Under proposals put forward by the Health and Care Act 2022 last week (November 4), certain products would be centrally stocked in community pharmacies.

These would include some vaccines, medicines used for the prevention or treatment of disease in a pandemic, and accompanying products such as diluents and syringes.

Pharmacies would receive these products free of charge from the NHS, which would eliminate the need for NHS reimbursement.

If made law, the proposals would standardise NHS arrangements for this procedure and “strengthen the legal basis for scenarios when the usual supply routes are bypassed”, the DH wrote.

It would also serve “as an efficient alternative option to distribute vaccinations or treatments connected to a pandemic”, it added.

However, the DH has not yet decided on the “exact circumstances of when the powers may be used”, nor has it identified “the specific products for which this power may be used”.

The changes “may or may not be implemented in future” as this would be dependent on secondary legislation being put in place.

 

Why would such powers be necessary?

 

The DH determined that the alternative to supplying products directly to pharmacies without reimbursement would be “inefficient”. This would require the NHS to sell stock to wholesalers, which would in turn sell it pharmacies for them to then be reimbursed by the NHS.

Pharmacies could also incur “resource costs [from] purchasing products from wholesalers” due to this “additional step in the supply chain”, the DH added.

 

Limited products likely to be affected

 

The government emphasised that it did not intend to “radically change NHS pharmaceutical service provision or payment mechanisms to community pharmacies or the pharmaceutical supply chain that they use” in introducing such a provision.

Although the DH was unclear on which products it would apply it to, it estimated the amount would be limited “compared to the total number of products delivered by wholesalers”.

 

Main costs might fall on wholesalers

 

Were the NHS to provide some products to pharmacies for free, the DH predicted that main costs might fall on wholesalers. This is because their role would change “from the role of a purchaser to a purely logistical role”.

“[Some] pharmaceutical wholesalers may potentially lose out” from such as provision “while others may benefit, dependant on [whether they] have bought the stock under the traditional model” or chose to become “logistic suppliers for centrally secured stock”, the DH wrote.

However, it emphasised that “any potential costs [to wholesalers] are also likely to be limited”, as the powers would be exercised in “limited cases”.