Christie & Co releases 2023 review of the UK pharmacy market

MARKET COMPOSITION

As of March 2023, the total number of pharmacies in the UK was 14,328. Between 2022 and 2023, corporate operators saw the most significant decline in pharmacy numbers, with a net loss of 200 stores, while medium-sized pharmacy groups saw a decline of 68. Independently run pharmacies gained 167 pharmacies over the year.

The sector’s composition is now weighted firmly in favour of regional multiples and independent contractors, whilst those companies operating more than 300 have reduced to circa 35 per cent of the overall market.

Looking at it geographically, there was a 0.2 per cent reduction in the number of pharmacies in Northern Ireland, a 0.3 per cent decrease in England, and a 0.8 per cent decrease in Wales. In contrast, Scotland saw a 0.2 per cent increase.

OPERATIONAL REVIEW

Operators continue to face significant operational challenges with little respite or ability to offset costs within the current contractual funding framework. Whilst gross margin performance has stayed more or less in line with what Christie & Co recorded in 2022, recently published accounts show downward pressure on margins by up to two percentage points. This is likely to be felt even harder by those pharmacies that have not developed income through wider services provision.

Over this time, contractors faced continued challenges of drug shortages not only impacting supply but also resulting in a significant rise in pricing. As a result, the sector saw stark increases in the number of drugs for which price concessions are granted. Whilst not a new issue, the volume of drugs attracting price concessions has increased significantly over recent years.

In the first six months of 2023, the Department of Health and Social Care awarded an average of 161 price concessions per month, causing Community Pharmacy England (previously PSNC) to make repeat requests to senior government officials to overhaul the current system.

EMPLOYMENT CHALLENGES

The sector continues to face pressures as Pharmacists and qualified staff are lured away to GP surgery and PCN roles under the ongoing Additional Roles Reimbursement Scheme.

Data supplied by Locate a Locum - which analysed over 160,000 locum pharmacy shifts for the period July 2022 to June 2023 - shows that, whilst respite in locum costs was aired by some contractors in the first half of 2023, workforce pressures are driving locum rate increases. Between 2022 and 2023, rates rose by 0.3 per cent in England, 7.6 per cent in Wales, and 17.5 per cent in Northern Ireland. Scotland, however, saw a decrease of 2.9 per cent to £45.36.

From a towns and cities perspective, rates increased by an average of 3.5 per cent across the board. The largest decrease was in Inverness where the hourly rate dropped by 14.8 per cent to £50.91. In contrast, the rate in Cardiff increased the most, by 30.3 per cent to £42.59. Dumfries has the highest hourly locum rate in the whole of the UK, at £51.80, and Belfast has the lowest at £27.38.

DISPENSING ACTIVITY

According to NHSBSA data, in the 12 months to March 2023, dispensing activity in England increased by 4 per cent, with the average volume dispensed by community pharmacies rising to 8,078 items per month. All types of settings saw a rise in dispensing volumes, with standard settings taking the lead with an increase of 5 per cent.

From a volume perspective, however, integrated settings continued to lead the way with an average volume of 10,030, followed by health centre adjacent settings returning 9,354, and standard settings averaging 7,529 items.

By operator type, independent contractors saw the highest volume increases, with independent settings now averaging 8,949 items per month.

SERVICES ACTIVITY

In the 12 months to March 2023, 452,614 advance services were undertaken across 8,629 pharmacy settings. The highest volume of service delivery was through Community Pharmacist Consultation Service, in which 6,808 pharmacies delivered 134,729 consultations, and the second largest was blood pressure tests, for which 4,680 pharmacies undertook 119,913 blood pressure checks.

Over the four months to July 2023, 2,216 pharmacies registered for the Pharmacy Contraception Service, with a peak of 769 in May. It was predominantly group operators who delivered the service. On average 9,113 pharmacies undertook 280,110 New Medicines Service per month.

BUYER PROFILES AND SALE STRUCTURES

In the first six months of 2023, the spread of buyer types was far more even than Christie & Co had seen in recent years, with a third of all sales completed to first-time buyers.

In 2022, 55 per cent of the sales Christie & Co completed were share sales. This has increased in 2023, with H1 statistics showing 57 per cent of sales had been of corporate structures. The company anticipates that the split between asset sales and share sales may narrow as outstanding change of ownership applications are determined over the second half of 2023.

ONLINE PHARMACY

Dispensing volumes for seven prominent online platforms - Superdrug, Hey Pharmacy, Chemist4U, Boots UK, Lloyds Direct, Well, Pharmacy2U - grew 12 per cent, with just over 32.5 million items dispensed in the 12 months to March 2023, representing 2.6 per cent of the overall items dispensed in the sector. Of this number, Pharmacy2U continues to dominate, dispensing just short of 1.6 million items in March 2023.

With EPS prescribing accounting for almost 96 per cent of items dispensed for the year ending March 2023, it is clear that the larger platforms will continue to develop market share. However, none are immune to the cost pressures seen across the wider sector, adding weight to comments regarding the sustainability of some smaller online businesses.

THE FINANCE LANDSCAPE

Whilst some respite was witnessed in inflation figures in July, some financial market commentators consider that the implied path for the Bank Rate over the next three years is more likely to be 5.5 per cent, well ahead of that forecast by the Bank of England’s Monetary Policy Committee in its Monetary Policy Report – August 2023. As a result, it is inevitable that the cost of commercial borrowing will not only continue to squeeze trading performances but may also restrict the number of products available in the marketplace.

From January to June 2023, asset finance covered one-third of all finance provided by Christie Finance, with continued strong demand to support the installation of automated dispensing robotics. Activity suggests that many community pharmacies across the UK and Ireland are taking advantage of automation to free up the space, time, and resources needed to become more customer-facing, handle additional services, and grow their businesses.

Tony Evans, Head of Pharmacy at Christie & Co, comments, “Looking ahead, 2024 will be a big year for the sector in England, as a new funding package to replace the 2019 Five-Year Deal should be delivered by the sector’s negotiators. The success of such negotiations will no doubt have a huge bearing on the future of pharmacy. It seems inconceivable that the Government can continue to ignore the pressure the sector is facing in its delivery of what must be regarded as one of the most important services to impact the country’s health.”

The report also includes an overview of supply and demand in the market, a review of pharmacy stocktaking services by Orridge, and key Christie & Co activity over the last 12 months.

To read the full Pharmacy Market Review 2023 report, visit: https://www.christie.com/pharmacy-market-review-2023/

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For further information on this press release, contact:

Phoebe Burrows, Corporate Communications Manager
P: 07540 063 598 or E: phoebe.burrows@christie.com