Pharmacies in England cutting services amid financial pressures, research finds
Tobi Thomas Health and inequalities correspondent
Sun, 4 August 2024
The research comes as data shows that almost 1,000 pharmacies in England have closed since 2017.Photograph: Graeme Robertson/The Guardian
Pharmacies across England are unable to provide critical NHS and public health services owing to the overwhelming financial and operational pressures they are facing, according to research.
A poll of pharmacy owners representing more than 2,100 pharmacies found that more than 96% of respondents said they had stopped providing locally commissioned services over the past 12 months.
These include emergency contraception and products to help quit smoking.
Four in five (81%) of pharmacy owners polled said they have had to stop offering extended opening hours, while 90% have had to stop employing locum pharmacists owing to the high costs.
Of the 92 owners polled for the representative body Community Pharmacy England, more than one-fifth said they have had to end free delivery of prescription medicines to patients.
The research comes as data shows that almost 1,000 pharmacies in England have closed since 2017, with poorer areas being affected disproportionately by the closures.
The Pharmacy First scheme was fully launched on 1 January this year, with patients in England now offered treatment for seven common conditions including urinary tract infections and shingles by a chemist without having to see a GP.
Janet Morrison, chief executive of Community Pharmacy England, said: “Across England patients and local communities are paying the price of our collapsing community pharmacy network, as thousands of pharmacies have been left with no choice but to reduce the services that they can offer. These are not decisions that any pharmacy wants to make, but with a 30% real-terms funding reduction and spiralling costs, pharmacy owners are having to make impossible decisions to try to keep their doors open.
Nick Kaye, the chair of the National Pharmacy Association, said: “The nation’s community pharmacies are under enormous pressure and are totally underfunded for their vital work on the health service frontline.
“This has inevitably resulted in cutbacks such as reduced opening hours and ending free medicines deliveries to housebound patients. Worse still, well over 1,000 pharmacies have been forced to close in the past decade.
“The government should be investing in us to reduce GP waiting times, but right now we are going backwards instead of fulfilling our potential as skilled clinicians.
He added: “If GPs limit the number of daily appointments, more patients will come to community pharmacies for help, but we are not in great shape after years of cuts. Our ability to be an effective shock-absorber for disruption elsewhere in the healthcare system has been eroded and we have serious capacity challenges.
“We need a new deal for community pharmacies that properly funds our work and allows us to deliver great NHS services.
A Department of Health and Social Care spokesperson said: “The NHS is broken, and pharmacies have been undervalued for too long.
“This government will shift the focus of the NHS out of hospitals and into the community. We will expand the role of pharmacies making better use of pharmacists’ skills, including accelerating the rollout of independent prescribing and establishing a community pharmacist prescribing service.”
Many online pharmacies selling weight loss products illegally: Study
Tara Suter
Sat, 3 August 2024
Many online pharmacies that are selling semaglutide, the main ingredient in weight loss drugs such as Ozempic and Wegovy, are doing so illegally, according to new research.
The study, released Friday in the journal JAMA Network Open, found that when researchers used search engines to try and find “websites advertising semaglutide without a prescription” in the summer of last year, 42.27 percent of the online pharmacies that came up “belonged to illegal pharmacy operations.”
“This qualitative study found that semaglutide products are actively being sold without prescription by illegal online pharmacies, with vendors shipping unregistered and falsified products,” the study reads. “Two websites evaluated were sent [Food and Drug Administration (FDA)] warning letters for unlawful sale of unapproved and misbranded semaglutide.”
Tim Mackey, an author of the report and professor at the University of California, San Diego, said those who are shopping online for the anti-obesity meds are facing “serious consumer risks” of receiving medicine that is fake, ineffective and potentially dangerous.
The research echoes alerts from the World Health Organization (WHO), which warned in June that fake versions of semaglutide were located, and being sold, in different countries.
The World Health Organization (WHO) put out a medical product alert in June that warned of fake versions of semaglutide, diabetes drug, being located in different countries
“WHO advises healthcare professionals, regulatory authorities and the public [to] be aware of these falsified batches of medicines,” Dr. Yukiko Nakatani, WHO assistant director-general for Access to Medicines and Health Products, said in a statement. “We call on stakeholders to stop any usage of suspicious medicines and report to relevant authorities.”
Manufacturers have found it difficult to keep up with the demand for the anti-obesity meds, which can cost up to $1,300 per month, the study found. Because of this, the number of people searching for the medicine on online pharmacies has increased, exacerbating the rise in “knock off” products, per the research.
Mackey added that the rise in potentially illegal online sales can also be credited to insurance plans that do not cover the injections or patients whose doctors will not write them a prescription for the drug. Medicare also will not pay for the medicine when they are prescribed for weight loss, the study explained.
Mackey and his colleagues tested six different samples of semaglutide from different online pharmacies. In their study, they found that at least two of the pharmacies had received warning letters from the Food and Drug administration for the unlawful sale of misbranded semaglutide.
The drugs purchased online also contained up to 39 percent more semaglutide than was labeled on the medicine, the research found. Overdosing on the medicine could lead to nausea, vomiting and dangerous drops in blood sugar, which can make people feel sick, per the FDA.
Pharmaceutical company Eli Lilly announced in June that it was filing several legal actions against med-spas, wellness centers and other entities that used unapproved products resembling their weight loss drug.
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Health experts issue paracetamol warning to all Brits after revealing study
Matthew Evans
Sun, 4 August 2024
Some people who take paracetamol regularly could have a heightened risk of certain deadly diseases (Image: Getty)
A medical study has highlighted the dangers of taking paracetamol regularly which has since prompted experts to send a warning to Brits.
It was assumed that - until fairly recently - paracetamol was a completely safe drug to use in patients with high blood pressure.
However, it has now been revealed that some people who take paracetamol regularly could have a heightened risk of certain deadly diseases.
A 2022 study found the effect on blood pressure is similar to that of non-steroidal anti-inflammatories (NSAIDs), such as ibuprofen.
NSAIDs are used to manage chronic pain but are also known to increase blood pressure and risk of heart disease, according to the ECHO.
Experts have said the increase in blood pressure might be expected to increase the risk of heart disease or stroke by around 20%. Researchers say patients who have a long-term prescription for the painkiller, usually used for the treatment of chronic pain, should be given the lowest effective dose for the shortest time possible.
Professor James Dear, personal chairman of clinical pharmacology at the University of Edinburgh, said: "This study clearly shows that paracetamol, the world's most used drug, increases blood pressure, one of the most important risk factors for heart attacks and strokes.
Prof Dear said doctors and patients should "together consider the risks versus the benefits" especially where patients are at risk of cardiovascular disease. He continued: "In summary, we've shown that two weeks of treatment with paracetamol increases blood pressure in patients who have hypertension (high blood pressure)."
Lead investigator Dr Iain MacIntyre, consultant in clinical pharmacology and nephrology at NHS Lothian said people who use paracetamol every once in a while shouldn't worry.
Dr MacIntyre said: "This is not about short-term use of paracetamol for headaches or fever, which is, of course, fine - but it does indicate a newly discovered risk for people who take it regularly over the longer term, usually for chronic pain."
The study found that after people stopped taking the drug, their blood pressure returned to what it was at the start of the study, suggesting the drug increased it.
"Doctors should always weigh up the benefits and risks"
Researchers said they did not have accurate numbers of the people in the UK who are on paracetamol long-term and have high blood pressure. However, it is estimated that one in three adults in the UK who have high blood pressure take paracetamol regularly.
According to the experts, the study was set up to see a very small effect on blood pressure, and they were surprised to see a much bigger impact.
Professor Sir Nilesh Samani, medical director at the British Heart Foundation, which funded the study, said the findings "emphasise why doctors and patients should regularly review whether there is an ongoing need to take any medication" and "always weigh up the benefits and risks."
Blood Pressure UK says around one in three adults in the UK has high blood pressure. In England, this is 31% of men and 26% of women.