In August 2017, category M prices were reduced by £15 million per month for a 12-month period, to "correct overpayments of retained margin for both 2015-16 and 2016-17", the Pharmaceutical Services Negotiating Committee (PSNC) explained at the time.

This represented an average drop of around 17-18 pence per item on previous drug tariff prices, the negotiator said last year.

PSNC revealed last month that the margin survey for August-November 2017 is “expected to show a significant decline in margin from the first half of the year, given the reduction in reimbursement prices and the effects of generic supply shortages”.

However, “the total for the year won’t be known for some time, and at this point it is unclear what will happen to category M reimbursement prices from August 2018”, it said in documents published after its May committee meeting.

PSNC confirmed to C+D on Wednesday (June 6) that it is too early to make predictions about whether there will be a further clawback.

The current category M clawback has been cited as a factor in drops in revenue at the largest multiples, and the need for independent pharmacy contractors to seek additional loans to stay afloat.