Cheaper private Covid boosters could end up being as expensive as their more expensive alternative because the vaccine must be given in groups of five, experts have warned.
Boots and pharmacies that partner with the company Pharmadoctor offers Pfizer/BioNTech boosts for those ineligible for a free NHS vaccination, with the former charging nearly £100 per shot. The latter also offers the latest Novavax jab, a protein-based vaccine, at a cost of around £50.
While experts welcomed access to the samples, they also cautioned high costs can widen inequalities.
Concerns have been raised about the use of the Novavax jab, as each vial of the vaccine contains enough for five doses, which – once opened – must be used within 12 hours if refrigerated, and preferably immediately.
Nathan Burley, a public health pharmacist and president of the Guild of Healthcare Pharmacists, said that while multidose vaccine vials were used for Covid-19 vaccines during the pandemic to maximize doses available for rapid deployment and mass, it comes with a number of pharmaceutical concerns. , including logistical issues.
“If patient scheduling is lax or patients don’t attend, doses can be wasted,” he said. “Pharmaceutical waste must be avoided at all costs. It is expensive to dispose of properly and, where it is not, it can unfortunately pollute waterways.”
Prof Lawrence Young, a virologist at the University of Warwick, said the Novavax jab was just as effective at protecting against serious disease as the Pfizer/BioNTech and Moderna jabs, and was also cheaper and easier to store .
He said there was some evidence that protein-based jabs had fewer side effects, while other research indicated that a “mix and match” approach using different vaccines led to a better immune response.
He also emphasized that once a Novavax vial is opened, five doses must be administered.
“It may not be cost-effective for pharmacies and may lead to wastage of the vaccine if fewer than five people are booked in for vaccination,” Young said. “This could also lead to pharmacies increasing the cost of the Novavax vaccine to compensate for any wastage.”
The Guardian has seen communications which suggest some pharmacies are already adopting a flexible charging approach.
One pharmacy sent an email to customers saying Novavax jabs would be reserved for patients with multiple bookings involving friends or family. If only two individuals received Novavax injections on the same day, the charge would be £90 per person.
“For three individuals the cost will be £65 each, for four individuals it will be £55 each, and for five individuals there will be a flat rate of £50 per person,” the email said.
Lara Wong, the founder of the support and advocacy group Clinically Vulnerable Familiessaid the approach was problematic.
“Coordinating group vaccinations to make full use of each multidose bottle presents a major challenge, especially for patients who cannot easily organize themselves into groups due to health problems or logistical constraints. This can lead to higher individual costs for those who cannot form groups. We are deeply concerned that this situation will create barriers to vaccination,” she said.
Graham Thoms, the chief executive of Pharmadoctor, said each of its partner pharmacies set its own prices, adding that Pharmadoctor did not charge a fee and did not take a cut from the pharmacy.
Thoms said strategies are in place to avoid waste. He said: “Some of our individual partner pharmacists have already received more than 160 patient appointment requests from Pharmadoctor for April, so they will simply need to arrange the appointments in blocks of five patients so that there is no wastage. Most of our partner pharmacies are already planning for this.”
