Tag Archives: drugstores

Strep A antibiotics prices, shortages hit drugstores amid UK outbreak

Drugstores are warning of major shortages of key antibiotics used to treat Strep A, as cases rise in the U.K.

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LONDON — Drugstores in Britain are warning of shortages of key antibiotics used to treat Strep A, as cases rise and the number of child fatalities reaches 15.

A surge in Group A Streptococcus, especially among schoolchildren, has increased demand for amoxicillin and penicillin, the main antibiotic treatments, over the past week.

Where supplies do exist, they are “flying off the shelves,” according to drugstores, with some saying they are now dispensing medication at a loss due to soaring wholesale prices.

In some cases, pharmacists say wholesale prices for the drugs have spiked as much as 850%. These increased costs must be absorbed either by the U.K.’s National Health Service or drugstores, rather than parents, who typically receive children’s prescriptions for free.

At least 15 children have died in the U.K. from severe cases of Strep A this winter season, according to health agencies across England, Wales and Northern Ireland. A further death from suspected infection was reported 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 illness and complications, such as scarlet fever. The bacteria can also get into the bloodstream and cause an illness called invasive Group A strep (iGAS). 

These severe infections can be deadly, and are thought to be the cause of the recent spate of deaths. It has led to an increase in clinicians prescribing antibiotics for children.

Cases have been on the rise in Britain this year, with the U.K. Health Security Agency reporting 6,602 cases of scarlet fever from Sept. 12 to Dec. 4, well above the 2,538 reported during the last peak in 2017-2018.

Fears of a national shortage

The government and wholesalers have insisted that 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 are no current shortages of drugs available to treat this and there are well-established procedures in place to ensure that 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 drugstores may be experiencing a “temporary interruption of supply of some relevant antibiotics due to increased demand.”

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

This just shows the incompetence of those in charge. This is not the first time this has happened.

Dr Leyla Hannbeck

CEO, Association of Independent Multiple Pharmacies

“Quite clearly there isn’t (enough supply), because it’s not finding its way to pharmacies,” she said. “And where there are patchy supplies, they are flying off the shelves.”

“This is very concerning for us, especially when we have parents coming into pharmacies, and unfortunately they haven’t got the stock,” she added.

Parents have been advised to call ahead to drugstores to check prescription availability after Hannbeck noted reports of families traveling for miles between stores.

She said the government shouldn’t be surprised by the shortages given similar shortfalls in medication for other outbreaks, such as monkeypox, earlier this year.

“This just shows the incompetence of those in charge,” she 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 the matter with the U.K.’s drug supply chains.”

The U.K. health department did not comment on allegations of incompetence when contacted by CNBC.

Drugstores ‘footing the bill’

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

It has left drugstores spending more time — and money — sourcing medications.

Under the U.K.’s National Health Service (NHS) drug tariff scheme, drugstores receive set compensation for medication. There is also a concession list of medications for which higher prices can be paid.

Despite this, when wholesale prices jump, drugstores can end up making a loss.

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 Strep (GAS) — is a bacterial infection of the throat or skin, which typically arises during the winter months.

Halfpoint Images | Moment | Getty Images

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

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

Martin Sawer, executive director at the Healthcare Distribution Association, which represents drug wholesalers, said higher prices “directly reflect” the increased costs charged by manufacturers. He rejected claims of supply shortfalls, pointing instead to a “huge demand surge.”

“Right now there is too much demand for products and not enough competitive products being made available to buy from the manufacturers,” Sawer said.

If Government doesn’t intervene soon to protect pharmacies, patients can expect to see ever more problems with receiving their medicines.

Janet Morrison

chief executive, Pharmaceutical Services Negotiating Committee

Drugstore owners are now calling for the government to update its concessionary price for amoxicillin and penicillin, to ensure they are fairly reimbursed even if prices rise further.

Janet Morrison, chief executive of the Pharmaceutical Services Negotiating Committee, which negotiates the concessions list with the health department, said pricing assistance was “urgently” needed.

“Pharmacy teams are at breaking point,” she said. “They are helpless against market forces that are working against them, and urgently need Government assurance that all medicines will be available, and not at wildly inflated prices.”

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

“For months on end, pharmacies have been footing the bill for NHS medicines themselves when these should be covered by Government,” said Morrison.

“This can’t continue,” she added. “If Government doesn’t intervene soon to protect pharmacies, patients can expect to see ever more problems with receiving their medicines. Government and the NHS must fix this, and fast.”

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US drugstores squeezed by vaccine demand, staff shortages

A rush of vaccine-seeking customers and staff shortages are squeezing drugstores around the U.S., leading to frazzled workers and temporary pharmacy closures.

Drugstores are normally busy this time of year with flu shots and other vaccines, but now pharmacists are doling out a growing number of COVID-19 shots and giving coronavirus tests.

The push for shots is expected to grow more intense as President Joe Biden urges vaccinated Americans to get booster shots to combat the emerging omicron variant. The White House said Thursday that more than two in three COVID-19 vaccinations are happening at local pharmacies.

And pharmacists worry another job might soon be added to their to-do list: If regulators approve antiviral pills from drugmakers Merck and Pfizer to treat COVID-19, pharmacists may be able to diagnose infections and then prescribe pills to customers.

“There’s crazy increased demand on pharmacies right now,” said Theresa Tolle, an independent pharmacist who has seen COVID-19 vaccine demand quadruple since the summer at her Sebastian, Florida, store.

Pharmacists say demand for COVID-19 vaccines started picking up over the summer as the delta variant spread rapidly. Booster shots and the expansion of vaccine eligibility to include children have since stoked it.

On top of that workload and routine prescriptions, many drugstores also have been asking pharmacists to counsel patients more generally on their health or about chronic conditions like diabetes and high blood pressure.

Pharmacies also have been handling more phone calls from customers with questions about vaccines or COVID-19 tests, noted Justin Wilson, who owns three independent pharmacies in Oklahoma.

“We’re all working a lot harder than we did before, but we’re doing everything we can to take care of people,” Wilson said, adding that he has not had to temporarily close any of his pharmacies or limit hours so far.

Tolle said she was lucky to hire a pharmacy resident just before the delta surge arrived. The new employee was supposed to focus mostly on diabetes programs but has largely been relegated to vaccine duty.

Tolle said her Bay Street Pharmacy is now giving about 80 COVID-19 vaccines a day, up from 20 before the delta wave.

“God’s timing worked out well for me,” she said. “We would not have gotten through without having that additional person here.”

Others haven’t been as fortunate. A CVS Health store on the northeast side of Indianapolis shuttered its pharmacy in the middle of the afternoon Thursday due to staffing issues. A sign taped to the metal gate over the closed pharmacy counter also told customers that the pharmacy will soon start closing for a half hour each afternoon so the pharmacist can have a lunch break.

Such temporary closures have ebbed and flowed in pockets around the country throughout the pandemic, but they have grown more acute in recent months, said Anne Burns, a vice president with the American Pharmacists Association.

Pharmacies all need minimum staffing to operate safely, and they sometimes have to close temporarily if they fall below those levels.

Burns said many pharmacies already had relatively thin staffing levels heading into the pandemic, and a wave of pharmacists and pharmacy technicians left after the virus hit.

“There is a lot of stress and burnout for individuals who have been going at this since March of 2020,” she said.

CVS Health spokesman T.J. Crawford said he couldn’t comment on the circumstances for one store. But he said his company continues “to manage through a workforce shortage that isn’t unique to CVS Health.”

Rival drugstore chain Walgreens also has adjusted pharmacy hours “in a limited number of stores,” spokesman Fraser Engerman said.

Both companies are hiring. CVS Health says it has hired 23,000 employees from a push it started in September. About half of that total was pharmacy technicians, who can deliver vaccines.

As companies scramble to hire or keep staff, Burns and Tolle worry about adding even more responsibilities like diagnosing and treating COVID-19.

Tolle noted that it is not clear yet how pharmacists will be reimbursed for the time they take to diagnose and prescribe. That will have to be clarified, especially if cases surge again and drugstores need to add even more workers to help.

“We want to be able to help our communities,” she said. “I don’t know how pharmacies are going to manage it.”

Sherri Brown, a city employee in Omaha, Nebraska, was searching for a vaccine booster dose, but two nearby pharmacies didn’t have appointments available and a third didn’t have the brand she wanted. She wound up getting a shot at a county-run clinic on Friday.

“I just wanted to protect myself,” said Brown, who suffered through two weeks of coughing, headaches and fatigue when she caught the virus in January, before she was vaccinated. “I guess I’m encouraged to see that people are taking this more seriously.”

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Grant Schulte in Omaha, Nebraska, contributed to this story. Follow Tom Murphy on Twitter: https://twitter.com/thpmurphy

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.



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CVS Health to close hundreds of drugstores over next 3 years

CVS Health will close hundreds of drugstores over the next three years, as the health care giant adjusts to changing customer needs and converts to new store formats

The company said Thursday that it will close about 300 stores a year for the next three years, nearly a tenth of its roughly 10,000 retail locations as it reduces store count density in some places.

CVS Health said it has been evaluating population changes, customer buying patterns and future health needs to “ensure it has the right kinds of stores in the right locations.”

The company released no details Thursday on where the closings will occur. It did say they would start next spring.

Major drugstore chains routinely close underperforming stores or shutter locations for other business needs. CVS rival Walgreens, for instance, has closed several stores in San Francisco since 2019 due partly to problems with organized retail theft.

The growth of online shopping has blunted the need for CVS and Walgreens to operate a vast network of drugstores that are just a few minutes’ drive from most American homes.

CVS Health also has neglected its retail business and pushed some of its locations “into the downward spiral of irrelevance,” GlobalData Managing Director Neil Saunders said in an email.

“Too many stores are stuck in the past with bad lighting, depressing interiors, messy merchandising, and a weak assortment of products,” Saunders said in an email. “They are not destinations or places where people go out of anything other than necessity.”

CVS Health said Thursday its stores will be grouped into three models.

Some will be traditional pharmacies that offer retail products as well as some health care services. Others will be dedicated to customer primary care, and the company will break out an enhanced version of its “HealthHUB” locations.

The company started introducing those stores a few years ago. The stores are geared toward helping customers monitor chronic conditions like diabetes and stay on top of their health. Those locations can include health care workers like dietitians as well as community rooms for things like yoga classes.

The companies have dealt with staffing issues as they widen their focus. They’ve raised starting pay and hired thousands of additional workers for their stores.

But customers in markets like Kansas City and Indianapolis have complained recently to local newspapers about long waits or problems getting vaccinations at some Walgreens stores because of closed pharmacies.

A Walgreens spokesman said the company is always reviewing staffing levels and trying to minimize disruption to customers when a staffing shortages affect stores.

CVS Health said Thursday that it expects to take an impairment charge of between $1 billion and $1.2 billion in the fourth quarter for the closures. That charge won’t affect the company’s 2021 adjusted earnings forecast, which it raised earlier this month.

The company also said it will have an immaterial impact on adjusted earnings per share next year.

Aside from operating drugstores and selling health insurance, CVS Health also runs prescription drug plans for big clients like insurers and employers.

Shares of Woonsocket, Rhode Island-based CVS Health Corp. rose 3% to $95.55 Thursday afternoon while broader trading indexes were nearly flat.

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Follow Tom Murphy on Twitter: https://twitter.com/thpmurphy



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