Key Summary
- The analysis showed that pharmacies lost £5.8 million a month on average dispensing these six drugs alone.
- The NPA warned that years of underfunding has left supplies at risk, and it would deprive patients of their essential medicines.
- An earlier NPA survey had found that two-thirds of pharmacies made a loss in 2025 and 72 per cent of pharmacy owners had raided personal savings to keep afloat.
An analysis by the National Pharmacy Association (NPA) reveals that the NHS pays only 20 percent of the cost for some of the commonly dispensed drugs, forcing pharmacists to pay from their own pocket.
The NPA, which represents around 6,000 independent community pharmacies, wants the Government to end this "scandal" of pharmacy owners subsidising NHS medicines and warned of drug shortages.
Pharmacies in England buy prescription drugs from wholesalers and are paid via a central NHS contract, which reimburses them through a drugs tariff set in Whitehall.
Similar arrangements govern medicine supplies in Wales and Northern Ireland.
However, due to fluctuating wholesale prices, government funding cuts, and varying prescribing by doctors, NHS funding often falls short of what pharmacies have to pay for the medicines.
The NPA analysis was done for an average ‘shopping basket’ of six medicines, and in some instances, the NHS was paying a mere fifth of the cost.
A 28-tablet strip of Aspirin 75mg costs £3.97 for pharmacy, but the NHS pays only £2.18, a loss of £1.79.
Pharmacies across the UK are already facing a widespread shortage of low-dose aspirin, a vital medicine for heart and kidney patients, and have started rationing it to patients.
For Tolterodine 2mg (56 tablets), which is used to treat overactive bladders, the difference is much steeper.
The cost for pharmacy is £14.55, but the NHS pays a mere £4.09, or 28 percent of the cost.
In the case of Irbesartan 150 mg, a blood pressure medication, pharmacies have to shell out £6.09 for a strip of 28 tablets, but the NHS pays only £1.68 (28 percent).
For Mometasone 0.1 percent cream (30), used to treat eczema, the cost price for pharmacists was £12.09, but NHS paid around one-fourth at £3.75.
Similar instances of NHS underfunding was found in the case of Lofepramine 70mg, an anti-depressant, and Ivabradine 2.5 mg tablets, used to treat Angina.
NPA analysis showed that pharmacies lost £5.8 million a month on average, dispensing these six drugs alone.
The NPA warned that years of underfunding have left supplies at risk, and it would deprive patients of their essential medicines.
It warned that without urgent reform of the ‘fundamentally broken’ pharmacy contract, the shortages will only worsen and pharmacies could be driven out of providing services for the NHS.
Pharmacies have seen huge reductions in their real terms funding over the last 10 years, and despite recent uplifts, they face a £2.6 billion funding gap according to independent economic analysis commissioned by NHS England last year.
An earlier NPA survey had found that two-thirds of pharmacies made a loss in 2025 and 72 per cent of pharmacy owners had raided personal savings or remortgaged their homes to keep their pharmacies open.
NPA chief executive Henry Gregg said, “It is a scandal that all too often pharmacies are subsidising the cost of the nation’s medicines. It pushes pharmacies to the edge of closure and exacerbates chronic problems with medicine supply.
"The government must stop funding pharmacies below the cost price of medicines – no other part of the NHS would tolerate this.
“Just like GPs and dentists, pharmacies are a vital part of the NHS but are forced to deal with an outdated and broken contract."
