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Drug reimbursement consultation ‘crucial’ to pharmacy’s survival

Mr Shah: Contractors struggle to manage their finances under the existing reimbursement scheme
Mr Shah: Contractors struggle to manage their finances under the existing reimbursement scheme

It is “crucial” that every contractor responds to the government’s drug reimbursement consultation to ensure the survival of community pharmacy, a wholesaler has stressed.

As part of the five-year funding contract for England, the Department of Health and Social Care (DH) launched a consultation on a series of drug reimbursement reforms for community pharmacy in July.

“The arrangements generally work well, but improvements can be made to ensure that community pharmacies are paid fairly,” the DH said at the time.

Sigma Pharmaceuticals co-founder Bharat Shah told C+D “this is the most important consultation as far as remuneration in pharmacy is concerned”.

Under the existing reimbursement scheme, contractors are “struggling” to manage their finances. While pharmacy owners make a reasonable margin when they dispense generics, they “get a very limited discount” when they dispense a branded product, he claimed.

The consultation “is a chance for [contractors] to air their grievances on how the reimbursement scheme in dispensing has really lowered their margins, [meaning] they either cannot survive, or they cannot provide the services that are being required of them”, Mr Shah stressed.

Respond or be ignored

However, the consultation can only have an impact if every contractor responds, he stressed.

The government will only consider reforming the system if “there is an overwhelming response” from the sector, Mr Shah claimed. He urged every pharmacy owner to respond, rather than rely on the pharmacy bodies to do it on their behalf.

“If there are around 1,500 or more responses, they will take notice of it. Otherwise, there is a risk pharmacy’s voice will be completely ignored.”

Knock-on effect for wholesalers

“My business is [based on] my pharmacy customers,” Mr Shah said. “If my pharmacy customers are struggling, it will have a knock-on effect at the wholesaler level.

“If you talk to every wholesaler in the country, they’ll tell you that pharmacies are already struggling to pay their bills.”

Sigma also owns or partly owns 14 pharmacies, Mr Shah explained, and he will be advising them on topic areas to consider in their responses to the consultation.

He suggests the DH should:

  • discourage clinical commissioning groups from switching from generics to branded generics
  • introduce or legalise generic substitution for branded generics – allowing pharmacists to substitute products that are “exactly the same”
  • introduce a reimbursement formula based on the buying prices of the products in short supply
  • either abolish the clawback system or implement clawbacks “every three months”
  • review category M prices “every three months rather than every six months”
  • introduce a minimum generic price of £1.

The consultation closes on September 17.

Will you be responding to the DH's consultation on drug reimbursement?

Independent Dave, Community pharmacist

Dipak Pau, Community pharmacist

I would urge all contractors to heed Mr. Shah's comments. If we do not respond to the consultation, we as a profession will pay the price. Give the DOH something to think about and then moan if they ignore all our responses. While the discussions about conferences have their place, perhaps we should also listen to the message put out here. Mr. Shah is a well respected meber os of our profession and I agree with him that all pharmacy contractors should respond to the consultation. It only takes a few minutes. So please take part. Mr. Shah thank you.

Alexander The Great, Community pharmacist

NSCO system needs urgent reviewing. NO WAY should any pharmacy dispense at a loss.

Branded generics are a farce, manufacturers should not be allowed to give their generic a brand name.

We need to be reimbursed for our extra time needed to sort out downloaded scripts, pay for printer toner and drums, and paid for time submitted and clicking exemption boxes every night.

Ben Merriman, Community pharmacist

The whole contract needs reviewing. Why aren't pharmacists being paid for management of long term conditions as supplementary prescribers? This model utilises pharmacists skills, allows GPs to use their skills to make diagnoses and save the NHS moneyby making the whole model efficient, as per a model seen in Canada? To insist pharmacy is nothing more than a supply function is an insult to the people working in the 11,500 or so pharmacies in the country

Alexander The Great, Community pharmacist

You forget, our primary job is to supply meds. Anything else on top should be funded separately.

Ben Merriman, Community pharmacist

Remind me, where's next year's conference, Mr Shah?

Ben Merriman, Community pharmacist

Forgive my glibness. Having recently left community pharmacy, something I needed to do for the sake of my health, I can safely say I never went to any of these far flung exotic places for a conference. I did go to Leicester for a National LPC meeting once though.

I've been as vocal as pretty much anyone over the last few years re: cuts to pharmacy funding, anyone in any doubt as to my thoughts about community pharmacies and what they do for their patients each and every day need look no further than my Twitter timeline.

My point is this: imagine you're looking in from the outside, it seems pretty odd for someone to be crying foul and asking for a new contract to deliver fair funding in one breath when they're off to a conference in Oman, Brazil or the Philippines the next.

The people on the coal face, the people working without replacement staff, the people being forced to explain why their pharmacy can't hold more than 5 boxes of atorvastatin, the people being browbeaten into capturing repeat Rx business, the people like me who gave years of their lives to their patients, the most vulnerable in their own communities, to these people, a trip to Leicester seems a far flung and exotic place...

N patel , Non Pharmacist Branch Manager

Mr merriman i detect sour grapes....where sigma holds it conferences is no one's business...if u can afford to go anyone is welcome......for.a.lot of contractors it is the only holiday they have and it is not extravagant...
Perhaps you should ask billy kenber at the times to do an expose on pharmacists having an educational holiday at there own expense

Ben Merriman, Community pharmacist

Ben Merriman, Community pharmacist

Good heavens, old bean, not at all. If I wanted to earn oodles of cash and head off on my jollies to Borneo, I'd have kept away from healthcare. But I didn't. Because wanted to be a pharmacist. I wanted to be both a patient facing healthcare professional and I wanted to be a scientist. Pharmacy gave me the perfect blend.

Again, if pharmacy is crying foul about slashing to funding, and again, it's absolutely right to be doing so, hearing those that are making these calls then heading off on such jaunts is a real kick in the teeth to those contractors that can't afford a holiday, goodness, even pay themselves a wage! I know of contractors who have extended their PERSONAL line of credit to fund their businesses, to keep people in their jobs. How do you think THEY feel about such conferences?

Kassim Kurji, Community pharmacist

A little harsh considering everything he said will help, in particular, small independent pharmacies. 

N O, Pharmaceutical Adviser

** Add any product with single manufacturer in to DND list. Example: all brnded rpoducts like Eliquis, Xarelto, Ultibro and non brnded Primidone Phenytoin caps etc. Smaller Pharmacies who cannot sign up to the rediculous minimum order generic basket schemes, do not get any discount.

A.S. Singh, Community pharmacist

Exactly. Dispensing at a loss is the same as stealing, no overall dispensing quibble. Note PSNC! Has anyone tried this LPC cost calculator ?

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