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Scottish specials tariff could cause confusion, manufacturer warns

Business The new tariff, which was introduced on February 1, is already raising fears among contractors of extra administrative burdens and confusion over payments, manufacturer IPS Specials has said.

A specials tariff that sets national reimbursement prices for commonly prescribed unlicensed medicines in Scotland could be an extra administrative burden for pharmacists, according to manufacturer IPS Specials.

Pharmacists are expected to seek approval of reimbursement from their local NHS board if they intend to use a special or unlicensed medicine that does not appear on the tariff, which came into effect on February 1, but IPS Specials said one of its customers was confused about who they were supposed to get approval from on the health board.

A specials manufacturer warned that one of its customers complained they had not been adequately prepared for the tariff introduced this month

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"They are worried that the approvals process is going to add extra administrative burden and that confusions in pack sizes and quantities may result in refusal or reduction of payments," said IPS Specials sales and marketing director David Clough.

"They were not informed about the tariff until the day before, giving them limited time to prepare," he added.

"Unlike the England and Wales tariff, which was introduced after long consultation with pharmacist bodies and the Association of Pharmaceuticals Manufacturers (APSM), the Scottish tariff appears to have been developed without similar input."

Pharmacist Douglas Forsyth of Baird's Pharmacy in Aberdeen agreed that the tariff could require pharmacists to do "a bit more work".

"The only downside is that it's a bit more of a hassle for us re-sourcing things from the cheapest manufacturer. ‘Cheapest' means it'll take about a week for the patient to get it, so it's a bit of a balance between where you're getting things from and how long it's going to take," he told C+D.

But ultimately it was a positive move for both the NHS and the taxpayer, Mr Forsyth added.

Mr Clough added that it would increase transparency in prescribing specials, "ensuring that the needs of the patient are the number one priority for all of us."

The APSM agreed that the tariff was beneficial and said it was "fully supportive" of it, despite not having been involved in the consultation process.

"We believe... that it will bring long-term benefits to the specials sector in terms of restoring confidence in the supply chain," said APSM vice chair Sharon Griffiths.

But specials manufacturer Rosemont Pharmaceuticals said it was "difficult to gauge just how much of an impact" the tariff would have in Scotland.

"Even before the introduction of the specials tariff, prices were already somewhat under control as pharmacists needed to obtain three quotes before they were able to procure a special," said Rosemont Pharmaceuticals marketing manager Jan Flynn.

The tariff was designed by Community Pharmacy Scotland (CPS) and the Scottish government to encourage pharmacy contractors to seek out the most cost-effective source of specials and should provide "greater clarity" for pharmacists, said CPS policy development pharmacist Matthew Barclay.

The prices of specials will appear in part 7S of the Scottish drugs tariff, and include a handling allowance. Specials that are not listed in part 7S will be reimbursed, depending on where the product was manufactured.

A specials tariff was introduced by the NHS Business Services Authority in England and Wales in November 2011. At the time, experts warned pharmacists not to waste time shopping around for the lowest price and to consider factors such as quality of service and ordering flexibility.

Is the specials tariff causing any problems in your day-to-day work?

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Jonathan Burton, Superintendent Pharmacist

I think Scottish contractors will be generally welcoming of the introduction of a specials tariff, although it is very unfortunate that it's introduction has been with virtually no notice or apparent wider consultation. My hope would be that, providing pricing is fair and responsive to change, the tariff expands relatively quickly as it has done in England/Wales and provides a more stable and risk-free model of specials reimbursement than we currently have. For non-tariff specials items the recent guidance asks more questions than it answers, and it will be interesting to see how the various Health Boards, many of whom have their own arrangements in place for managing specials pricing and have put considerable effort & resource into doing so, respond to the new advice from Scottish Government. I think everyone is agreed that the days of hyper inflated specials prices have to be consigned to history, but however I hope the arrangements that develop going forward are mindful of the professional responsibility that pharmacists take on when ordering and supplying unlicensed medicines and that we should maintain an element of choice regarding our purchases. These decisions should be made by the responsible pharmacist, not by a Health Board pharmacist on the end of a phone. This is why I am personally in favour of a vastly expanded tariff, because this enables the NHS to achieve it's goals in terms of pricing, but for pharmacists to deal with their preferred suppliers based on service levels and various technical preferences in terms of paperwork, packaging etc, without having to worry solely about costs.

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