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Memo to Boris: Bulk Medicine Purchases Could Save the NHS Millions Annually

by John Brian Shannon

The UK’s excellent National Health Service could save millions of pounds annually if the UK government were to bulk purchase all medicine for the entire country and thereby obtain huge discounts from pharmaceutical manufacturers.

The NHS can save itself millions of pounds sterling per year by simply purchasing a year’s worth of medicines in advance, similar to what is done in Canada where the government of Canada, using their mass-purchasing power, negotiates massive discounts on medicines from multinational pharmaceutical corporations.

In Canada, each province operates its own provincial health service and pays the entire cost of it via provincial income tax, sales tax and other fees — but they couldn’t succeed without the huge price discounts that the federal government of Canada obtains from its medicine suppliers. Not only do Canada’s healthcare systems benefit from lower drug costs, but the Canadian military and Coast Guard also benefit from those lower prices.

It’s not the whole answer to solve all NHS spending problems all the time but it could be a good part of the answer.

As the NHS constantly struggles to meet the demands placed on it by attempting to treat everyone, all the time, no matter the disease, ailment or injury; Saving millions annually on medicine costs could allow NHS funding to be better spent on treatment for patients, instead of it being consumed by drug costs.

It’s not about purchasing low quality medicines, nor is it about payoffs or patronage.

It’s about deciding how much medicine to purchase (a year in advance) and thereby obtain competitive pricing from the legitimate pharmaceutical corporations in America and Europe which appreciate knowing (in advance) how much of each medicine to manufacture and (in the case of some medicines) they are willing to offer deep discounts (usually about 50% off the listed prices, but in certain cases those discounts can reach 80% off the list price) which can help healthcare providers to lower their costs.


Using the Mass Purchasing Power of the UK Government to Lower Medicine Costs

Of course, the NHS has almost certainly looked at this model in the past.

But ‘timing is everything’ they say, and in the midst of recession, austerity, or during times of political upheaval, it isn’t practical to divert millions of pounds to prepay an entire year’s worth of medicines, nor is it likely to be done without prior approval of the UK government.

However, once we move out of the Coronavirus crisis (but while there’s still plenty of well-deserved focus on the heroic NHS workers) it might be time to have a national conversation about bulk purchasing the UK’s entire annual medicinal requirements — including purchasing on behalf of all devolved territory NHS units and the UK military. The UK government would thereby become the sole wholesale purchaser and wholesale seller of medicines in the UK, even acting as the sole supplier to every wholesale medicinal distributor in the country.

It might take a bit of UK legislation for this to happen and some money, because for all it’s merits, you must still pay for an entire year’s worth of medicine in advance in order to qualify for those quite wonderful discounts.

Also, every NHS unit including NHS Scotland, NHS Wales, NHS Northern Ireland and NHS England, and the UK military and every pharmacy supplier would need to provide a list of medicines to the UK government a year in advance so they could form an accurate picture of the pending mass purchase and consequent deep discount.

Yes, it would take some work to calculate that list and perfect it over time. But if Canada (and certain other countries and militaries) can do it; Why not the UK?

The truth is that certain global healthcare systems benefit massively from volume discount medicine purchases and the UK government needs to act now to create the requisite legislation so each NHS unit can save millions, allow the UK military to save hundreds of thousands of pounds sterling, and allow pharmacies to lower their retail prices via significant cost saving on the wholesale price they pay their suppliers.

But other than the price — as everything else would remain the same — the UK must get organized so it can obtain those astonishing discounts and benefit as other healthcare systems benefit from bulk purchasing.


The NHS Will Save Multi-Millions on Medicine Costs

You’ve got to like that.

Ditto for the UK military and for retail pharmacies.

Therefore, I respectfully submit that the UK government pass legislation to create a National Medicines Purchasing Agency (or ministry) that should thenceforth operate as the sole purchaser for all (non-homeopathic) medicines for the entire UK, including on behalf of all NHS units, the UK military, and for suppliers to pharmacies UK-wide, and provide it with generous funding to accomplish the task.

The legislation should require the agency or ministry to create a continuously updated website that is robust enough that the public and medical professionals could find relevant information on every medicine sold in the country — including general information, dosages, contraindications, along with high quality images of each pill or tablet to help counter possible fraudulent imitation pills or tablets.

Further, I believe that such an agency should be set-up — not to earn a profit from reselling medicines, but to simply recover the cost of each medicine — and that should remain true whether the agency is selling to any NHS unit, to the UK military, or to pharmacy suppliers across the UK.

However, if other national healthcare systems wish to purchase surplus UK medicines, then perhaps that UK agency could offer them to other healthcare systems at cost-plus-ten-per-cent for example, or whatever seems reasonable. No favouritism, please. Just enough to maintain a zero deficit/zero profit annual budget within the national medicines purchasing agency.


Selling Medicine that is ‘Near To Expiry Date’ & Selling Other Surplus Medicine to the UK Foreign Aid Office in Lieu of Monetary Donations to Developing Nations

The UK is highly regarded globally for its foreign aid commitment of .7% of GDP. It’s one of the most generous foreign aid budgets in the world by percentage and compares well with larger countries even when measured in total currency amounts.

However, more can always be done.

And instead of dumping ‘near to expiry date’ medicines or other surplus medicine in a landfill or incinerator; By staying current with the expiry dates, the UK could boost its foreign aid spending by sending such surpluses to developing nations once those medications are down to 6-months remaining on their batch number expiry date.

Therefore, whatever those drugs have cost the UK government, by simply reallocating them to the Foreign Aid Office for transshipment to a developing nation along with a note to the Foreign Aid Office explaining how much the National Medicines Purchasing Agency (or ministry) paid for that pallet of medications, it’s a just way to increase the UK’s foreign aid budget by that exact amount. Or to top it up  to .7% during lean years.

In either case, it won’t hurt to send a truckload or two of nearly outdated medicine (annually) to the developing nations that need them and include those donations as part of the UK’s foreign aid spending.

It’s a ‘Win-Win’ when you bulk purchase an entire country’s worth of pills annually and thereby receive astonishing discounts from multinational pharmaceuticals, it’s ‘Win-Win’ when each NHS unit never again runs short of medicine and only ever pays the deeply discounted wholesale price, it’s ‘Win-Win’ for pharmacy suppliers that benefit from a much lower wholesale price than they could ever hope to negotiate themselves, the UK military wins by having lower cost medicine for its personnel, and it’s a ‘Win-Win’ for the UK foreign aid budget/developing nations.

And all that, just by getting the UK organized on its total annual medicine purchase.
Who knew?