Boots rapped for cash-back ‘incentives’ on addictive pills offering Advantage Card points on purchases of co-codamol
- The high street chain offers Advantage Card points on drugs such as co-codamol
- NHS guidance recommends GPs avoid prescribing powerful opiod-based drugs
High Street pharmacist Boots is offering points on purchases of addictive codeine painkillers – which customers can then use to buy ‘treats’.
The firm gives about 24 Advantage Card points – worth 24p – to customers buying Boots Ibuprofen & Codeine over the counter. It offers similar incentives for buying co-codamol, which are paracetamol and codeine tablets.
NHS guidance recommends that GPs avoid prescribing powerful opioid-based painkillers such as codeine to tackle a growing addiction problem in the UK.
UK medical regulators are currently considering whether to ban all over-the-counter drugs containing codeine, making them prescription-only.
In March last year Boots told a parliamentary committee it would no longer allow customers to gain points on its Advantage Card scheme when purchasing codeine-based medicines.
The firm gives about 24 Advantage Card points – worth 24p – to customers buying Boots Ibuprofen & Codeine over the counter. It offers similar incentives for buying co-codamol, which are paracetamol and codeine tablets
UK medical regulators are currently considering whether to ban all over-the-counter drugs containing codeine, making them prescription-only
However, The Mail on Sunday has found the practice is ongoing. Last week, we bought a 32-tablet pack of Boots Ibuprofen & Codeine for £9. This awarded our reporter 24 Advantage Card points.
Boots encourages customers to accumulate these points, which can be spent on other Boots products. On its website, it tells customers: ‘You can save [points] up for a big shop, like Christmas, or just treat yourself!’
It also quotes a Boots employee called Caroline saying: ‘I love hearing the cashier say I can use my points to pay for my shopping. It’s a little treat every so often.’
Experts warn the strategy could encourage people to buy codeine pills and raises the risk of customers becoming addicted.
Addiction expert Professor Ian Hamilton, a lecturer at the University of York, said: ‘It seems bizarre given the rise in opioid addiction in the UK. It doesn’t take long to become addicted to codeine, and Boots should be discouraging use. It should reconsider this policy.’
Opioid addiction has been an increasing problem in the NHS over the past decade. Since 2012, drug deaths involving opioids have nearly doubled. In the US, opioid overdoses have caused over 500,000 deaths over the past two decades alone, outstripping AIDS.
Desperate to avoid a US-style crisis, the NHS has cracked down on opioid prescriptions. In 2020, new guidance was released recommending GPs do not prescribe the medicines for chronic pain because they are ‘harmful’ and cause addiction.
This March, the NHS announced opioid prescriptions had been cut by almost half a million in the past four years. But medicines that contain lower doses of codeine – co-codamol has about 8mg, half the strength of the prescription version – can still be bought in pharmacies over the counter.
In 2020, the UK medicines regulator said it ‘will consider’ reclassifying codeine-based medicines as prescription-only.
The pills are prescription-only in at least 25 countries, including Germany, Japan and the US. Experts say the move would help cut addiction in the UK.
‘It’s clear that an increasing number of people are frequently buying co-codamol and taking it in large quantities,’ says Prof Hamilton. ‘It’s very possible that these drugs may end up going under the counter soon.’
Boots has previously spoken out against making the drugs prescription-only. In March 2022, the company submitted evidence to a Home Affairs Committee where it stated that increasing regulation on codeine-based medicines would ‘drive this population to turn to more illicit substances, further compounding their addiction’. Instead, Boots said it planned to tackle the problem by training staff to spot the signs of codeine addiction.
It also said that codeine-based medicines would ‘no longer qualify for points as part of the Boots Advantage Card Scheme’.
Experts criticised the company for continuing with this practice. ‘Boots are incentivising people to buy very strong opioid painkillers, when potentially all they might need to relieve pain is a less-addictive painkiller or even something less medical,’ says Nuno Albuquerque, head of treatment for the UK Addiction Treatment group, UKAT. ‘Offering points for painkillers doesn’t feel like the right approach, especially during a cost-of-living crisis.’
A spokesman for Boots said: ‘Boots Advantage Card holders can earn points on all pharmacy medicines but cannot redeem their points against opioid-containing pharmacy medicines.
‘In addition, we do not run promotions on these medicines.
‘Boots works closely with external medicines regulators and professional healthcare bodies to help tackle opioid misuse. Our pharmacists are trained to spot signs of potential medicine misuse and support patients in these circumstances.’
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