been protected from making big losses on lines where concessions either haven’t been granted or are nowhere near the market price. This is important because, this time last year, money was so tight we had to reduce our stock levels to the very minimum and were hit with every out-of-stock price increase. It nearly killed us.

So when every other pharmacy in the town couldn’t get any furosemide, guess where patients were sent? This has been a good thing for us and good for my patients because we have saved a huge amount of time, effort and distress for people we would have had to send elsewhere, or supply at a big loss.

I know some people will be pointing the finger at us for creating shortages – but we didn’t. We’re not selling stock on or exporting it; we are just ordering what we need for our patients.

But isn’t this increasing prices for the NHS, I hear you ask? Well, it is true the NHS is addicted to cheap generics. However, it is also true that some prices are unsustainably low, especially when you consider our currency has lost a lot of value since the referendum. Prices were always going to increase at some point.

The other issue is that, because of delays in concessions being granted and the level at which they are set, if we didn’t buy early we’d have lost thousands of pounds on a handful of lines since August.

It is true to say, however, that there are three big problems with this approach:

• Staff moaning when 50 boxes arrive in the morning order
• Finding somewhere to put it all
• The amount of tissues needed to dry the boss’s tears when he pays the wholesaler bills...

* Pen name of a practising community pharmacist. Alexander Humphries’ views are not necessarily those of Pharmacy Magazine. What are your thoughts on stockpiling? Email pm@1530.com