Group items tagged

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.

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it submitted a request for a price concession, which was granted and subsequently published but this was later withdrawn after confirmation from the Department of Health and Social Care (DHSC) that due to the price change mechanism, the reimbursement price for Promethazine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."

Nine more new products have been classed as 'Drugs for which Discount is Not Deducted' (DND) from 1 July 2022, announced Department of Health and Social Care (DHSC). This takes the total number of products granted DND status over the past 2 years to over 500 following checks made by the Pharmaceutical Services Negotiating Committee. The Committee had made an application to DHSC and NHSBSA for the following 9 products to be added to the DND list of Individual items to which the discount deduction scale will no longer apply from July 2022: Fludrocortisone 50micrograms/5ml oral suspension (Group) Lorazepam 1mg/5ml oral suspension (Group) Lorazepam 500micrograms/5ml oral suspension (Group) Zopiclone 3.75mg/5ml oral solution (Group) Zopiclone 7.5mg/5ml oral solution (Group) GA explore5 oral powder 12.5g sachets HCU explore5 oral powder 12.5g sachets MSUD explore5 oral powder 12.5g sachets TYR explore5 oral powder 12.5g sachets 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.

The Pharmaceutical Services Negotiating Committee (PSNC) has announced the margin delivery rates will increase from October as the agreed £100m write off is implemented. "The baseline margin allowance will remain £800m per year in 2022/23 and 2023/24," said PSNC. "Margin levels in the last two full years (2020/21 and 2021/22), as measured by the Margin Survey of independent pharmacies, were in excess of the baseline allowance, meaning that an excess was accrued." As new services have been introduced and take up of these has accelerated, the amount of unallocated funding left in the CPCF is now less than it previously was. As such, the value of the Transitional Payments will decrease from its current level. Some of the unallocated funding remaining in 2023/24 will be repurposed into a Flat Payment for all contractors (see details below). Over the course of the second half of 2022/23, the value of the Transitional Payments will be phased down. This will start in October 2022 with a reduction in payment levels to approximately 85% of the current level, as shown in the following table:

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.

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:

Pharmacy contractors will no longer need to print and submit a paper copy of their completed FP34C declaration made through the Manage Your Service (MYS) portal when submitting their paper prescription bundle to the NHS Business Services Authority (NHSBSA), said the Pharmaceutical Services Negotiating Committee (PSNC). Instead, from August 2022 (for July 2022 prescriptions), NHSBSA will post out a paper Account Identifier Document along with the red separators and pharmacy address labels each month. "The Account Identifier Document should be placed alongside the paper prescription bundle before it is dispatched for payment to the relevant pricing division of NHSBSA," said PSNC. With the help of Account Identifier Document, NHSBSA will be able to easily identify the pharmacy that has submitted the prescription bundle, which will help to speed up prescription processing. "If the Account Identifier Document is lost or misplaced, contractors will still be able to download and print another copy from MYS. The July 2022 Drug Tariff will be updated to reflect this change."

The Pharmaceutical Services Negotiating Committee (PSNC) has challenged price concessions imposed by the Department of Health and Social Care (DHSC) on some of the medicines. It has raised concerns on the process for setting price concessions to senior government officials responsible for medicines supply, warning that the system is not working in the current environment from a community pharmacy contractor perspective. "When a new government takes over next week, this will be one of several urgent topics being raised by PSNC to new ministers, alongside the fuel price crisis, inflationary pressures and winter pressures on pharmacy businesses," said PSNC. The final update to August price concessions was announced yesterday taking the total concessions granted to a record 138 for August. PSNC said: "Of those, 99 were in line with PSNC requests, but prices for 39 lines were imposed by the Department of Health and Social Care (DHSC): those impositions do not match the purchase prices reported by contractors and the evidence of market prices which we passed on to DHSC. In particular, the final imposed prices of Apriprazole and Temazepam tablets has generated a lot of concern amongst contractors due to the large variation between their reimbursement prices and purchase prices during the month of August."

The Pharmaceutical Services Negotiating Committee (PSNC) has expressed its concerns over sustained pressures on medicines supply that are having a very serious impact on community pharmacy teams and their patients. It has asked contractors and their teams to continue using its regular reporting tools to help them demonstrate the scale of the problems to the Department of Health and Social Care (DHSC) and to support escalations as needed. The committee said: "The sustained increases in price concessions that we have seen so far in 2022 - with more than 100 concessions being granted in some months - show no signs of abating, and we know that many pharmacies now find themselves in a critical situation trying to source medicines in timely manner and facing significant financial risk due to greater uncertainty around expected reimbursement prices for a large number of medicines." "We know that some concessions being imposed by the Department do not match contractors' experience on the ground, and we would ask all contractors to continue reporting pricing issues to us on a regular basis to support our representations: Report product over Drug Tariff price."

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.

The Pharmaceutical Services Negotiating Committee (PSNC) has raised concerns over the impact that high medicine price rises are having on contractor. Recently, the Department of Health and Social Care (DHSC) has granted the final list of price concessions for December 2022. The latest additions bring the total number of concessionary prices granted for the month of December to 198, surpassing the previous record of 159 granted in September 2022. PSNC has heard from hundreds of community pharmacy contractors who are paying inflated prices for antibiotics used for the treatment of Strep A and who have rightly been concerned about the lack of certainty around the final reimbursement prices for these medicines. It added: "We welcomed the involvement of the Competition and Markets Authority (CMA) to look into the pricing of antibiotics. But the number of reports we are getting from contractors about medicines price rises are just not acceptable and this goes far beyond the antibiotic crisis."

The Royal Pharmaceutical Society (RPS) has urged the government to amend medicines legislation to allow pharmacists to make minor amendments to a prescription without any protocol being needed. RPS wants to see a change in the law that makes the whole process of supply of medicines easier and quicker, enabling pharmacists to use their knowledge and expertise in medicines to better support patients. "At present a prescription can only be changed by a prescriber, which causes unnecessary workload for GPs and delays for patients," said RPS. RPS President Professor Claire Anderson said: "We want to see all pharmacists across the UK able to supply a different quantity, strength or formulation of a medicine (for example changing capsules to tablets) when required, to avoid unnecessary bureaucracy and the need for an SSP to be developed, signed and authorised by a Minister. In effect it would mean that pharmacists can help patients straight away - it would future proof the problem to some degree.

The PSNC on Friday said it has warned the DHSC about the "very serious impact" of the limited supply of certain antibiotics on pharmacies who are "having to chase stock, purchase without sight of any concession prices, and cope with increasing patient questions and abuse." With higher than usual number of cases of scarlet fever, caused by invasive Group A Streptococci (iGAS) infections, being reported in children across the country, supplies of antibiotics for Group A Strep treatment have seen a surge in demand, leading to limited supply at certain wholesalers and pharmacies. PSNC has urged the DHSC to adopt measures that could help to manage the current crisis, such as allowing pharmacists more freedom to change strengths or formulations without prescriber approval, outside of Serious Shortage Protocols. It has also raised concerns on the significant rise in wholesale prices of many oral antibiotics as a result of the surge in demand and the ongoing supply disruptions. PSNC also said they have received reports of some suppliers putting up their prices for any oral antibiotics they do have in stock.