Speaking at the Avicenna conference in Vietnam yesterday (October 24), Sigma managing director Bharat Shah presented figures compiled by the pharmacy wholesaler, which revealed a 20% reduction in overall category M reimbursements between 2014 and 2017.

This drop had occurred while the total number of products in category M of the drug tariff grew by 54, according to Sigma’s figures, as a result of 83 products being added and 29 removed.

This added a net value of £6.6m to the category, Mr Shah showed delegates.

“Where has the money gone?”

In July 2014, there were 557 products in category M, reimbursed to the value of £140m, Mr Shah pointed out.

By October 2017, this had risen to 611 products – even though total reimbursement for the category had dropped to the current level of £112m.

This shortfall of almost £28m led Mr Shah to ask: “Where has the money gone?”

“It’s gone when [branded] products have come off patent,” he explained. “These products [had] been very profitable for pharmacy businesses.”

Mr Shah pointed to pricing changes prompted by Lyrica losing its patent for neuropathic pain in July 2017, followed by pregabalin entering category M a month later.

This meant contractors “really saw the effect” when “there was £180m taken from the system by the government in one swipe” as part of the category M clawback announced in July.

On Monday (October 23), PSNC referred to drug tariff reductions as one of the reasons it had asked pharmacy minister Steve Brine to agree a 15p rise in advance payments for contractors in November.

Bharat Shah @sigmaplcuk giving delegates at #aviconf lowdown on new regulations set to impact comm pharm. Like this: https://t.co/klxzXWYks5 pic.twitter.com/Ex6acnTwjK

— Lilian Anekwe (@CandDLilian) October 24, 2017