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Specials tariff details unveiled

Business Details of the new specials tariff, that comes into effect on November 1, have been unveiled by the NHS Business Services Authority (NHS BSA) and PSNC.

Details of the new specials tariff, that comes into effect on November 1, have been unveiled by the NHS Business Services Authority (NHS BSA) and PSNC.

The specials prices, which are being introduced as a new section of the Drug Tariff, will replace category E in a move designed to create a "more transparent system for reimbursing specials".

Prices for 58 specials now appear under Part VIIIB of the Drug Tariff, which NHS BSA says will "capture the majority of high cost, high volume specials prescribed".

The list of products in the tariff will be reviewed every six months, while prices will be reviewed quarterly. And the prices would be calculated using a "similar" system to category M, said NHS BSA.

Pharmacists buying specials at a higher price than that listed would not be reimbursed the extra cost, it warned.

"Pharmacy contractors are expected to shop around and negotiate lower prices in a similar way as they do for generics," NHS BSA said.

But contractors were advised to contact PSNC if they experienced "exceptional circumstances", when it would look at applying for an NCSO concession.

Specials that are not listed under the tariff will be reimbursed differently, depending on where the product was manufactured.

Products made by an MHRA-licensed manufacturer will be reimbursed at the invoice price, minus any discounts or rebates. There will also be a flat fee of £20 to contribute to any out-of-pocket expenses.

But if the product is manufactured under the section 10 exemption in the Medicines Act, pharmacies will be reimbursed for the cost of the ingredients. And there will be a £20 extemporaneous dispensing fee for the cost of preparing or sourcing the product.

Pharmacists should endorse prescriptions ‘SP' to claim out-of-pocket expenses and ‘ED' to claim the extemporaneous dispensing fee.

Full details of the tariff and how to endorse prescriptions are available here.


Samuel Jacobs, Community pharmacist

Another nail in the coffin for the independent pharmacist !

Mike Hewitson, Superintendent Pharmacist

More bureaucracy. More work for the Contractor, and a 'pat on the head payment' from DH. Amazing how DH can sort out problems like specials, but is seemingly unwilling to address issues of importance for Contractors, like Branded Generics. What about the millions of items that are dispensed every month at a loss?

This new system has been introduced with little or no warning for Contractors, and may have cash-flow implications for pharmacy businesses.

In addition this £20 payment is supposed to cover postage, etc, and encourage us to shop around! Using PSNC's patented 'sometimes you win, sometimes you lose technology'.

I'm not someone who likes to moan about anything and everything, but I think this is fairly level-headed criticism of a particularly poor deal. Understand the NHS needs value for money in everything that it does, and there are Contractors out there who probably have been excessive, but this is just a symptom of the underlying problem with our current contract, there isn't enough money for the volume of work, let alone the quality agenda which sits beside it. Sometimes for business to survive they have to do things they would rather not do, like make people redundant, ditch a long term supplier, or look for efficiencies. Specials is probably the same, most of us would rather not make a living out the current system, but it has compensated for the underfunding in other areas of the contractual framework.

The current paradigm is not working, that is clear. Time for some fresh thinking, and more than just warm words and empty promises from Govt. I'm sorry for the many hard working and dedicated people at PSNC, but this isn't good enough.

Nicholas Flinn, Locum pharmacist

Just seen the Specials Drug Tariff prices out today and they look pretty reasonable. As long as we are willing to shop around a bit amongst suppliers to find better prices, there's reasonable margins to be had.

Harnek Chera, Community pharmacist

Yep, funny how when they wish to make changes even as complicated as tis they are done with little or no notice in a similar fashion to launching NMS. When we request a moratorium on 100 hour applications we are told that a consultation period is required. Despite several consultations over the last few years. Still nothing!

Rajive Patel, Community pharmacist

Mike, I think you have summed up things quite concisely. Yet more red tape and less funding. Surely the PSNC have to push the issue more sternly. Its a perverted system where remuneration is cut and red tape is increased. As for the quality agenda it simply does not marry up with the cut in remuneration, we have to be realistic here, and tell the government: cut our funding, but dont expect quality services that require investment.

Nailesh Patel, Community pharmacist

Never a truer word spoken

K Dhanoa, Superintendent

Basically the PSNC has negotiated a complete loss of profit on the supply of specials. Where does the PSNC actually start negotiating any funding increases??

They have basically negotiated another ZD category into our contract. For those lines which enter the drug tariff will be devastated just like the Cat M is doing for all the top dispensing lines in pharmacy, we spend valuable time we don't have negotiating profit one quarter and the DOH rubs it's hands together in glee and tightens the screw until we are basically making nothing.

And as for the other lines:

"Products made by an MHRA-licensed manufacturer will be reimbursed at the invoice price, minus any discounts or rebates."

So basically there's no point negotiating these lines as we are being forced to make nothing on them.

This new contract negotiated by the PSNC some 7 odd years ago made pharmacy the patsy of the DOH. Using our hard work to make a profit against us at every possible turn. I'm just lost for words to describe the PSNC anymore.

In summary the PSNC not only negotiated us a 7% cut in funding this year but it gets worse they have also now helped devastate specials funding and further increased the risk to their contractors. I understand why specials had to be tightened up but this is just a knee jerk reaction in the opposite direction. I for one never took advantage of the situation surrounding specials as I am sure many others didn't but as per usual we'll all now be suffering as a result of it and from our inept negotiators at the PSNC.

Hope Mask, Locum pharmacist

Seems to be only bad news for Pharmacy. Is there still any future career for us? I'm completely disappointed in PSNC deals. Shouldn't we all start to look for another profession to practice. Someone tell me about I.T. cos it looks like i might not be able to own my own Community practice someday in the future, as this was one of my main reason for studying Pharmacy.

K Dhanoa, Superintendent

Efe don't feel too down, pharmacy is certainly going through the ringer right now but this is due to a number of reasons i.e an incompetent PSNC and serious economic circumstances that the UK and the rest of the world finds itself in right now.

There will always be a need for pharmacy provided we aren't forced down this incredibly short sighted route of service provision ahead of medicine supply. If the PSNC wakes up to this and what we are all saying they should begin to put pharmacy back on track again.

Remember we are not saying we don't want to provide services we are saying pay us responsibly and fairly for each facet of the work we carry out. Starting with our core function of medicine supply and then and only then any additional aspects afterwards.

The hope is the PSNC quickly begins to understand that it is ridiculous to negotiate funding for services through cost cuts in medicine supply and the fact that just because we are being paid less doesn't mean that magically our costs for dispensing reduces also. Nothing annoys me more than to be told that we need to work more efficiently as if to say pharmacies across the UK are all over staffed and work inefficiently??

Anyway Efe stick with it and help push the PSNC in the right direction in the present and we may all stand a chance in the future. But if we continue on the road we are on right now then lord help us all because the PSNC would have failed us.

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