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Dispensing Snippets - July/November 2004

 
     FRONT PAGE
 13 November 2004
Government cutting branded prices via PPRS
The Department of Health will cut the prices of branded prescription medicines by 7 per cent from January 1, 2005 .
The price reduction has been agreed as part of the new Pharmaceutical Price Regulation Scheme, and the Department of Health has said it will save the NHS over £1.8 billion over the next five years. This saving will be put back into PCTs to fund “frontline NHS services”, the DoH added.
Association of the British Pharmaceutical Industry president Vincent Lawton called the price cut “unnecessary”, but said other aspects of the PPRS meant the agreement offered stability to the industry.

Cutting branded drug prices will reduce wholesalers’ margins and affect the service offered to contractors, Sigma Pharmaceuticals managing director Bharat Shah has warned.   This does include services to dispensing doctors and maybe profits.

The 7 per cent price drop for branded medicines, agreed as part of the Pharmaceutical Price Regulation Scheme and effective from January 1 meant parallel importers would have less money to reinvest in their businesses. In time, this would lead to a reduction in the services offered to retailers, Mr Shah said.

Calling the PPRS agreement “a new enemy”, Mr Shah said it had further compounded the problems wholesalers were experiencing in obtaining PIs. Manufacturers imposing quota limits, the large number of parallel importers and the growing number of generic launches had already made such products difficult to get, he said.

Dispensing doctors will lose thousands of pounds following the recent 7 per cent price drop on branded pharmaceuticals, wholesalers’ representatives have warned.

Calling the recent Prescription Price Regulation Scheme renegotiation a “double whammy” when linked with the £200 million drop in generics payments, Steve Dunn, chairman of the British Association of Pharmaceutical Wholesalers, estimated that the collective effect of the PPRS and the generics pricing changes could take £4,000 out of the average pharmacy and an unestimated amount from dispensing practices.

“On top of the radical revision of generic drug remuneration this is just another way of stripping cash out of pharmacy and pharmaceutical wholesaling.”

For more information:
www.dh.gov.uk 

Reid orders MHRA reform

Health secretary John Reid has ordered radical reforms to the Medicines and Healthcare products Regulatory Agency to end alleged conflicts of interest between its members and the drugs industry it is supposed to regulate.

Officials said the timing of the changes had nothing to do with the current investigation by the House of Commons select committee on health, which has produced damning evidence about some of the practices of the drugs industry and the MHRA itself.  

Health minister Lord Warner has announced radical changes to the UK medicines regulatory body to make it more open and transparent.

Members of the MHRA’s committees will be subject to stricter controls over possible conflicts of interest under the proposed new legislation.

Chairmen and members of the new commission – a merger between the Committee on Safety of Medicines and the Medicines Commission – will not be allowed to hold interests in the pharmaceutical industry. They will be held accountable to a revised code of practice, on which the MHRA has opened a consultation. This move is “to ensure impartial advice is given on regulation of medicines”.

The new commission, provisionally called the Committee for Safety and Efficacy of Medicines, will advise ministers on regulatory matters for human medicines. Its remit will be to exercise judgement based on medical and scientific evidence, but representing a “wider risk-benefit judgement”.

8 November 2004
New pharmacy contract to go live on
April 1 2005

The new contract for community pharmacy in England will be implemented on April 1 next year, subject to pharmacists’ approval, the Department of Health has said.

“Following successful negotiations with PSNC and the NHS Confederation, a new contract for high street pharmacists should go live, subject to a ballot by pharmacists, from
April 1, 2005 ,” the DoH said in an announcement yesterday.

Commenting, health minister Rosie Winterton, who will be speaking at an All Party Pharmacy Group meeting at the House of Commons this evening, said:

"I am delighted that we have reached this stage. This new contract represents the beginning of a new era for pharmacy in the community, in which everyone will benefit.

"Until now, pharmacists have been an untapped resource. I want to see them more integrated with the NHS family. There will be provision made for pharmacists to offer a much wider range of services to the public. For example, supporting self-care and the management of common ailments, promoting healthy lifestyles and helping patients to get the best from their medicines.

"The introduction of repeat dispensing in every pharmacy will mean that patients will be able to get a prescription from their GP (for up to a year at a time) to be dispensed in instalments agreed by the prescriber and the pharmacist.

"Patients will no longer have to make repeat visits to the surgery for prescriptions, helping reduce GP workloads and offering opportunities for pharmacists to review patient medication. This can also help minimise waste by not dispensing medicines that patients no longer require and is especially suitable for people with long-term conditions."

Counter fraud measures to be extended

The Government is proposing to strengthen the powers of people investing potential fraud in the NHS. The proposals mean that the NHS Counter Fraud unit could prosecute anyone who refuses access to NHS counter fraud specialists to documents and information during the course of an investigation. "This will mean counter fraud specialists with knowledge of the NHS will be able to conduct investigations in a way that is sensitive to the needs of patients and staff and reduce the need for police assistance to search premises or take property which might contain vital evidence," says the Department of Health. Unlike the police, NHS counter fraud and management specialists would not have powers of entry, search or seizure.

27 September 2004
Minimise drug stocks

Dispensing practices should try to minimise stocks of branded pharmaceutical medicines prior to any possible price reduction within the Pharmaceutical Price Regulation Scheme, PSNC is warning.

The current scheme, which allows manufacturers of proprietary drugs to set their prices to the NHS within agreed profit criteria, is due to expire on September 30 and when the new agreement is announced in the near future, it could include a percentage reduction in the prices of proprietary drugs reimbursed to dispensing practices.

Dispensing doctors need to be aware that an announcement is imminent, and subject to the over-riding issue of service to their patients, try to minimise their NHS stock of proprietaries immediately prior to any price reduction.

 

17 September, 2004
Rural dispensing changes get go ahead
The Government is planning to introduce measures developed by the pharmacy and medical professions for reforming the rules governing NHS rural dispensing.

These changes will, at the very least, be the rather short-sighted, not to say idiotic changes negotiated by the DDA Ltd with the GPC and the chemists.  Changes which seem specifically designed to ring-fence dispensing practices  prior to being picked off one by one by pharmacy

Department of Health officials recently met with the Pharmaceutical Services Negotiating Committee and the British Medical Association’s GP Committee to discuss how best the reforms could be introduced.

In a further explanation on September 9 of how the control of entry changes will be implemented, health minister Rosie Winterton said the Government intended to implement the rural dispensing reforms at the same time.

Market town and other doctors should consider this to be the last chance to get a dispensing application in before the GPC and the DDA Ltd finally sell your rights down the river.

HANSARD

General Practitioners

Chris Grayling: To ask the Secretary of State for Health (1) what compensation is paid to GPs who lose their right to dispense; [127629]

    (2) what plans he has to reform regulations that permit the removal of the right to dispense from a GP. [127630]

Ms Rosie Winterton: General practitioners do not normally receive compensation if they are no longer required to dispense National Health Service prescriptions. Primary care trusts can make transitional arrangements to ensure an orderly winding-down of such dispensing services.

The Government has no plans to change the conditions under which certain GPs can dispense NHS prescriptions. However, in our response to the Health Select Committee Fifth Report, The Control of Entry Regulations and Retail Pharmacy Services in the UK (Cm 5896) on 17 July 2003, we said that we would invite medical and pharmacy representative bodies to look again at existing proposals to reform the rules governing rural NHS dispensing.

We are setting up an advisory group to advise on how best to implement a series of changes we are proposing to current NHS dispensing rules. We published further details on 29 August 2003 in Proposals to Reform and Modernise the NHS (Pharmaceutical Services) Regulations 1992. A copy has been placed in the Library. We will also ask the group to consider the results of the representative bodies' consideration of their proposals for reforming the rules governing rural NHS dispensing.

9 Sept 2003 : Column 331W

Contact me, David Roberts, on Davidroberts@doctors.net.uk any time for immediate and urgent help.

 

 25 August, 2004
Counterfeit Cialis
Mhra Recalls Counterfeit Cialis Tablets

DEPARTMENT OF HEALTH News Release (2004/0313) issued by the Government News Network on 24 August 2004

The Medicines and Healthcare products Regulatory Agency (MHRA) is recalling two lots of counterfeit (fake) Cialis 20 mg tablets following the discovery of counterfeits of the drug in the legitimate supply chain.

Cialis is used to treat erectile dysfunction and is manufactured and distributed by Eli Lily Ltd. Initial tests of the counterfeit product show that the counterfeits do not pose an immediate risk to patients.

The lot numbers affected are A031410 and A041410 (these numbers can be found at the end of the carton and on the blister strip inside the carton). Any patient in possession of either of the above lot numbers should return the material from where it was purchased.

MHRA Chief Executive, Professor Kent Woods said:

“Patients who are in possession of this counterfeit drug should return it immediately. Whilst initial tests show that the product does not pose an immediate risk to patients, the quality of this product can not be guaranteed. If patients think that they have taken the product and are concerned about any side effects they should consult their doctor“.

No lots manufactured and distributed by Lilly ICOS Ltd are impacted by this recall, and there is no concern with the genuine Lilly ICOS product.

Patients who are concerned about the recall can also contact Eli Lilly on the following free phone number: 0800 085 3847.

Notes to Editors:

1. This is the first such incident of a counterfeit product being discovered in the legitimate UK supply chain since the case involving AZANTAC (ranitidine) tablets in 1994.

2. Cialis (tadalafil) is used to treat erectile dysfunction and is a centrally authorised product (by EMA European Medicines Agency) Eli Lilly product. The licence holder is Eli Lilly and Co Ltd.

3. The Medicines and Healthcare products Regulatory Agency (MHRA) investigates all allegations of counterfeit medicines in the UK, the vast majority of which are not associated with the tightly regulated legitimate supply chain. Action in the form of legal proceedings is taken when appropriate.

4. Counterfeit medicines is a global problem, therefore the MHRA continues to liaise closely with international Regulatory partners and the pharmaceutical industry to ensure that the tackling of counterfeiting medicines remains a priority activity.

 

20 July, 2004
Generic reimbursement cuts

The Government is to cut further the reimbursement dispensing doctors receive for supplying four generic medicines on NHS prescription.

Reimbursement for supply of doxazosin, lisinopril, omeprazole and simvastatin was first cut last December. Health minister Lord Warner announced further cuts from September 1.

The Department of Health said: "The decision to reduce the reimbursement prices of these medicines is expected to save the NHS about £100 million per annum. Over the last six months the prices at which dispensing doctors purchase these medicines from suppliers has again dropped significantly. To address this, the government proposes to further reduce the reimbursement price paid to dispensing doctors (and chemists)."

The Government announced its intention to overhaul the arrangements for the supply and reimbursement of generic medicines in the NHS in a consultation document last September. It has still to finalise its proposals which will be published "in due course".

Dispensing doctors, as business people, should consider carefully whether it is in their best interests to continue to supply these medicines under their generic names.   The government should understand that very action may have a reaction and that dispensing doctors are not NHS serfs - are they?

 

Software to explain drug name changes to patients
Positive Solutions has launched new software that automatically produces a prescription label explaining why the name of a patient’s usual drug has changed under the BAN to rINN switch.

Martin Jones, a pharmacist at Positive Solutions, said: “The BAN to rINN name changes, which vary from minor spelling amendments to a completely different name, will undoubtedly confuse patients who may either think that the pharmacist has got it wrong or that their doctor has prescribed something different without telling them.”

To solve this problem, Positive Solutions has developed a new feature on its Analyst PMR system that will automatically generate an explanatory label informing the patient of any changes either to the name or the spelling of the drug name, the first time a patient has a repeat prescription.