Pharmacies 'struggling to cope' with rising costs and drug shortages

Pharmacists are under mounting pressure as rising drug prices outpace NHS reimbursements, forcing some to supply medicines at a loss to patients.

Those in the industry are calling for increased funding to help meet soaring costs and growing demand for services.

Under the Scottish Government’s Pharmacy First scheme, most patients are encouraged to go and speak to a pharmacist before making a GP appointment for minor illnesses and common clinical conditions.

But with the cost of running a business rising for everyone, chemists say they often feel forced to “bridge the gap” between the cost of drugs and the payments they receive from the NHS.

Independent prescriber Sehar Shahid said: “One of the issues when it comes to any shortage of medicine is supply and demand; the prices will then increase.

“They’re purchasing higher price than what they’re reimbursed and are often supplying out of pocket.

“It puts a lot of financial burden on pharmacies.”

Unlike other businesses, pharmacies cannot simply put their prices up to reflect rising costs. Over-the-counter sales only make up about 5% of turnover, meaning most of the pharmacy’s income relies on the NHS.

Other services that pharmacies offer, like deliveries and blister packs for people on multiple prescriptions, are provided free of charge and funded entirely by the pharmacy itself.

Pharmacists say they are often forced to 'bridge the gap' financially — Pharmacists say they are often forced to ‘bridge the gap’ financially STV News

“It’s nearly impossible for our members to plan and invest in their businesses going forward,” says Adam Osprey, policy lead at Community Pharmacy Scotland.

“There is a whole load more our network could deliver if it were properly invested in. There needs to be specific investment to unlock the potential of the community pharmacy network.

“We can’t expose our members to additional workload without the reward to reinvest back into their businesses.”

‘A leap of faith’

Davidson's managing director, Alan Gordon — Davidson’s managing director, Alan Gordon STV News

Davidson, a pharmacy chain with 57 branches around the country, has felt the pressure firsthand.

Managing director Alan Gordon said fluctuations in the drug tariff, which sets NHS reimbursement prices, mean pharmacies are “gambling” on stock costs.

“The drug tariff affects reimbursement prices for around a thousand drugs. Those drugs come and go. When there’s a shortage, that price will go up.

“If it does, community pharmacies have to buy the product at that price and hope the price goes up at the end of the month.”

He points to the skyrocketing price of fluoxetine, commonly known as Prozac.

If NHS reimbursement rates aren’t adjusted to match market prices, he warns that Davidson’s stands to lose £20,000, which scales to roughly half a million pounds across Scotland’s entire community pharmacy network.

“Pharmacists are expected to provide products. There is a patient at the end of the chain who needs their medication. There is a leap of faith the pharmacy will take to ensure that the patient gets their medication, and we’re able to not provide at a loss.

“The vast majority of pharmacies will continue to supply regardless of cost – but some undoubtedly will have a decision to make.”

A Scottish Government spokesperson said: “We are supporting Community Pharmacies to provide essential NHS services, acting as the first point of contact for non-urgent care and treating minor illnesses.

“We are about to enter negotiations for the 2026/27 financial framework. Our aim is to put in place arrangements that balance the needs of the community pharmacy network, our shared ambitions for the delivery of pharmaceutical care services, and the current financial environment we are operating in.”