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Insight: High prices mean tough choices for patients


Insight: High prices mean tough choices for patients

Some of my patients are already having to choose between heating and eating; now they have the even more unenviable choice of ‘treating, heating or eating’.

We are seeing people making tough decisions every week, whether it is to do with items of ‘low clinical value’, which are no longer being prescribed, or patients themselves facing a choice of which items they need or can afford. 

Just last week I had a lady come in with a prescription she had collected earlier in the day “for the wrong thing”. It had been dispensed correctly, but was an older prescription that had been sitting around for some time. 

What she actually wanted was an item prescribed by her psychiatrist that day. As she had already taken the prescription, we were unable to accept it back into stock and, even if we had, the claims message had already been sent at the point of handing it over to the patient.

She explained that she and her partner both worked, were not entitled to benefits and she couldn’t afford the prescription charge for the new medicine. She was in tears. I felt terrible and was on the verge of paying for it myself – but if I start down that road I’m basically going to be working for free as I’ll get every sob story going. As much as I might empathise with her over what is a bad situation, it is the system that is wrong. 

“We are seeing people making tough decisions every week”

Wholesale increases

Today’s wholesale bills are approximately 50 per cent higher than they were pre-Covid and they are certainly more than they were three months ago. I think that we will see medicines costs continue to increase next year as the impact of rising global fuel and transportation costs continues to be felt. This is probably great news if you have a giant warehouse and a massive chequebook... but everyone else will suffer.

I nearly fell off my chair recently when I went to check the price of generic promethazine as we had run out of Phenergan on the counter. Normally these are a few quid for 56, but the price had sky-rocketed up to £35 – yes, £35! – a pack. That is pretty typical for generic price fluctuations but what I am seeing is huge inflationary rises across the board with OTC medicines as well. 

The prices of some common OTC treatments have shot up by as much as 60 per cent in the last 12 months. I know this because I can see the old retail price every time I zap a barcode and compare this to the new retail price, which is based on the invoice price.   

Take one of my favourites, Nexium Control, which now retails at £12.99 for 14 capsules, while the POM packs are listed around £3.00 for 28. 

Increasingly, as pharmacists become prescribers, they will look to write prescriptions to avoid the high costs of some OTC medicines. Of course, this carries some additional clinical and professional risk, but I think pharmacists will put patients first, as we do when telling patients who pay for their prescriptions when they can buy it cheaper OTC. 

Grateful patient

Yesterday an American chap came into the pharmacy with his first NHS prescription for levothyroxine. He was a bit confused about the payment system, so the staff explained how it worked. He hadn’t got a medical exemption certificate as he didn’t know that he needed one. 

When my colleague told him that he would have to pay for his prescription, he looked terrified – but when he was told that it would be £9.35 he apparently leapt for joy, given that it was only a fraction of what he had been paying in the States. 

For all the doom and gloom, we have to remember what a brilliant thing it is that at least patients aren’t having to sell their homes to pay for their medicines! (Yet, anyway...)

What price increases have you seen that have shocked you? Email

*Alexander Humphries is the pen name of a practising community pharmacist. The views in this article are not necessarily those of Pharmacy Magazine.*

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