In late 2025 and early 2026 the English Drug Tariff declined to its lowest point for four strengths of Ramipril Capsules (£0.68 – £0.75). This was a few months after the market prices of these products reached their lowest level (£0.26 – £0.34). More recently concessions of between £0.73 and £6.82 have been granted each month since January to help Pharmacies dispense.
These low prices would have prompted difficult conversations at generic manufacturer pricing meetings, with the drop in the Drug Tariff possibly being the final straw, and market exit a real possibility.
Additional to these profitability issues are difficulties with international supply and the number of packs being made available to the UK. Over the last 10 years the number of capsules used in England has grown from 78 million per month to over 100 million. This means that the demand for Ramipril Capsules is increasing while prices are declining and internationally we are low on the profitability scale.
The only good news is that there are other ACE Inhibitors, with Lisinopril, Perindopril and Enalapril all being possible alternatives.