Pharmacy should base specials decisions on more than price

We don't have any choice - we need to find out what we will be charged to ensure we are not being reimbursed less than we are paying. The problems will arise when quantities prescribed exceed tariff minimums. The prices per ml/g paid for extra amounts seem very low. Take for example Omeprazole 10mg/5ml. Tariff for 75ml = £146.78. Price for each ml above minimum = 28p. A prescription for 100ml would be reimbursed at 75ml + 25*1ml = £153.78. We would probably have to order 2*75ml and be severely out of pocket - if I understand correctly we cannot claim broken bulk. Am I understanding this correctly? If so, I can foresee some pharmacists refusing to dispense such prescriptions.

Totally agree with you on this Margaret, we had this very situation arise in our pharmacy and we took the decision to send the script back to get the quantity changed to a complete tariff pack size. I don't see why we should have to sit on a split pack hoping that we get another prescription for the remainder. And even then its likely to be another split pack. So we end up constantly out of pocket.

With the decommissioning of some services and the addition of other services, as well as reimbursement changes suffered in recent years, it is getting tougher and tougher for Community Pharmacy is getting to turn a profit and concentrate on medicinal provision and advice for the patient, but I think the introduction of the Specials Drug Tariff is a positive thing. Reputable Specials companies will ensure that they are providing value for the pharmacist and quality for the patient and work with Pharmacists to ensure flexibility and provide assistance on the extra admin involved.

It's true that Broken Bulk can no longer be claimed, but Specials Manufacturers will provide any quantity required is made to order and you should receive it next day - no different to what you would normally do. Of course, some Specials suppliers provide certain specials in bulk, but manufacturers will make to order. I've created an interactive spread sheet which will automatically calculate any quantity on Drug Tariff, which many of our Pharmacists are finding useful. However, if the prescription is for exactly double the minimum amount, it may be worth requesting a change of prescription for 2 x the minimum quantity - but this is at the Pharmacists' discretion and whether they have the time to chase it.

By partnering with the right Specials Manufacturer, the burden and worry shouldn’t be an issue as the balance between quality, price and delivery will be a fair one for all parties, putting the pharmacists & patients’ needs first with product quality paramount. Working with someone you trust to get it right across the board is the most important aspect of any partnership, as well as being flexible to meet individual needs…Your Specials Manufacturer should understand the pressure Community Pharmacy is under and should endeavour to ensure that no party is out of pocket

It is easy to be clever, but Raj Nutan claerly does not pay the bills, is not responsible for paying wages, bank loans etc. If the numbers don't add up at the end of the month you ain't going be seeing patients anyway - because you would have closed down! We are not totally stupid - I have been in this game for over 20 years and of course patient care is our number one priority. I don't need to be patronised. Just look at the numbers - the lack of cash in the system is going to kill many pharmacies in he next 12 months. Raj, If have nothing constructive to say, keep your idealistic opinions to yourself.

Could you not get the surgery to change them to MUPS!!! I think may be delibrate

In the case of omeprazole, possibly, however the same principle applies to many other specials which may not be available as dispersible tabs. Maybe I didn't choose the best example!!!

I based a specials desicion on price this week. It was 500gm Emusifying ointment /liquid paraffin 50:50 .Price from a well respected 'chosen' specials manufacturer £360 plus £11.99 delivery.Price ED from my pharmacy ingredient cost £2.88 plus £20 Extemp fee. It would be interesting for C+D to do one of their online surveys to see which option the majority of pharmacists would take.