MEDICINES MANAGEMENT
What you need to
know about ordering specials
Kasia Jawor, marketing manager at IPS Specials, asks: do pharmacy teams need more education and training around specials? What do you think pharmacies would welcome and how would that help?
suggested that pharmacy teams needed more training and education on specials. This reflects a feeling within the pharmacy community that a large majority of pharmacists believe they don’t have enough experience about the manufacturing of unlicensed medicines. Since the ‘Peppermint Water’ case in 1998, when a four-day-old baby died after being given the wrong strength of peppermint water, it became a concern to all that these mistakes could be made by busy pharmacists and risk patients’ lives.
A
Out of this grew companies like IPS Specials, whose main focus was manufacturing high- quality unlicensed medicines conforming to exact prescriptive requirements. This enhanced patient care and minimised risk to patients as well as pharmacists – whose legal responsibility as ‘manufacturer’ of the special was shifted to the manufacturer.
The situation in Scotland
The feedback we have received is that the specials tariff is now working well in Scotland and we have noticed stable pricing.
However, for non-tariff specials, contractors in some health boards are required to obtain three separate quotes and then submit these for approval before they can order. This is an unrealistic expectation of busy pharmacists and we have had reports that it is a painful experience – particularly for prescriptions that come in before 9am or after 5pm and on weekends.
I understand that NHS Scotland is assessing its procedures though and will continue to develop the process based on key learnings.
IPS Specials would like to remind pharmacists that they cannot only get their ‘one-off’ and bespoke manufactured specials from companies like us, but we also manufacture in bulk for large/repeat orders, have a dedicated special obtains department (who are experts and will inform you if your order is not eligible for out of pocket expenses before placing the order), and we import medicines from all over the world, meaning we are truly the ‘complete specials solution’.
recent survey by the Association of Pharmaceutical Specials Manufacturers
It is no surprise that today’s pharmacists would state they feel they lack experience due to lack of exposure, practice, and even actual specials prescriptions (specials scripts still only account for 0.8% of all prescriptions in primary care). The kinds of tools IPS provides pharmacists are aimed both at educating them as well as having a practical use in reducing errors and saving time. Such tools include the drug tariff endorsement guide, which was first introduced by IPS Specials in October 2011 as soon as the new tariff and endorsement guidelines were confirmed.
Services and support
We have continued to update this, and also introduced a dispensing practices version, as well as one for Scotland when it introduced its specials tariff in February last year. We were also the first to create invoice stickers for prescription endorsement and actually ran a trial in Wales to test the quality and to assess if
there were any issues (there was not one single problem out of the 5,000 tested).
Also, being a specials manufacturer and supplier, all we do is specials – meaning that our sales team are highly skilled and knowledgeable, passing on information to customers when visiting. Finally, our customer services team are experts in specials and special obtains and will always inform the pharmacist if there’s a licensed version available and give out technical information and advice where necessary. All these things add up to a more knowledgeable pharmacist who can provide his/her patient with the best service possible.
One cannot create a demand for specials – either the patient needs a special or they don’t, and the decision should only be taken by the clinician. There may be some local prescribing differences, but I think there have been occasions where some CCGs focus on the cost of certain lines. While discrepancies need managing, the focus must always be on prescribing the right medicine for the patient.
The specials tariff has grown from 49 product lines to 222 in 32 months, and we believe this will continue to grow. Overall, I think the initiative was a great success and has helped stabilise the specials market, giving prescribers and contactors confidence in specials as well as helping control NHS spend. The only threat I see with the tariff is that we could end up with a ‘Category M situation’ before long, where some lines are not sustainable to manufacture.
It is important that the NHS gets value for money, but service and quality must all play an important role in this.
FOR MORE INFORMATION W:
www.ipsspecials.com
national health executive Nov/Dec 14 | 87
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