The above is not a new question but it’s a pertinent one. It crossed my mind as I reviewed a story in this issue about LloydsPharmacy inserting a legally-binding clause into a purchase agreement for one of its branches telling the buyer they must agree to use AAH Pharmaceuticals as the business’s “primary” wholesaler for at least three years after the sale has been completed.

My instant reaction was it was unfair. Having sold the branch, why should LloydsPharmacy dictate which wholesaler the new owner should use? And what does “primary” wholesaler mean in practice? (LloydsPharmacy did not clear that up.)

“What incentive is there for AAH to give those branches competitive prices?” tweeted Sheffield-based pharmacist Chris Armstrong. It is a good question. The clause may be a Competition and Markets Authority issue rather than a Medicines and Healthcare products Regulatory Agency one.

It may be neither but I felt that given pharmacists’ struggles with shortages and increasing drug prices, someone in authority should look at the clause. However, let’s stay with the MHRA. Three years ago, the Healthcare Distribution Association’s executive director Martin Sawer called on the Agency to enforce laws governing wholesalers more rigorously and transparently in response to concerns that some wholesale dealer’s license holders were hoarding supplies.

In October 2020, PSNC representative David Broome alleged pharmacies were being denied supplies of medicines by certain wholesalers with whom they were not ‘first line’ customers.

The PSNC issued a series of recommendations to address the problem, including ending zero quotas and relaxing minimum spend surcharges for drugs affected by quota restrictions. The MHRA says “pharmaceutical manufacturers and distributors operating in the UK marketplace are subject to a system of licensing and inspection” to ensure “medicines are manufactured, stored and distributed in compliance with required regulatory standards.”

But has the MHRA looked into the allegations we’ve heard about in recent years? And if not, why not? I don’t recall an occasion when it cracked down on a wholesaler following a thorough investigation. It could be the allegations are baseless. What do you think?

Neil Trainis is the editor of Independent Community Pharmacist.