ENGLAND — NHS England added 210 named medications to its price concessions list in April, a record high, as surging global prices contributed to widespread shortages of everyday drugs. People living with heart conditions, stroke risks, eye infections, bipolar disorder and ADHD are among those unable to obtain the medications they depend on.

The NHS pays pharmacies a fixed price for each medicine dispensed, and pharmacies are expected to source each drug for that amount or less. When a drug's market price rises above the NHS payment, the medication is placed on the government's price concessions list, and pharmacy owners are reimbursed at the new price. When market prices rise suddenly above both the original tariff and the concession price, pharmacies dispense medications at a loss, making it harder to maintain stock and increasing the chance of delays or shortages.

Medicine prices have risen as it has become more expensive and more difficult for manufacturers and suppliers to get medicines into the UK. Global tensions have pushed up energy and transport costs, and many medicines rely on oil-based ingredients. Venlafaxine is on the concessions list with a reimbursement price of £3.89 while the cheapest purchase price is £5.25.

Chloe, 29, who has epilepsy, takes a Lamotrigine-based medication that has become extremely hard to obtain. She sometimes spends several hours riding a bus searching for the medication she needs. "In the last few weeks I haven't been able to get the right medications and my seizures came back. I fell and hit my head and have a big scar across my back now from it," she said. "I get panic attacks. It's just terrifying," Chloe said. The Epilepsy Society identified three deaths in the last two years where lack of medication was a contributing factor.

Chris Henry, 49, takes Co-Careldopa for Parkinson's disease, and his medication has been added to the concessions list. He placed his next order after hearing about the shortages, hoping it arrives before he runs out. "This is genuinely concerning. Trying to manage medication for Parkinson's Disease is a nightmare at the best of times, so thinking there is a shortage is incredibly worrying and scary. These medications make my life liveable," Henry said.

In Shepperton, Surrey, pharmacist Akash Patel could not complete a monthly prescription for a patient with epilepsy because some items were unavailable. The pills he could provide would leave the pharmacy out of pocket by nearly £9. "It's been getting worse in the last few years but now is the worst I've ever known it," Patel said. "It's a big loss-making drug so we only ever order small amounts in the hope the price will come down when we order it next. And even when I order it, there's no guarantee it will actually come." His pharmacy lost £140,000 on NHS medicines it dispensed last year.

Since 2017, 1,500 High Street pharmacies in England have shut, with 27 closing so far this year, leaving the number of pharmacies in England at its lowest level in 20 years. Some pharmacists have remortgaged their homes or used pensions to keep their businesses afloat while waiting for reimbursement prices to catch up with costs.