To ask the Minister of Health to detail any consideration his Department has given to the financial impact on community pharmacies of dispensing medicines at a loss where reimbursement does not reflect market prices.

My Department has a statutory duty to ensure fair, accurate and prompt payment for HSC commissioned pharmaceutical services, and the Northern Ireland Drug Tariff sets out the remuneration and reimbursement arrangements for medicines supplied by community pharmacies.

The prices of medicines fluctuate daily, and with over 45m items dispensed in 2024/25, its simply not practical to reimburse pharmacies with the exact amount they paid to purchase each item. That means, at an individual prescription level, pharmacies may sometimes receive less than they paid for the product, and at other times more than they paid.

An annual margin survey is completed to ensure that, on average, the reimbursement arrangements for community pharmacy cover the cost of purchasing medicines plus a guaranteed level of margin, or ‘retained purchase profit’, meaning that HSC dispensing should be a profitable activity overall. In recent years, actual margin achieved has exceeded the agreed minimum threshold. For 2025/26, the retained minimum margin threshold has been increased from £31.5m to £34m.

If there is significant price instability or price fluctuations in-month for medicines, then a “concessionary price” is activated to help reset the price. Furthermore, since 1 April 2024, all drugs awarded concessionary prices have been subject to Zero Discount, i.e. discount is not deducted from these products.

In Northern Ireland, unlike other parts of the UK, there is also a special advance in the system for drugs on concession. The advance is currently set at £3,000 per contractor. I have listened to the recent concerns from contractors in relation to the financial pressures arising from current price fluctuations for a number of medicines, and in order to support the network, the Department is taking steps to review the special advance payable to contractors.

The Department remains committed to working constructively with the sector to ensure that community pharmacies are supported within a fair and sustainable framework.