Strep A antibiotic costs, shortages hit drugstores amid UK outbreak

Drugstores warn of major shortages of key antibiotics used to treat Strep A as cases rise in the UK

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LONDON – Drugstores in the UK are warning of shortages of essential antibiotics to treat Strep A as cases rise and the death toll in children reaches 15.

A surge in group A streptococci, particularly among schoolchildren, has increased demand for the main antibiotic treatments, amoxicillin and penicillin, over the past week.

Where stocks are, drugstores say they’re “flying off the shelves,” and some say they’re now selling drugs at a loss due to rising wholesale prices.

In some cases, pharmacists say wholesale prices for the drugs have increased by as much as 850%.

At least 15 children have died from severe cases of Strep A in the UK this winter season, according to health officials in England, Wales and Northern Ireland. Another death from suspected infection was reported on Saturday but has not yet been confirmed.

While most cases of Strep A are mild and often go unnoticed, it can also lead to more serious conditions and complications, such as scarlet fever. The bacteria can also enter the bloodstream and cause a disease called invasive group A streptococcus (iGAS).

These serious infections can be deadly and are believed to be the cause of the recent wave of deaths.

Cases have risen in the UK this year, with the UK Health Security Agency reporting 6,602 cases of scarlet fever from September 12 to December 4, far more than the 2,538 reported during the last peak in 2017-2018.

Fear of a national shortage

The government and wholesalers have insisted the country is adequately equipped to deal with the outbreak. Prime Minister Rishi Sunak last week dismissed fears of a “national shortage” of antibiotics.

“There is currently no shortage of medicines to treat this and there are established procedures to ensure this remains so,” he told the House of Commons on Wednesday.

However, a letter to NHS England pharmacists, seen by Sky News, acknowledged that local drugstores may be experiencing a “temporary halt to the supply of some relevant antibiotics due to increased demand”.

dr Leyla Hannbeck, executive director of the Association of Independent Multiple Pharmacies (AIMP), which represents drugstore owners nationwide, told CNBC the reality on the ground was becoming desperate.

That just shows the incompetence of those responsible. This isn’t the first time this has happened.

dr Leyla Hannbeck

Managing Director, Association of Independent Multiple Pharmacies

“Clearly there isn’t (enough supply) because it doesn’t find its way into pharmacies,” she said. “And where there are gaps in stock, they fly off the shelves.”

“This is of great concern to us, especially when we have parents who come into pharmacies and unfortunately don’t have the stock,” she added.

Parents were advised to call drugstores beforehand to check prescription availability after Hannbeck noticed reports of families traveling miles between stores.

She said the government shouldn’t be surprised by the shortages earlier this year, given similar shortages of medicines for other outbreaks like monkeypox.

“It only shows the incompetence of those responsible,” she said. “This is not the first time this has happened. Since the beginning of this year I have been speaking to community pharmacies about what is wrong with the UK pharmaceutical supply chains.”

When asked by CNBC, the British Department of Health did not comment on the allegations of incompetence.

Drugstores “foot the bill”

Pharmaceutical supply chains have been severely disrupted this year due to a combination of factors including Russia’s invasion of Ukraine, inflation, Covid-19 and Brexit.

It has resulted in drugstores spending more time – and money – on sourcing drugs.

Under the UK National Health Service (NHS) drug tariff system, drugstores receive a fixed fee for drugs. There is also a discount list of drugs for which higher prices can be paid.

Despite this, When wholesale prices rise, drugstores can end up making losses.

The Government’s Department of Health and Social Care has warned that while prices can fluctuate, “no company should use this as an opportunity to exploit the NHS”.

Streptococcus A – or Group A Strep (GAS) – is a bacterial infection of the throat or skin that typically occurs during the winter months.

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However, in the past week wholesale prices for amoxicillin and penicillin liquid solutions – which are an alternative to children’s tablets and are particularly scarce – have risen in some places from around £2 to between £15 and £19, AIMP’s Hannbeck says.

London-based drug wholesaler Sigma Pharmaceuticals reportedly increased the price of its amoxicillin liquid solution by more than 10-fold to £19 on Thursday, but later told CNBC the increase was due to an “IT error”.

Martin Sawer, executive director of the Healthcare Distribution Association, which represents drug wholesalers, said higher prices “directly” reflect increased costs for manufacturers. He dismissed claims of supply shortages, instead pointing to a “huge surge in demand.”

“Right now there is too much demand for products and there aren’t enough competitive products available for purchase from manufacturers,” Sawer said.

If the government doesn’t step in soon to protect pharmacies, patients will face increasing problems getting their medicines.

Janet Morrison

Chief Executive, Pharmaceutical Services Negotiation Committee

Drugstore owners are now calling on the government to update their preferential pricing for amoxicillin and penicillin to ensure they are reimbursed fairly even if prices continue to rise.

Janet Morrison, executive director of the pharmaceutical services negotiation committee, which is negotiating the list of concessions with the Department of Health, said help on pricing was “urgently” needed.

“Pharmacy teams are at breaking point,” she said. “They are helpless against the market forces working against them and desperately need government assurances that all medicines will be available and not at grossly inflated prices.”

A total of 158 medicines were on the NHS’s concession list in November, compared with 135 in October. Morrison said she expects a “record number” of drugs to be added to the list in December as supply shortages exacerbate shortages and drive drug prices even higher.

“For months, pharmacies have been footing the bill for NHS medicines themselves when they should be covered by the government,” said Morrison.

“It can’t go on like this,” she added. “If the government doesn’t step in soon to protect pharmacies, patients can expect increasing problems getting their medicines. The Government and the NHS need to fix this, and fast.”