Group items tagged

There has been a lot of coverage in the national and pharmaceutical press of the prices being charged to pharmacy owners for certain medicines. Leaving aside the reasons for steep price rises, I have been asked on social media and elsewhere whether pharmacy owners can refuse to supply prescribed medicines if they would make a significant financial loss. Legal obligation The first thing to point out is that the National Health Service Act 2006 imposes a legal duty on the Secretary of State and NHS England to make arrangements for people to receive sufficient prescribed drugs. These arrangements involve the publication of the Drug Tariff. The Drug Tariff includes reimbursement prices or a method for determining prices. Various factors can be taken into account in determining reimbursement prices. The Drug Tariff does not provide a pound for pound reimbursement for medicines that pharmacies supply on NHS prescriptions.

NHS England has secured a deal for 'Dexcom ONE Real Time-Continuous Glucose Monitoring' device which will help type 1 diabetes patients to keep track of their glucose levels at all times without having to scan or take a finger prick test. Once the patients receive their starter pack - which will include information on the product and usage, a sensor and transmitter - from the hospital or GP surgery, they can go to the community pharmacy for their repeat prescription. The wearable arm gadget sends information to a mobile app and allows diabetes patients to keep track of their glucose levels. "Traditionally, continuous glucose monitors are more expensive than their flash monitor counterparts - which record glucose levels by scanning a sensor - but thanks to the NHS agreeing on a new cost-effective deal with manufacturers DEXCOM, they will now be available for NHS patients on prescription at a similar price," said NHS. Dexcom ONE Real Time-Continuous Glucose Monitoring, uses a sensor no bigger than a bottle cap that attaches to the arm for up to 10 days and measures glucose levels from just under the skin. The wider rollout of the technology will help diabetes patients manage their condition better - reducing hospitalisations and associated diabetic illnesses which will ultimately ease pressure off the NHS. Karen Baxter, vice president, UK & Ireland, Benelux, France and Spain at Dexcom: "The addition of Dexcom ONE to the NHS England drug tariff is enormous progress towards improving the choice of diabetes tech, providing an alternative to burdensome finger pricks and scanning.

Dr Bharat Shah CBE regrets that neither community pharmacists nor pharmaceutical wholesalers in the UK have any control over how Category M reimbursement prices in Part VIII A of the Drug Tariff are determined. The co-founder and chief executive of Sigma Pharmaceuticals was speaking at a conference organised by Avicenna in West London on Sunday (March 6). Introduced into the Drug Tariff in April 2005, Category M is used to set the reimbursement prices of over 500 drugs. The Department of Health and Social Care makes the final decision on the amount of reimbursement (cost of drugs and appliances supplied against an NHS prescription form) and remuneration (fees paid as part of the NHS community pharmacy contract for the provision of a service).

The Department of Health and Social Care (DHSC) has added further 28 new products to the list of 'Drugs for which Discount is Not Deducted' (DND) in Part II of the Drug Tariff from 1 August 2022. PSNC said, "It will continue its work to assess whether other drugs and appliances fulfil the current DND entry requirements under either the 'Group' and 'Individual item' criteria and make applications to NHSBSA and DHSC, accordingly." A total of 529 products have been granted DND status following checks made by PSNC within the past 26 months.

Department of Health and Social Care (DHSC) has increased the rate of discount deduction for generics from 17.52 per cent to 20 per cent. The Drug Tariff for April 2023 will contain changes to the discount deduction arrangements for pharmacy contractors, which will include- all concession lines to be considered as Group Items for Discount Not Deducted i.e. DND or zero discount (ZD) items; and rate of discount deduction for generics to increase from 17.52% to 20% The Pharmaceutical Services Negotiating Committee (PSNC) and DHSC agreed on the changes for all concession lines to be considered as Group Items for Discount Not Deducted. Therefore from 1 April 2023, a new category will be introduced into Part II of the Drug Tariff 'Drugs for which discount is not deducted'. However, the committee had rejected the changes in the rate of discount deduction for generics. It said, "Following pressure from NHS England, Ministers have now chosen to impose changes to the previously agreed discount deduction arrangements, which come into effect from 1 April, and will be kept under review."

The Department of Health and Social Care (DHSC) is pushing ahead with its plans to implement a new drug tariff from April 2024. However, this move has sparked strong opposition from Community Pharmacy England (CPE), raising concerns about its potential impact on pharmacies and patients. Earlier, it was announced that the April drug tariff will include the new 'Retrospective top-up payment for Concessionary prices, which will be applied automatically for the products listed in Part VIIIE each quarter by the NHS Business Services Authority (NHSBSA), according to the volume the contractor was paid for. However, CPE argued that the government has imposed these "untested" changes without their agreement, and strongly opposed them stating that "no recovery or downward pressure on margin is acceptable given the financial fragility of community pharmacies." Janet Morrison, chief executive of CPE, has voiced strong opposition to these changes, arguing that "any system expecting pharmacies to dispense at a loss" jeopardises the sector's financial stability and compromises patient care.

The regulators have added 10 new products to the 'Drugs for which Discount is Not Deducted' (DND) list from Thursday (01 June). Community Pharmacy England on behalf of its members had made further applications to the Department of Health and Social Care (DHSC) and the NHS Business Services Authority (NHSBSA), resulting in the inclusion of 10 new products in the DND. More than 610 products are granted DND status following checks made by Community Pharmacy England's dispensing & supply team over the past 3 years to ensure fair reimbursement for our members. The DND list is updated monthly by the DHSC and includes grouped and individual items. Individual items are separately listed in Part II of the Drug Tariff. Any items covered by the 'Group Items' heading are not listed again individually in Part II. "We will continue our work to assess whether other drugs and appliances fulfil the current DND entry requirements under either the 'Group' and 'Individual item' criteria and make applications to NHSBSA and DHSC, on behalf of our members accordingly," said Community Pharmacy England.

The Department of Health and Social Care's (DHSC) response to the 2019 consultation on community pharmacy drug reimbursement reform has paved the way for the second phase of consultation with the pharmacy negotiator. The second round of the consultation will focus on eight proposals: Changes to the way Category A prices are set Changes to how medicine margin is distributed in Category M drugs Changes to how Category C prices are set for drugs with multiple suppliers Inclusion of non-medicinal products in the Drug Tariff Changes to the way prices of drugs in non-Part VIIIA are set Changes to arrangements for reimbursement and procurement of 'specials' Changes to reimbursement of generically prescribed drugs and appliances dispensed as 'specials' Changes to the discount deduction scale The Pharmaceutical Services Negotiating Committee has been discussing these proposals with the DHSC and the outcome was featured in the final package of the 'Community pharmacy in 2016/17 and beyond' document.

The Pharmaceutical Services Negotiating Committee has announced that the Department of Health and Social Care (DHSC) has granted the following price concessions for November 2021. Contractors can find information on the price concessions and learn about the process involved on PSNC's website. A price concession only applies for the month in which it is granted. No additional prescription endorsement are required as the new price is automatically applied by the NHSBSA to all items submitted for payment in the same month for which a price concession is granted. PSNC is still working with the DHSC to agree further concessionary prices on other drugs reported to be unavailable at the stated November 2021 Drug Tariff price.

The NHS Business Services Authority (NHSBSA) has published the Drug Tariff Category M price list for July which reflects an increase in reimbursement level of approximately £5m per quarter. An adjustment of -£23.8m was announced, in light of the results of the margin survey (latest result up until end of December 2022), and the phasing down of the additional £100m agreed across years 4 and 5 as part of the Community Pharmacy Contractual Framework and uplifts for underlying market prices (between January - March 2023). Community Pharmacy England has agreed the adjustments based on the analysis of margin delivery and on current projections for 2023/24. It said: "The objectives are to ensure full delivery of agreed margin and smooth delivery as much as possible. As always, the impact on individual pharmacies will vary depending on dispensing mix."

The Department of Health and Social Care has updated the list of community pharmacies eligible for the Pharmacy Access Scheme (PhAS) and approved 43 cases out of 63 applications, bringing the the total number of eligible pharmacies in England to 1,445. Earlier this year, NHS England and NHS Improvement (NHSE&I) invited community pharmacy contractors to apply for a review if they believed there were any inaccuracies in relation to pharmacy premises addresses or unforeseen circumstances affecting access, such as a permanent roadblock. Submitted applications were reviewed by the relevant NHSE&I regional pharmacy contract team, and determined by the relevant pharmaceutical services regulations committees (PSRC). Due to the workload pressures seen over winter, the review deadline was extended, giving contractors applying for a review two full months to complete their applications. This also pushed back the announcement of the outcome of the review, but where an application has been successful, PhAS payments will be backdated to the start of the scheme.

Any prescription for Promethazine hydrochloride 10mg tablets x 56 submitted for payment to the NHSBSA for July 2022 will be reimbursed at the new price of £17.77 not as per the price concession of £13.45 announced in the 4th concessions update published on 29 July 2022, said the Pharmaceutical Services Negotiating Committee (PSNC). In July 2022, PSNC received several reports from contractors unable to obtain Promethazine hydrochloride 10mg tablets (56) at the published Drug Tariff price of £4.24. Therefore, it submitted a request for a price concession, which was granted and subsequently published but this was later withdrawn after confirmation from the Department of Health and Social Care (DHSC) that due to the price change mechanism, the reimbursement price for Promethazine hydrochloride 10mg tablets has increased from £4.24 to £17.77 for July 2022. PSNC said, "Following the price change mechanism rules, for generic drugs (excluding drugs in Category M), a price change up to and including the 8th of the month takes effect for prescriptions dispensed in that same month. Any price change after the 8th takes place in the following month."

The Pharmaceutical Services Negotiating Committee has announced that the Department of Health and Social Care (DHSC) has granted final price concessions to further items for the month of November 2021. A price concession only applies for the month in which it is granted. No additional prescription endorsement are required as the new price is automatically applied by the NHS BSA to all items submitted for payment in the same month for which a price concession is granted. Contractors can find information and learn about the process involved on PSNC's website. Check pharmacy business website for price concession list november 2021.

The Pharmaceutical Services Negotiating Committee has announced that the Department of Health and Social Care (DHSC) has granted further price concessions for the month of December 2021. A price concession only applies for the month in which it is granted. No additional prescription endorsement are required as the new price is automatically applied by the NHS BSA to all items submitted for payment in the same month for which a price concession is granted. Contractors can find information and learn about the process involved on PSNC's website.

Department of Health and Social Care (DHSC) has updated the final price concessions for June 2023, following a discussion by Community Pharmacy England regarding medicine pricing issues reported by pharmacy owners (its members). A price concession only applies for the month it is granted; any prices agreed for concessions requested late in the month will roll over into the following month. Community Pharmacy England encouraged pharmacies to report any problems obtaining a Part VIII product at or below the stated Drug Tariff price, using the online feedback form on the Community Pharmacy England website along with full details of the supplier and price paid for any products sourced above the Drug Tariff price. The association will investigate the extent of the problem and, if appropriate, discuss the issue with DHSC.

The Department of Health and Social Care have retrospectively granted a concessionary price for Isocarboxazid 10mg tablets for the months of May and June 2021. While the reimbursement price had previously been £217.75, a concessionary price of £249.10 has now been granted. The NHS Business Services Authority confirmed that payment for the difference - £31.35 for every pack of 56 claimed - will be adjusted accordingly for the mentionedtime period where contractors have submitted claims in those months. This adjustment will be paid on 31 December 2021 in the next Schedule of Payments.

Community Pharmacy England (CPE) has notified pharmacy teams that starting 1 August 2024, three Hormone Replacement Therapy (HRT) medicines will be discontinued and will no longer be covered under the NHS HRT Prescription Prepayment Certificate (HRT PPC) scheme. These are Bedol® 2mg tablets, Climanor® 5mg tablets and Clinorette® tablets. Since Climanor® 5mg tablets have been discontinued, Medroxyprogesterone 5mg tablets will also be removed from the HRT PPC list, as this generic product is no longer available as a licensed HRT medicine. The CPE also noted that Provera® 5mg tablets, being an unlicensed HRT medicine, are not covered by the HRT PPC. Pharmacy staff are advised to check the NHS Business Services Authority (NHSBSA) website for the most current list of HRT medicines covered by the HRT PPC. The CPE has updated its HRT PPC medicines list to reflect these changes, which will also be updated in Part XVI of the August 2024 Drug Tariff.

A Lake District pharmacy is grappling with significant medication supply issues, affecting its ability to provide essential drugs to customers amidst nationwide drug shortages. According to Simon Butterworth, whose family has operated Collins & Butterworth Pharmacy in Hawkshead for nearly 40 years, voiced his concerns to the ITV stating that the staff is "having to spend time hunting for (medications), looking for it or doing our best to find ways to solve that problem" for distressed patients. "They've got to know when they can get the medications they need," he added. Butterworth also highlighted the financial strain pharmacies face due to the NHS's fixed tariff system. "Certain items are actually costing more to buy than we get paid for them by the NHS. An item we were trying to get this morning was 250 per cent higher than the tariff price, which is significant and builds up over lots of items," he explained.

Along with pharmacists, pharmacy technicians in England are now able to perform blood pressure checks as part of the Hypertension Case-Finding Service and deliver the Smoking Cessation Service (SCS). The government has amended Drug Tariff and includes the amendments to The Pharmaceutical Services (Advanced and Enhanced Services) (Amendment) (England) Directions 2023. Pharmaceutical Services Negotiating Committee (PSNC) said: "The service specifications for both services are currently going through NHS England's publication process; when these are published PSNC will alert contractors through their normal communication channels. PSNC resources for both of these services are also currently being updated."

The Department of Health of Social Care (DHSC) has re-determined that all six Madopar (Co-beneldopa) preparations meet the special container criteria as outlined in Part II Clause 10 of the Drug Tariff. "The NHS dictionary of medicines and devices (dm+d) has now been updated with special container status applied to the complete pack sizes of all Madopar preparations," said PSNC. "The special container rules apply immediately to all branded or generically written prescriptions for Madopar dispensed from December 2022 onwards." The following products will be treated as special containers for prescriptions dispensed from December 2022 onwards: