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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).

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it submitted a request for a price concession, which was granted and subsequently published but this was later withdrawn after confirmation from the Department of Health and Social Care (DHSC) that due to the price change mechanism, the reimbursement price for Promethazine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