Layer 1

‘My pharmacy is losing over £10,000 a year on branded generics’

Exclusive
Nottingham Clinical Commissioning Partnership: We invite any pharmacist with concerns to contact our medicines management team
Nottingham Clinical Commissioning Partnership: We invite any pharmacist with concerns to contact our medicines management team

A pharmacy director has told C+D he estimates his business is losing over £10,000 per year due to an increase in the prescribing of branded generics.

Raza Ali, director and superintendent at Riverside Pharmacy in Nottingham, has claimed his local clinical commissioning group's (CCG) decision to switch certain generic prescriptions to branded versions has left the pharmacy "overrun" with the more expensive option.

Mr Ali told C+D: “Based on a 10% clawback on four products over one year, I estimate I am losing over £10,000 on top of the [funding] cuts I am already facing. This does not take into account expenses that may be incurred on obtaining some branded generics.”

Mr Ali listed "quetiapine, metformin, co-codamol, insulin needles and even paracetamol", as examples of medicines that have been switched to a branded generic by the CCG.

“If we dispensed and were paid as per the drug tariff for metformin MR, the pharmacy would make roughly £4,632 a year. Instead we incur a loss of about 35 pence per pack, so a net loss of over £5,000,” Mr Ali explained.

A spokesperson for Nottingham Clinical Commissioning Partnership told C+D its medicines management team "continually evaluates and updates its guidance regarding individual medicines". See below for the CCG's full response.

Mr Ali continued: "Overall, this is short-sighted and leads to price hikes and market shortages, undoing the hard work pharmacists have done over the years reducing the cost of medicines."

“Branded generics will [continue to] be pushed [by CCGs], prescribing changes will be made, and the effect on community pharmacy will be ignored.”

Patient distrust

The switch to branded generics has resulted in “a real distrust” towards pharmacies from patients, said Mr Ali, who added that “GP practices are poorly communicating [prescribing] changes”.

“[Patients] feel we are behind the changes and are doing it to make a profit,” he said.

“The community pharmacy either makes a loss if they dispense the prescription, or refers the business on and loses the patient,” Mr Ali added.

CCG benefits from pharmacists' feedback

Nottingham Clinical Commissioning Partnership told C+D: "We benefit from excellent feedback from our community pharmacists to develop [our prescribing] advice and guidance."

"We would invite any pharmacist with concerns about the prescription of particular medicines to contact our medicines management team or to raise [the issue] with the local pharmaceutical committee," it added.

36 Comments
Question: 
Has your CCG increased the prescribing of branded generics?

IAN FRASER, Community pharmacist

Returning to oncost is the only sensible option or remove buying profit completely and the farcical deductions

DTP supply is a farce and bring deducted more discount than you redeive is just wrong

As are finding out how much you may or may not be reimbursed for supplying short in the market generics 3 weeks after you supplied them

I have eight wholesalers and can attain the prices than appear as concessions.Please can someone explain why this is?

 

IAN FRASER, Community pharmacist

Nearly retired

IAN FRASER, Community pharmacist

Read more Now see mr Johan is long in the tooth has seen the good years and happily retired I guess

 

 

IAN FRASER, Community pharmacist

I do hope that when mr Johnny Johan has his salary cut by £15000 a year or never increased or bonus paid that was for the good of the NHS and the public in general

Moral - idiots that have never owned a business or had a huge loan to repay should mind their own business

Pharma Tron , Community pharmacist

Guys, guys, guys- the abilities for Pharmacy contractors to make profit was double pronged- it allowed for a race to the bottom price wise, ensuring that pricing was keen by purchase power alone. Also, profit= goodwill= compensation for not having an NHS pension scheme. I find BGs quite challenging in that the said funding model for community pharmacy doesn’t favour the small regional chains or independents, as any loss to retained margin is allegedly ploughed back into category M, but Joe Bloggs in an independent just gets his pants down yet again ‘for the greater good’. The system is broke- end of! And as for rebates- get an FOI in and just see the incentives available for CCGs- we send our Certificate of Compliance in so it’s only fair!

Mohammed Patel, Community pharmacist

Everybody knows pharmacies are under the kosh. Should have bought a McDonalds franchise instead and you would probably have paid off your mortgage in the first few years.

Jonny Johal, Pharmacy Area manager/ Operations Manager

Yes, Mr Patel, you should have. So this is all about greed then?

Wolverine 001 , Pharmacist Director

Surley its about ROI??

Jonny Johal, Pharmacy Area manager/ Operations Manager

I agree, contractors want ROI, but from the taxpayer? What sort of dependency culture is this? Do remember the NHS is a patient oriented body, it does not have a duty to bankroll contractors’ bad investments. Contractors enter into arrangements willingly without coercion, if the ROI is not agreeable, do something else. The NHS puts up no obstacles if one wants to stop being a pharmacy contractor. 

Wolverine 001 , Pharmacist Director

No they dont have to bankroll the contractor but surley getting paid accordingly for our role has been enough, if they dont want to pay £2bill for dolling out medicines then nationalise the supply chain and they can do whatever, but they dont.  They want private contractors to provide the medicine - the tax payer takes the medicine free of charge but does want to pay to supply it???

 

Jonny Johal, Pharmacy Area manager/ Operations Manager

Wolverine, you have a point, caused by the failure of the PSNC. The answer is to put the PSNC on performance related pay.

Wolverine 001 , Pharmacist Director

The PSNC can do nothing to halt the change in attitude at the DOH, they know pharmacy is a lame duck - a fully automated supply chain will save so much money.  IN 20 years there will be fully automated pharmacies for acute prescriptions and a hub in each main town to delivery medication amazon style.  

There is nothing that the PSNC can do about it as they primarly represent the independent when the multiple are already beginning it.  The Shoe Compnay have 3 central depots in each third of the country ready to belt out repeats and fully automated MDS robots like in Finland and Sweeden.  

There is nothing that can be done.... all this nonsense about services is a smoke screen 

Mohammed Patel, Community pharmacist

Yeah, the NHS is "patient-orientated". And the GPhC is also "supposed" to have a mandate to protect the public.

However, it is unwilling to go toe-to-toe with the multiples against extreme workplace pressure, and insists on reprimanding individual pharmacists who were accidentally accused of theft, or who inadvertantly got involved in a late night scuffle at the local kebab shop.

Workplace pressure is causing more errors, more harm to the public, and more stress to anybody who is unfortunate enough to be involved in this "profession".

Always easier to go for the small-fry who cannot fight back. Why is it that the GPhC has no power over the under-handed tactics of the multiples? Because the CEO isn't a pharmacist? Are you having a laugh?

Jonny Johal, Pharmacy Area manager/ Operations Manager

Mr Patel, you keep mentioning work place pressure, my impression is I am not experiencing more pressure in recent years than when I qualified in 1979, and I work for a multiple. I do, however, see an increasing number of pharmacists who say they can’t cope. 

Mohammed Patel, Community pharmacist

Obviously you don't work 8-8 (or more) on the shop floor then. Sounds like you're behind a desk somewhere in a head office. Shame we can't all be "Rambo" pharmacists like you and keep on going despite being mortally wounded, but that is the nature of normal human beings.

Anyone who has actually worked in a pharmacy, as a pharmacist, over the last ten years can see the decline easily. Although as your account says you are an area manager, I suspect you just drive around in your BMW harrassing people from your bluetooth dongle.

Ilove Pharmacy, Non Pharmacist Branch Manager

I believe the answers to your questions are plain for all to see. Whether C&D would publish those answers is something else altogether.

Mahesh Sodha, Superintendent Pharmacist

 

The CCG pharmcists have omited to mention that they have also accepted pay backs from the comopnaies producing the brandede generics. This is described as "rebate" formally but other terms that are used to desctibe the practice in some countries in the world do spring to mind. 

C&D could do the profession a great favour by obtaining the data on rebates being given to CCGs around the country. C & D jourmalists can obtain this under Feedom of Information act. The CCG pharmacists involved in this should also be reported to the GPhC for investigation.

I have evidence to show that many patients have suffered because doctors have been forced to prescribe branded version of drugs for use in palliative care. Despite having the generic versions in stock the patinets are made to wait until the brandede version can be obtained.

 

 

James Vince, Pharmacy Buyer

Any legitimate way to save public funds must be done. I am 100% behind the CCG. If you were making £4000 on just metformin, can you post your financial figures for the last tax year and we will see if you get support from the general pubic and fellow pharmacists/ locums. Yet another contractor who wants immunity from cuts..just like Pharm owners pay the least amount they can get away with, when the CCG does this, Mr Ali wants it to reverse their decision. Why should the tax payer pay more for a product when it didn’t have to, what happened to the 3000 closures. What number are we on? 4 maybe 5 closed? 

James Vince, Pharmacy Buyer

No no no ....plz CCG , go further, our A/Es are struggling , please move funding away from bloated community pharmacy to front line services. 

Wolverine 001 , Pharmacist Director

The government should nationlaise supply so there is no need for indiviual pharmacies and that should help A&E more no??? This is going to become a Malthusian Catastrophe plain and simple....

James Vince, Pharmacy Buyer

*This comment has been deleted for breaching C+D's community principles*

Wolverine 001 , Pharmacist Director

Hows Infohealth Ltd doing these days.........????

Wolverine 001 , Pharmacist Director

Still here Rajive???

Rahul Dahya, Community pharmacist

James pls tell me more about your profit margins and the deals u have with your own wholesalers. I am new to owning a independent pharmacy and I agree with Mr Ali. Margins have slumped and it's very difficulty to make ends meet especially if you have a bank loan.

James Vince, Pharmacy Buyer

Open as many wholesale accounts as u can.... try to get 8 week payment not 4. This will help with cash flow. 

Wolverine 001 , Pharmacist Director

Seriously......!!??

James Vince, Pharmacy Buyer

Rahul , the profit margin is around 30% if you buy well. 

Jonny Johal, Pharmacy Area manager/ Operations Manager

His filed companies accounts, net asset growth in the last few years is quite spectacular, but he is telling a ‘hard life’ story! C&D got taken in again. 

His registered company name is Firstcare (UK) Ltd

Adam Hall, Community pharmacist

"We invite ny pharmacist concerned to raise the issue" .... and will do absolutely sod all about it! Because we have a budget deficit to plug. Never mind that it undermines a Nationally agreed contract; nevermind that it destabilises the pharmacy service locally. I do wonder if GPs get a kick-back from following CCG guidance - sorry, did I say "kick-back"? I meant "incentive"

Jonny Johal, Pharmacy Area manager/ Operations Manager

We reap what we sow. One has to go back to the origin of the discount clawback to understand where we are today. Contractors only have themselves to blame. 

Pages

Job of the week

Pharmacist Manager
Midlands, Cheshire & Dorset
Salary dependent upon experience