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The announcement Eli Lilly made about Mounjaro threw us into uncertainty. It was the very thing we were trying to protect ourselves against, says Nick Kaye…

The last few weeks have been a period where, although you feel like you have a lot going on, the unexpected comes at you from left field. To borrow a line from Baz Luhrmann’s The Sunscreen Song, ‘the real troubles in your life are apt to be things that never crossed your worried mind, the kind that blindside you at 4pm on some idle Tuesday.’

But for me, it was an idle Thursday at 11am when the price of Mounjaro suddenly jumped and then the world knew about it at 12pm as it hit the newspapers.

The pharmacy where I am superintendent is new (14 months old) and has a large private services offering. When starting the pharmacy with my amazing partners, we made a conscious choice to commit to offering clinical private services and, of course, weight loss is one of those services.

Protect ourselves from any sudden NHS shocks

We did this to try to protect ourselves from any sudden NHS shocks, as we all know in community pharmacy that wherever in the UK you own a business, it has been painful over the last 10-plus years.

I have been blown away by how much the population value the professional advice we give them as pharmacists and if that service is professional and of a high standard, most are more than happy to pay for that service.

The announcement Eli Lilly made then threw us into uncertainty – it was the very thing we were trying to protect ourselves against. Would this part of our business dry up?

It would add much-needed financial viability to a start-up business. But would we be able to get supply? Would expansion be slowed? How, clinically, would we be able to manage those people who now maybe can’t afford the medicine they were taking?

Time will tell what impact Eli Lilly’s decision will have on our business

We have rallied as a team and are putting in play multiple things to help our patients and what is transpiring is those patients can see how hard the whole pharmacy team is working to help them. They value what we are doing for them but only time will tell what longer term impact Eli Lilly’s decision will have on our business. However, I’m sure we will adapt and continue to thrive.

What it has made me do, though, is reflect. One of our directors said to me ‘go and figure it out Nick, pharmacy is not one dimensional. We as a business are not a one trick pony and if we put our patents first, we will see this through’.

Now, I completely agree with him but my further reflection is that contractors and business owners are adaptable but we also need to have the opportunity to show off our skills.

Although we may pivot and react to situations like sudden market shocks, we must have a strong NHS and private offering to give us the best chance to survive.

We can see all around us talk of the Government investing in us but the money must follow through as in England, the spending review is on the horizon, and I hope Community Pharmacy England is back in negotiations soon.

We have the opportunity at national and local level with the creation of integrated neighbourhood teams to drive income generation through best care, but the road is far from certain. I believe we will be moving away from a volume-based dispensing contract to one of clinical care delivery as set out in the 10-year plan, but this won’t be easy at all to achieve.

This shift must be realised and matched with delivery. For example, it is shocking that those on the independent prescriber pathfinder sites may find themselves between January and April with project management support and IT system that have been paid for but no money to pay to deliver the service. You couldn’t make it up!

It's examples like this that mean we will all need to step up. There will be a need for great local and national leadership to make this happen.

I know, more than most, the toll a national leadership role can take but having stepped away from the role of National Pharmacy Association chair for serval months, I was looking at old emails and came across one I had been sent when I was first elected as chair.

It had a quote from the late MP Tony Benn and although it’s quite irrelevant to political beliefs, I think it’s a great comment – those lucky enough to hold leadership roles should ask themselves ‘what power have you got, where did you get it from, in whose interests do you exercise it, to whom are you accountable and how can we get rid of you?’

So, dear reader, I have taken you from Baz Luhrmann to Tony Benn. I feel privileged to have the opportunity to write these pieces and I know you’re all so busy, so thank you for taking the time to read it.

Nick Kaye is a National Pharmacy Association board member and pharmacist based in Newquay. These are his personal views.