Current shortages and exchange rates – most ingredients are priced in dollars – have caused huge fluctuations in drug prices. It’s created an opportunity for some to play the stock market, but for most independent contractors who replenish stock on a dispense-one, order-one basis, it has caused significant problems. They lack the market intelligence to play the stock market and there is a lag period between the purchase price and the item being listed on concessionary prices.
To make matters worse, some purchases are in excess of listed prices, which can lead to huge losses.
Counter arguments have been put forward that this works both ways: that contractors sometimes gain, as well as lose. This is true when the swings and roundabouts balance out, but there is a strong belief among independents that it doesn’t work in our favour. Suppliers may have the stock at Drug Tariff prices, but to order, you need to have an account with them and abide by their minimum spend, which could offset savings and create extra administration issues. Moreover, PSNC cannot disclose which supplier is offering at that price.
Some multiples have taken a bold step to close uneconomical branches and charge for home delivery. This is understandable from a business point of view. Independents, too, need to be honest with themselves and give careful consideration to these difficult business decisions. I think that we do now need to ask ourselves whether add-on services, such as free delivery, are an opportunity or a mine trap.
Funding cuts plus a lack of clarity on the direction of travel are causing confusion. The extra cost of managing various regulatory issues is adding to our stress, which is further complicated by the need to cut costs in order to survive.
So is there a healthier future? It can be a win-win situation if we make the best use of available resources. I recall that there was a huge outcry from GPs when pharmacists started providing EHC services. Similarly, warmongering goes on with flu services, where community pharmacists are often viewed in a different light compared to those who work in GP surgeries. It is strange that those in our profession are viewed in such different ways, but I suppose that this all boils down to the commercials and territorial protection.
How we present community pharmacy is important. For example, when we talk about pharmacy and ‘minor’ ailments does this give the impression of community pharmacists also being minor players? We should make sure that we are seen as major players who offer complete service packages, such as vaccination programmes and managing a range of long-term conditions.
In contrast to the internet pharmacies, we provide free consultation without appointments – and often without a sale – and offer an excellent service to the public and great savings to the NHS. Payment that recognises this contribution is being eroded away, which in the long term will destroy a successful system.
For me, the future is about collaboration between healthcare professionals. We need to be seen as equal players on the field, and for commissioners to put a new vision of pharmacy into action. There is plenty to be done, but it will be worth the effort. Let’s show the NHS and the public what we can do.
Salim Jetha is chief executive of independent pharmacy support group Avicenna