to persuade UK drug companies to lower their sometimes inexplicably high prices. Two years
ago, St Mary's had bought a large number of its HIV drugs through parallel
imports. GSK and other companies declared they would not compete with
parallel imports; but, a year ago, they significantly cut their own prices.
St Mary's now gets most of its drugs from UK manufacturers.
The pharmacist went on to tell me that the hospital is part of a consortium
of several hospitals that includes the UK's largest HIV clinic, the Kobler
at the Chelsea and Westminster. They spend about £65m on drugs every
year, with HIV drugs accounting for around a third of the total. The advantage
of a consortium is that pharmacies can come together to negotiate price
discounts with drug companies - and obviously the bigger the consortium,
the more clout it carries. The pharmacists I spoke to were naturally reluctant
to reveal the specific discounts they negotiated for particular drugs,
but they can range from five per cent to 25 or 30 per cent at the highest
levels.
A 25 per cent discount on the BNF price of 3TC (including VAT) still works
out at £500 a year more than France. It begs the question: if hospital
consortia can negotiate large discounts for drugs, why can't the NHS as
a whole do even better? The BNF price is top whack, but it seems to be
set rather high compared with elsewhere in Europe. And smaller hospitals
are not in such a strong position to drive bargains.
Britain is different from the rest of Europe, by regulating the profits
of drug companies more than actual prices. Companies are free to set the
prices they want
page 3 of 5
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