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“Many” independent pharmacies are concerned that “clawback demands” from Mounjaro manufacturer Lilly relating to an NHS rebate scheme may not be based on accurate figures, a representative group for contractors has said. 

The Independent Pharmacy Contractors network, which has over 500 members operating around 2,000 pharmacies in England and Wales, has launched a campaign to support contractors with concerns about looming clawbacks for Mounjaro items dispensed in the first three months of this year.

The scheme, which commenced in September 2025 after Lilly increased the price of Mounjaro, allows contractors to request a rebate on their wholesaler costs each month, provided they pass on the discount to patients. 

IPCN said contractors have reported that the rebate calculations provided by Lilly “cannot be reconciled against their own dispensing and purchasing records”.

“Many have also raised concerns regarding the short notice being given before substantial deductions are made from pharmacy accounts,” it added.

The organisation said its campaign “does not seek to avoid legitimate financial obligations” but rather aims to ensure “that any recovery is based on accurate, transparent and verifiable data”.

IPCN has given its members a formal dispute template to encourage them to request information from Lilly, including “full disclosure” of the NHSBSA dispensing data and wholesaler purchase records used to calculate rebates, as well as confirmation that stock purchased before the list price increase “has been excluded from any clawback calculations” and a “complete itemised reconciliation of rebate payments already made”.

Contractors were also urged to demand an immediate suspension of account deductions or clawbacks while disputes are ongoing. 

“IPCN believes these are reasonable requests consistent with basic principles of commercial transparency and natural justice,” the organisation said.

It advised contractors who believe their rebate calculations may be inaccurate “to undertake a full reconciliation of their dispensing and purchasing records and to formally notify Lilly where discrepancies exist,” also calling on the manufacturer to “engage constructively” and “provide the requested data promptly”.

Halesowen pharmacist Rifat Asghar-Hussain said: "Independent pharmacies are not refusing to honour legitimate rebate arrangements. They are asking to see the evidence upon which significant financial demands are being made.

“Businesses cannot reasonably be expected to accept substantial deductions from their accounts without being able to verify the underlying calculations. Any organisation making financial claims has a responsibility to demonstrate how those figures have been derived.

“Where pharmacies dispute those calculations, any clawback should be paused until the matter has been properly investigated and agreed by both parties.

“Community pharmacies continue to operate under unprecedented financial pressure. Large deductions made at very short notice have the potential to create avoidable cash flow problems for businesses already delivering essential NHS services.

“This campaign is about fairness, transparency and proper commercial practice. Independent pharmacies simply want the opportunity to reconcile the figures before money is removed from their accounts."

A Lilly spokesperson said: “We have clear contractual terms and we are implementing reconciliations based on those terms.

“We will work with individual providers on an appropriate resolution.”

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