HDA UK Media And Political Bulletin – 5 February 2018

Media and Political Bulletin

5 February 2018

Media Summary

19 wholesalers under MHRA ‘suspicion’, claims BBC

Chemist and Druggist, Grace Lewis, 2 February 2018

Chemist and Druggist reports on claims by the BBC that nineteen wholesalers are “under suspicion” for the diversion of prescription-only medicines onto the criminal market. BBC Radio 4’s File on 4 programme aimed to investigate the “extensive network of criminality involving businesses such as wholesale dealers and registered pharmacies” diverting POMs to be sold illegally online. One of the “weak link[s] in the chain is among wholesalers who trade in bulk”, the BBC has claimed. “Offenders have been buying from them, sometimes using fake licensing documentation.”

The publication also highlights the response to this investigation from Martin Sawer, Executive Director of the Healthcare Distribution Association (HDA) – which represents “less than 5%” of the “2,500 wholesale dealer” licences in the UK – who told C+D that “many of these [licences] are held by [organisations] whose main business is not wholesaling or distribution”.

All licence holders “are mandated to observe EU good distribution practice guidelines”, he added. “HDA members have rigorous checks in place to ensure we only supply medicines to those who have a legal right to dispense to patients and who are subject to strict professional regulation.” They also “conduct their own internal audits and inspections to ensure full compliance with the due diligence process”, Mr Sawer said.

UK medicines regulator looks to post-Brexit future with China links

Pharmaphorum, Andrew McConaghie, 2 February 2018

Pharmaphorum highlights that the head of the MHRA accompanied the Prime Minister’s delegation to Beijing last week. While there, Dr. Ian Hudson, chief executive of the MHRA, signed a new memorandum of understanding (MoU) with Chinese counterparts.

Dr. Hudson signed the agreement with the China Food and Drug Administration (CFDA), which oversees regulation for the country’s 1.39 billion citizens. The agreement pledges new areas of co-operation such as an exchange of learning from the UK’s Accelerated Access Review (AAR), the life science industry-focused strategy, and insights on how to regulate the trading of medicines online.

European Medicines Agency surveys pharmaceutical companies on preparedness for Brexit

The Pharmaceutical Journal, 2 February 2018

The Pharmaceutical Journal reports that the European Medicines Agency is surveying pharmaceutical companies on their preparedness for Brexit, in order to identify issues that could disrupt medicines supply and impact on human and animal health when the UK exits the European Union.

The survey is targeted at marketing authorisation holders of centrally authorised human and veterinary medicines that are located in the UK, or who have an important part of their site operations in the country. It asks about their plans for submitting transfers, notifications or variations to their marketing authorisations after Brexit.

The deadline for return of completed questionnaires to the EMA is 9 February 2018.

Parliamentary Coverage

Commons Tabled Written Questions – Department of Health and Social Care, 2 February 2018

Kevan Jones: To ask the Secretary of State for Health and Social Care, what assessment he has made of the robustness of the vertically integrated community pharmacy network and the medicines distributions chain and the effect on patients of the failure of one part of that network.

Kevan Jones: To ask the Secretary of State for Health and Social Care, what assessment he has made of the effect on competition and the availability of medicines across the community pharmacy network by the use of sole supplier agreements by branded manufacturers and wholesalers; and if he will make a statement.

Kevan Jones: To ask the Secretary of State for Health and Social Care, what assessment he has made of the effect on competition and the availability of medicines across the community pharmacy network of the operation of vertically integrated wholesaler and pharmacy businesses; and if he will make a statement.

 

Full Coverage

19 wholesalers under MHRA ‘suspicion’, claims BBC

Chemist and Druggist, Grace Lewis, 2 February 2018

 

Nineteen wholesalers are “under suspicion” for the diversion of prescription-only medicines (POMs) onto the criminal market, the BBC has claimed.

BBC Radio 4’s File on 4 programme – which aired on Tuesday (January 30) – aimed to investigate the “extensive network of criminality involving businesses such as wholesale dealers and registered pharmacies” diverting POMs to be sold illegally online, which the UK’s medicines watchdog revealed earlier in the day.

The Medicines and Healthcare products Regulatory Agency (MHRA) said that its latest crackdown – which leads on from its 2016 investigation into the “significant diversion of benzodiazepines and other hypnotics/anxiolytics” onto the black market – involves “businesses such as wholesale dealers and a small number of registered pharmacies” across the UK.

Following the MHRA’s confirmation of “more than 40 arrests” and the suspension of five pharmacists, the BBC – which claimed to have seen a full copy of the watchdog’s intelligence report – said 19 wholesalers are still “under suspicion as investigations into the criminal network continue”.

One of the “weak link[s] in the chain is among wholesalers who trade in bulk”, the BBC claimed. “Offenders have been buying from them, sometimes using fake licensing documentation.”

The BBC also claimed that 12 wholesale dealer licences have been handed in or terminated so far, as part of the MHRA’s investigation.

The MHRA would not confirm the figures to C+D and said it could not comment while investigations are ongoing.

HDA responds

Martin Sawer, chief executive of the Healthcare Distribution Association (HDA) – which represents “less than 5%” of the “2,500 wholesale dealer” licences in the UK – told C+D that “many of these [licences] are held by [organisations] whose main business is not wholesaling or distribution”.

All licence holders “are mandated to observe EU good distribution practice guidelines”, he stressed.

“HDA members have rigorous checks in place to ensure we only supply medicines to those who have a legal right to dispense to patients and who are subject to strict professional regulation.”

They also “conduct their own internal audits and inspections to ensure full compliance with the due diligence process”, Mr Sawer said.

“Huge spike in demand”

John Preston, head of offsite dispensing at Phoenix Healthcare Distribution, told the BBC Radio4 programme the wholesaler had reported a customer to the MHRA after seeing “a huge spike in demand” for an unnamed product.

Phoenix’s close monitoring of its distribution activities “quite regularly throw[s] up cause for concern”, Mr Preston said on the programme.

The BBC said the “bigger players in the legitimate wholesale market” are vigilant to suspicious activity.

UK medicines regulator looks to post-Brexit future with China links

Pharmaphorum, Andrew McConaghie, 2 February 2018

The head of the UK’s medicines regulator accompanied the Prime Minister’s delegation to Beijing this week, and signed a new memorandum of understanding (MoU) with Chinese counterparts.

Dr Ian Hudson, chief executive of the MHRA, signed the agreement with the China Food and Drug Administration (CFDA), which oversees regulation for the country’s 1.39 billion citizens.

The agreement pledges new areas of co-operation such as an exchange of learning from the UK’s Accelerated Access Review (AAR), the life science industry-focused strategy, and insights on how to regulate the trading of medicines online.

The visit to China was important for Prime Minister Theresa May, who wanted it to demonstrate the UK being globally minded and ‘open for business’ as it searches for a new post-Brexit identity.

This year will be hugely decisive regarding the terms of Brexit, which is set to begin with a two-year transition period in March 2019.

However massive uncertainty still hangs over the venture – not least in the UK life sciences sector, which is lobbying hard to stay as closely aligned with Europe’s EMA medicines regulator and other EU standards.

In the event of a ‘no deal’ or ‘hard’ Brexit, however, the MHRA may have to go it alone, and break away from the EMA’s centralised marketing authorisation.

The UK pharma and biotech sectors are certain this will mean the UK will be relegated in importance for product launches, with new medicines either launched later, or not at all, unless a deal with the EU can be struck.

There is speculation that the UK could align itself with other major regulatory blocs around the world, although the viability or desirability of these ideas has yet to be tested.

The MoU was signed in Beijing’s Great Hall of the People with both Prime Minister Theresa May and China’s Premier Li Keqiang present.

This new signing expands on a previous MoU signed in 2014 which focused on the exchange of safety information on medicines and medical devices to protect patients in the UK, China, and around the world.

Dr Ian Hudson, chief executive at the MHRA said: “China is a world leader in the market for raw materials for the pharmaceutical industry and closer collaboration with MHRA will support the promotion of innovation, good practice, and protect UK patients.

“We operate in a global environment and formalising our international relationships helps strengthen regulatory systems to protect public health worldwide.”

The MoU is also of interest to China, as it is looking to rapidly bring its regulatory framework up to speed with Europe and the US.

The CFDA last year announced it will formally join ICH GCP, the international regulatory standards agreement.

It is also changing its clinical trial approval system to one similar to the US FDA’s Investigative New Drug (IND) process – a move which could eventually see a huge shift in global clinical trials into China.

European Medicines Agency surveys pharmaceutical companies on preparedness for Brexit

The Pharmaceutical Journal, 2 February 2018

The European Medicines Agency (EMA) is surveying pharmaceutical companies on their preparedness for Brexit, in order to identify issues that could disrupt medicines supply and impact on human and animal health when the UK exits the European Union (EU).

The survey is targeted at marketing authorisation holders of centrally authorised human and veterinary medicines that are located in the UK, or who have an important part of their site operations in the country. It asks about their plans for submitting transfers, notifications or variations to their marketing authorisations after Brexit.

The EMA said information gathered in the survey will help identify companies with a need for concerted action to address medicines supply concerns, and help the EMA and the European Commission ensure they direct adequate resources to the areas where submissions will be made. Information from the survey will also be used to inform next steps in Brexit preparedness for the EMA, the European Commission and the European medicines regulatory network.

The EMA also hopes that the survey will prompt pharmaceutical companies to prepare for the regulatory steps required for their centrally authorised products to remain on the EU market after Brexit, in order to minimise disruption to medicines supply and avoid shortages.

The Brexit Health Alliance, which includes the NHS Confederation, NHS Providers, and the Academy of Medical Royal Colleges among its members, warned in January 2018 that the distribution of medicines could be disrupted if the UK and the EU reached ‘no deal’ over Brexit.

The deadline for return of completed questionnaires to the EMA is 9 February 2018.

Most UK pharmacists satisfied with wholesaler distribution model study claims
Pharmacy Business, Neil Trainis, 16 March 2017

A study commissioned by the European Healthcare Distribution Association has found that most UK pharmacists are satisfied with the distribution system of pharmaceutical short-line and full-line wholesalers. Conducted by the Institute of Pharmaeconomic Research, the study found that 72% of pharmacists were satisfied with the wholesale model. The safety of medicines was also looked into, with results suggesting there is high confidence in wholesalers’ ability to protect against falsified medicines.

 

Why legal action is not the solution to funding cuts

The Pharmaceutical Journal, Terry Maguire, 15 March 2017

 

Northern Ireland pharmacy contractor Terry Maguire argues that legal action may not be the solution against the funding cuts announced by the UK Government. Northern Ireland experienced similar 10% cuts in funding in 2010-2011. While it was forecasted that 10% of businesses would close because of the funding cuts, no pharmacies have closed as a direct result of those cuts. Alternative actions are available to mitigate the impact of the cuts, such as reducing business costs and promoting the value of pharmacy through a public relations campaign.

 

Parliamentary Coverage

House of Commons, Written Answers, Thursday 16 March 2017

 

Kevin Hollinrake, MP:  With reference to the study published by Oxford Academic on 17 February 2017 on inappropriate checks undertaken by online pharmacies, if he will discuss with the Medicines and Healthcare Products Regulatory Agency means to prevent the online sale of antibiotics and other medicines without appropriate checks.

 

Department of Health

Nicola Blackwood, MP:

Standards for United Kingdom online pharmacy services are the responsibility of the relevant professional regulatory bodies. These are the General Pharmaceutical Council and the Pharmaceutical Society of Northern Ireland. The Medicines and Healthcare products Regulatory Agency is working with the General Medical Council, the General Pharmaceutical Council and the Care Quality Commission to monitor issues arising from online services. The four regulatory bodies issued a joint statement on 3 March stressing that providers and healthcare professionals working for online services must provide safe and effective care, including following professional guidelines on this matter. The Department is aware and supportive of this important work.

 

Full Coverage

Why legal action is not the solution to funding cuts

The Pharmaceutical Journal, Terry Maguire, 15 March 2017

 

As pharmacy contractors in England suffer budget cuts and their leaders instigate legal action, Northern Ireland pharmacy contractor Terry Maguire argues why this might not be a good idea and what English contractors might learn from their Celtic cousins.

 

Eye-watering funding cuts of £170m to community pharmacies in England, which equates to 6% of the community pharmacy budget, were announced in December 2015 by the Department of Health.

 

The cuts, which were put in place from December 2016[1], work out as a reduction in income of about 15% per contractor. Consequently, many contractors fear their businesses may no longer be viable and are seeking action. And so, in November 2016, the Pharmaceutical Services Negotiating Committee (PSNC) — which negotiates the community pharmacy contract on behalf of contractors in England and Wales — applied to the High Court for a judicial review of the decision to implement the cuts, on the grounds that it believes that Jeremy Hunt, the secretary of state for health, failed to carry out a lawful consultation on the proposals[2]. The National Pharmacy Association (NPA), which represents independent pharmacies, launched a second judicial review shortly after[3].

 

It is understandable why such drastic cuts would instigate fear, anxiety, anger and potential hostility among pharmacists, as seen from the reactions of leading pharmacy organisations and through some of the correspondence in The Pharmaceutical Journal. All contractors, but especially those in small, independent pharmacies, understandably feel vulnerable, isolated and powerless. However, from our own experience in Northern Ireland, it is questionable whether costly legal action against the government is the best solution.

 

The Northern Ireland situation

 

Contractors in Northern Ireland experienced a cut in remuneration of about 10% in 2010–2011 when there was an imposition of the English Drug Tariff prices on Northern Ireland. Community Pharmacy Northern Ireland (CPNI) — which represents community pharmacy contractors in negotiations on services, the pharmacy contract and remuneration and reimbursement — forecast that 10% of businesses would close. It was painful, but somehow we survived. We are all still here and no pharmacies closed as a direct result of those cuts.

 

Faced with such a serious challenge to contractors’ livelihoods, there were a number of things that could be done to mitigate the disaster of closure, including cutting business costs, garnering public support, going on strike, taking legal action and getting back to the negotiating table.

 

Legal action: a long and winding road

 

With legal proceedings in process and hearings set for March 2017, this is where the action for contractors in England is. Solicitors believe legal action is justified and have come up with a proposition that the cuts are unlawful. Legal opinion claims grounds for a judicial review based on the fact that: there was a lack of genuine consultation; the government has ignored what is considered a “fair and reasonable” return for contractors; there was a lack of an evidence base for pushing hub-and-spoke dispensing models; and the cuts are an inappropriate tool for delivering the right number of pharmacies in the right places[4].

 

In Northern Ireland, our experience with judicial reviews has been a mixture of pleasure and pain

 

Perhaps many in pharmacy will view launching a legal challenge, given the severity of the cuts, a reasonable option. I strongly disagree.

 

In Northern Ireland, our experience with judicial reviews has been a mixture of pleasure and pain, yet, in the end, some seven years after we started down the legal route, we are meekly back at the negotiating table and are soon to have a new settlement agreed while paying a hefty undisclosed legal bill (estimated to be up to half a million pounds) for which we got no benefit.

 

A legal challenge through judicial review must be made on specific objective issues and no doubt the PSNC and NPA’s legal teams will have clearly defined these in setting out their cases. In Northern Ireland, our first judicial review[5]found that the Department of Health, Social Services and Public Safety (DHSSPS) failed to comply with its statutory duty to publish a fit-for-purpose Drug Tariff, which details the amount paid to pharmacy contractors for NHS services including both reimbursement and remuneration. We were delighted with this finding because struggling businesses got significant reimbursement of monies cut from the budget over some three years. However, the DHSSPS simply implemented a process to remedy its legal deficiencies. It published a Northern Ireland Drug Tariff and began to extract the monies again. This led to the second judicial review[6] where CPNI claimed only a cost-of-service inquiry (CoSI) on the sector would provide the data to establish “fair and reasonable” payment for running a pharmacy service. CPNI claimed, with some justification — and the judge agreed — that the DHSSPS had “failed in its basic duty to acquaint itself with relevant information … and that it has not collected the basic economic facts it needed to inform its decisions”. However the judge did not direct DHSSPS to repay contractors.

 

This ruling was appealed both by DHSSPS and CPNI (both parties had different aspects of the ruling that they did not agree with) and, before the appeal was heard in December 2012, the parties signed an agreement that the DHSSPS would provide interim payments to contractors for two years on a non-recurrent basis until completion of a CoSI by October 2013. The CoSI was to “adopt a collaborative approach” between pharmacy negotiators and the DHSSPS.

 

Everything seemed to have been agreed and was going well. But then the DHSSPS failed to complete the CoSI over the following three years and CPNI sought continuation of the annual interim payment. The DHSSPS refused. Cue the third judicial review[7].

 

A year on from initiating judicial review number three, judge Seamus Tracy ruled that the DHSSPS was not wrong when it decided not to pay the interim payment in year three of the second judicial review agreement even though a CoSI, which would establish the true costs of providing a pharmacy service, had not been completed. CPNI claimed that the lack of “collaboration” by DHSSPS was the problem, but the judge did not agree.

 

The judge believed there was no evidence that DHSSPS failed to provide “fair and reasonable” remuneration. In Northern Ireland, retained purchase profit (RPP) — the profit pharmacies can earn on dispensing drugs through cost-effective purchasing — would provide £16.5m to contractors but margin surveys showed that, for the years in dispute (2011/2012 and 2012/2013), the margins were £27.75m and £32.6m, respectively, and was expected to be £28m for 2013/2014. So CPNI lost in the third judicial review, was handed a large legal bill (over a quarter of a million pounds including the DHSSPS legal costs) and contractors have spent the past year trying to mend fences and move to a new negotiated arrangement. We still need to address pharmaceutical needs — the number of contracts for our population — and we will be brought round to that soon enough.

 

The government will eventually get its way… A judicial challenge is no substitute for reponsible negotiations

 

There has been a lack of strategic engagement between the DHSSPS and CPNI. The contractor body has resisted setting a vision and strategy for innovation and development of the pharmacy service and network. Most discussions are based exclusively on the DHSSPS deciding on something and CPNI reacting to it. This confrontational approach only produces flawed short-term arrangements. There is also a risk that the DHSSPS might start to negotiate with other bodies (say, a large multiple pharmacy chain) if the relationship with CPNI continues to break down.

 

I have personally opposed the use of judicial reviews as a means of progressing the interests of community pharmacy and remain to be convinced of their merit. Even if one might win a judicial review, in the long-term, government, acting in the public interest as it will always claim, will eventually get its way. A judicial challenge, therefore, is no substitute for proper and responsible negotiations.

 

Sue Sharpe, chief executive of the PSNC, says she has “reached the end of the road” with the Department of Health[8]. If this is truly the case then the PSNC, as a negotiator on behalf of pharmacy contractors, is in real trouble. The future value of pharmacy — which includes community pharmacy — is clinical and the government is committed to achieving this with a rebalance in funding from our medicines supply function. Unless we align our long-term visions for our businesses with that of the government, the network will suffer as clinical pharmacy services, and the remuneration associated with them, shift to other venues such as GP surgeries.

It is difficult for most contractors to accept this but our insistence on fighting for a status quo position — which pharmacists in England have essentially done for more than 30 years despite a new contract in 2005 — will only create crisis after crisis such as the current challenge.

Other options need to be considered.

 

Alternative solutions

 

Cutting business costs, particularly those associated with delivering patient services, should be a last resort. But we have reached that stage so it has to be done. Contractors will need to ensure that every pound of business cost is justified. This will be a painful but essential task. At my pharmacy, we avoided cutting staff – natural wastage helped (two members of staff left and we did not replace them) — but we aggressively reduced insurance and energy costs and focused on maximising profits from other sources, such as smoking cessation and minor ailment services, and community projects paid from community development funding or public health purses. This was difficult. We had to ask why we provided services that no doubt benefit patients but are not commissioned and merely reflect competitive pressures. Monitored dosage systems and prescription collection and delivery services spring to mind. At our pharmacy, we began charging new patients who wanted monitored dosage systems. I have also heard of contractors who stopped offering a delivery service.

 

Most pharmacists do a great job and patients and customers know it, which means politicians should, in theory, also appreciate us. The NPA and the PSNC, using their network, ran a highly effective public relations campaign and this will bring benefits now and in the future. This needs to continue and not lose momentum because, unfortunately, pharmacy is competing with other healthcare sectors and beyond to fight against funding cuts.

 

The option of strikes is difficult because contractors are competitors. Sharpe has conceded that the PSNC is unable to drive strike action[9] and she is right. Pharmacists in the Republic of Ireland chose strike action in 2009[10] in response to significant government cuts of 34%. The strike lasted 11 days before government threatened legal action against contractors for failing to provide a service. After 11 days ranks broke and the strike collapsed with little public sympathy. It was a disastrous strategy.

 

As much as I want to wish the PSNC and the NPA well in their judicial reviews, the result will only, at best, postpone what is inevitable: that is the need for real and meaningful negotiations with the government about the development of a fit-for-purpose pharmacy network.

UK Government to revise drug price scheme
20 September 2016, Pharmaphorum, Richard Stains

The Government has announced that it wants further control over drug pricing in companies not signed up to the Pharmaceutical Price Regulation Scheme (PPRS). The Department of Health has reported that major savings are being missed because companies have signed up to the Statutory Scheme instead. The Government is proposing to replace a 15% discount, applied to all medicines sold to the NHS, with a repayment of 10-17% of sales in the Statutory Scheme. Leslie Galloway, Chairman of the Ethical Medicines Industry Group, is concerned about the impact this proposal will have on the pharmaceutical industry.

Wholesalers on track to complete flu deliveries in two weeks
Chemist &Druggist, Beth Kennedy

Two of Britain’s largest wholesalers have begun distributing stocks of flu vaccines despite worries from pharmacists that they would see a 2 week delay in delivery. Martin Sawer, Executive Director of wholesaler body the Healthcare Distribution Association (HDA) has confirmed that deliveries began at the end of August. However confirmed that the final round of deliveries are due to arrive at pharmacies across the country over the next two weeks.

 

Parliamentary Coverage

 

There is no parliamentary coverage today.

 

Full Coverage

UK government to revise drug price scheme

20 September 2016, Pharmaphorum, Richard Stains

 

The UK government is pushing on with proposals that aim to limit profits from companies operating outside the main pharma pricing scheme.

Most pharma companies have signed up to the Pharmaceutical Price Regulation Scheme (PPRS), where industry reimburses the government if drug spend exceeds pre-agreed thresholds.

But in a consultation the government said that it wanted further control over prices from companies that choose to stay outside the PPRS, and are instead signed up to the so-called Statutory Scheme.

In the consultation response, the Department of Health said a total of £157 million in savings have been lost because some companies had instead opted to join the Statutory Scheme.

The government has opted to replace a 15% discount, applied to all medicines sold to the National Health Service, with a repayment percentage of 10-17% of sales.

This applies to all medicines in the Statutory Scheme on sale on 1 December 2013, and all drugs on the scheme launched since then.

The consultation document, perhaps unsurprisingly, showed National Health Service organisations under intense pressure to make savings are in favour of the proposals.

However the government also noted that the changes proposed “could be viewed by global pharmaceutical boards as creating an unsettled market.”

One of the most notable companies on the Statutory Scheme is Gilead, whose hepatitis C and HIV treatments represent a high percentage of the NHS’s specialised medicines budget. The government wants to claw back as many savings from Gilead and other companies on the scheme as possible, and doesn’t want the Statutory Scheme to be a more attractive option than the main PPRS agreement.

Industry also suggested the government does not have the power in domestic legislation to implement the preferred option, saying it amounted to a “sales tax”, according to the consultation summary.

The government is also not yet clear on how the repayments will be calculated and the payment mechanism involved.

Some responses suggested the proposals were in conflict with European legislation, including the Transparency Directive, governing pricing arrangements for medicines.

Leslie Galloway, chairman of the Ethical Medicines Industry Group representing small and medium-sized pharma, was concerned about the impact of the proposals on the pharma industry.

He told pharmaphorum that the proposals “send the wrong messages to global pharmaceutical leaders about investing in our country.”

 

Wholesalers on track to complete flu deliveries in two weeks

Chemist &Druggist, Beth Kennedy

 

Britain’s two largest wholesalers have started distributing stocks of flu vaccines, C+D has learned.

Alliance Healthcare and AAH Pharmaceuticals told C+D last week that they already held the stock in their warehouses, and had started distributing it to contractors.

Pharmacies in England were given the legal go-ahead to roll out this year’s flu service on September 1. However, Nat Mitchell, pharmacist and director at JWW Allison & Sons in Cockermouth, Cumbria took to Twitter to report he had been warned to expect a two-week wait before receiving his vaccines.

Mr Mitchell told C+D that he expected his deliveries of the vaccine by September 14 at the earliest – despite ordering from three different wholesalers.

Martin Sawer, Executive Director of wholesaler body the Healthcare Distribution Association (HDA) said delivery of contractors’ orders began at the end of last month. However, both the HDA and Alliance Healthcare confirmed that some “final deliveries” of vaccines are due to arrive in pharmacies over the next two weeks.

Pre-orders going well

Pharmacy London chief executive Rekha Shah said Alliance’s daily orders of the Pfizer vaccine and pre-orders of “another brand” had helped many pharmacies in the capital begin rolling out the flu service early on launch day.

Alliance said orders for the vaccine are “broadly in line [or] slightly higher” than last year – when pharmacists in England delivered almost 600,000 jabs, despite paperwork delays meaning the service was launched two weeks behind schedule.

David Powick, proposition manager at AAH Pharmaceuticals, told C+D communicating with the Department of Health about the service had been “simpler” the second time around because the wholesaler knew “what to expect and when to expect it”.

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