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‘Unacceptable’ lack of April concessions ‘likely’ due to DH changes

The pharmacy negotiator has blamed the government’s "untested" changes to the April drug tariff for the lack of price concessions issued this month, which have left pharmacists wondering whether the government expects “contractors to make a loss”. 

Community Pharmacy England (CPE) “submitted a large number of price concession applications at the start of April in the usual way but is yet to hear back” from the government on any approvals, the negotiator said earlier this week (April 24).

In a newsletter sent to pharmacists, CPE added that the lack of “final outcome” from the Department of Health and Social Care (DH) is “likely” due to the government’s attempts to “manage purchase margins”.

At the start of the month, C+D reported that new changes to price concessions in the April drug tariff had been "imposed by the government without [the negotiator’s] agreement” and that CPE opposed them “in the strongest terms”.

At the time, it told C+D that the imposed price restrictions may lead to some pharmacies dispensing at a loss.

This week, CPE said it would “share the DH’s final concessionary prices as soon as [it determines] them”.

 

“It's unacceptable”

 

Pharmacists also took to social media to raise concerns about the lack of concessions issued this month.

“Still nothing - not a single concession announced”, pharmacist Ben Merriman said on on social media platform X (formerly known as Twitter) this week (April 24).  

“Does [the DH] expect contractors to make a loss to make up for excess margin? Or [does it] plan on using the new retrospective top-up payment three quarters later? Either way, it's unacceptable”, he added.

“How is it acceptable to expect companies to be obliged to dispense medicines needed by patients without knowing what they'll be reimbursed?” he asked the following day. 

 

DH “spreading margin adjustments”

 

“The medicine margin survey results up to the end of September 2023 indicated a downward adjustment to Category M prices by £16.2 million,” a DH spokesperson told C+D today (April 26).

“For April, May and June 2024, instead of making the downward adjustment to Category M, we are temporarily spreading the margin adjustments across Category M and concessionary prices,” they added.

They said that “concessionary prices remain important to ensure pharmacies are paid fairly” and requests “should therefore continue to come into CPE as normal”.

“We are working with CPE to grant the concessionary prices for April as soon as possible,” they added. 

Last week, a new report by the Nuffield Trust found that from mid-2016, the number of price concessions offered to pharmacists to secure scarce drugs spiked.

It estimated that between October 2022 and September 2023, the “total excess costs for medicines in the months when they were on the concessions list…came to £220m”.

And C+D revealed that since 2021, the number of qualified, trainee and student pharmacists seeking grants and support with debts, benefits and housing have skyrocketed.

Last month, C+D’s Salary Survey also revealed that contractors were left struggling to “make ends meet” with the majority reporting a drop in profitability and their own take-home pay last year.

Meanwhile, CPE said last month that negotiations for the England 2024/25 core contract “are still in progress” despite the previous five-year deal ending this month.

“Until these negotiations have concluded, fee levels will remain the same and existing service arrangements will continue as previously announced,” it said.

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