Pharmacies warn of major shortages of key antibiotics used to treat strep A as cases rise in UK
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LONDON – UK drugstores are warning of shortages of key antibiotics used to treat strep A as cases rise and the death toll in children reaches 15.
The rise in group A strep, especially among schoolchildren, has increased demand for amoxicillin and penicillin, the main antibiotic treatments, over the past week.
Where there are supplies, they are “flying off the shelves”, according to pharmacies, with some saying they are now dispensing drugs at a loss due to rising wholesale prices.
In some cases, pharmacists say wholesale drug prices have increased by as much as 850%.
At least 15 children have died in the UK from severe cases of Strep A this winter, according to health agencies in England, Wales and Northern Ireland. Another death from suspected infection was reported on Saturday but has yet to be confirmed.
Although most cases of strep A are mild and often go unnoticed, it can also lead to more serious illnesses and complications, such as scarlet fever. The bacteria can also enter the bloodstream and cause a disease called invasive group A strep (iGAS).
These serious infections can be fatal and are believed to be the cause of the recent spate of deaths.
Cases have increased in Britain this year, with the UK Health Safety Agency reporting 6,602 cases of scarlet fever since September. 12 in December. 4, well above the 2,538 reported during the last peak in 2017-2018.
Fears of national shortages
The government and wholesalers have insisted the country is adequately equipped to deal with the outbreak. Prime Minister Rishi Sunak dismissed fears of a “national shortage” of antibiotics.
“There is currently no shortage of drugs available to treat it and there are well-established procedures to ensure that remains the case,” he told the House of Commons on Wednesday.
However, a letter to pharmacists from NHS England, seen by Sky News, acknowledged that local pharmacies may be experiencing a “temporary disruption in the supply of some relevant antibiotics due to increased demand”.
Dr. Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies (AIMP), which represents pharmacy owners across the country, told CNBC that the reality on the ground was becoming desperate.
“It’s clear there’s not (enough supply), because it’s not finding its way to pharmacies,” he said. “And where there are irregular supplies, they fly off the shelves.”
“This is very worrying for us, especially when we have parents who come into the pharmacies and, unfortunately, they don’t have stock,” he added.
Parents have been advised to call pharmacies ahead of time to check on prescription availability after Hannbeck noted reports of families traveling miles between stores.
He said the government should not be surprised by the shortage due to similar drug shortages for other outbreaks, such as monkeypox, earlier this year.
“This just shows the incompetence of those in charge,” he said. “This is not the first time this has happened. Since the beginning of this year, I have been discussing with community pharmacies that there is something wrong with the supply chains of medicines in the UK.”
The UK Department of Health did not comment on allegations of incompetence when contacted by CNBC.
Drugstores “pay the bill”
Drug supply chains have been severely disrupted this year due to a combination of factors including the Russian invasion of Ukraine, inflation, Covid-19 and Brexit.
It has left pharmacies spending more time and money on buying drugs.
Under the UK National Health Service (NHS) Medicines Fee Scheme, pharmacies receive fixed compensation for the medicine. There is also a list of drug concessions for which higher prices can be paid.
Despite this, When wholesale prices jump, pharmacies can end up making losses.
The Government’s Department of Health and Social Care has warned that while prices may fluctuate, “no company should use this as an opportunity to exploit the NHS”.
Streptococcus A – or group A streptococcus (GAS) – is a bacterial infection of the throat or skin, which usually appears during the winter months.
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However, over the past week wholesale prices for amoxicillin and penicillin liquid solutions, which offer an alternative to tablets for children and are particularly scarce, have risen in some places from about 2 pounds to between 15 and 19 pounds, according to reports. AIMP’s Hannbeck.
London-based drug wholesaler Sigma Pharmaceuticals on Thursday raised the price of its amoxicillin liquid solution more than 10 times to £19, but later told CNBC the increase was due to a “computer error”.
Martin Sawer, chief executive of the Healthcare Distribution Association, which represents drug wholesalers, said the higher prices “directly reflect” the increased costs charged by manufacturers. He rejected claims of a supply shortfall, pointing instead to a “huge increase in demand”.
“Right now there is too much demand for products and not enough competitive products available to buy from manufacturers,” Sawer said.
Drugstore owners are now calling on the government to update its concession price for amoxicillin and penicillin, to ensure they are reimbursed fairly even if prices rise further.
Janet Morrison, chief executive of the Pharmaceutical Services Negotiating Committee, which is negotiating the list of concessions with the health department, said price assistance was “urgently” needed.
“Pharmacy teams are at breaking point,” he said. “They are helpless in the face of market forces working against them and urgently need a guarantee from the government that all medicines will be available, and not at wildly inflated prices.”
A total of 158 medicines were on the NHS’ November concession list, compared with 135 in October. Morrison said he expects to see a “record number” of drugs added to the list in December as supply constraints exacerbate shortages and push drug prices even higher.
“For months, pharmacies have been footing the bill for the same NHS drugs when they should be covered by the government,” Morrison said.
“This cannot continue,” he added. “If the government doesn’t act soon to protect pharmacies, patients can expect to see more and more problems getting their medicines. The government and the NHS need to fix this, and fast.”