A Hampstead pharmacy is facing an official investigation after admitting that it sometimes asks patients to pay extra for their prescriptions.
The Department for Health and Social Care (DHSC) ordered an investigation into Keats Pharmacy, Rosslyn Hill, after a heart patient claimed it refused to order his medication unless he paid more than the government-set price.
NHS prescription prices are set by law, with one item capped at £9.35 and an annual pre-payment certificate at £108.10.
Keats confirmed that it sometimes asked patients to pay extra, claiming the NHS does not fully reimburse it for some expensive medications, causing losses for the business. Its manager welcomed the investigation saying it would highlight this problem.
The authorities say pharmacies have no discretion to charge extra.
John’s Story
John Davies, 58, of Fitzjohn's Avenue, said he went to Keats in February to collect a beta-blocker called Atenolol.
“They only had a small amount in stock, so they gave me a receipt to say I was owed more,” he said.
But after visiting Keats twice in the following weeks to try to collect the rest, he said he was given an ultimatum by a member of staff.
“The cost for the drug was too expensive to gain any profit – so she asked if I could pay more to make up the difference,” he alleged.
“I was unwilling to do that and she said it would not be viable for her to order the drug. That’s what upset me. I was owed the remainder of the prescription but she wouldn’t issue it.”
Complaint
John complained to the General Pharmaceutical Council (GPhC) and on March 30 it wrote back, saying an inspector had spoken to the pharmacy, which had apologised and cited an “issue with the supply” of Atenolol.
“The outstanding quantity of tablets on your prescription are now ready to collect if you wish to do so,” the GPhC wrote.
“In light of this, we are of the view that the pharmacy has taken the appropriate action and there is no further action required by the GPhC from a regulatory perspective.”
But, said John: “I don’t think that’s good enough. If they’re breaking the law, something needs to be done about it.
“I’m never going to use that pharmacy again. My main concern is if they’ve done it to other people.”
Keats
David Harvey, practice manager at Keats, said that he believed pharmacies were entitled to ask for extra money, as “community pharmacy has been placed for some time in an anomalous position".
“Patients from time to time present NHS prescriptions for medications where the cost to the pharmacy of buying in the medication is more than the amount that the NHS will provide in reimbursement,” he said.
In those circumstances Keats gave patients two options.
One, he said, was to “pay the difference between the cost price to Keats... and the NHS reimbursement amount”.
The other was to return at the end of the month, by which time the NHS may have introduced price concessions so that “pharmacies are no longer left out of pocket".
“Many patients, when the options are put to them and understanding the difficulty, will be happy to pay the difference and take their dispensed medication,” said Mr Harvey.
“To be clear, there is no gain to the pharmacy in this, it is simply to ensure there isn’t a dispensing loss.”
Mr Keats added that the pharmacy would incur a loss rather than leave a patient without necessary medication.
The Law
The National Health Service Charges for Drugs and Appliances Regulations 2015 says pharmacists “must” dispense prescriptions at the legislated prices.
When the Ham&High raised Mr Davies’ case with the government's Health Department, an investigation was ordered.
"Pharmacies are not permitted to charge more than the current prescription charge for any item,” said a London NHS spokesperson.
“This case is being further investigated... Further action will be taken if required upon investigation."
Mr Harvey continued to dispute that pharmacies could not charge more than the government-set price.
“It is a recipe for further undermining the stability and effectiveness of community pharmacy, with no pharmacy being willing to stock medications that it could only dispense at a loss,” he said, adding that an investigation was “a good idea” and would “focus attention on the inoperability of their reimbursement mechanisms”.
“Plainly the current system does not operate in the interests of either patients or community pharmacy, and other stakeholders in the sector may take the opportunity to add their views,” he said.
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