FAILING CONCESSIONARY PRICE SYSTEM ADDS TO FUNDING MISERY


Community pharmacy contractors have described supplying medicines under the current concessionary price arrangement as ‘financial suicide’.


community pharmacy is the one place where people know they can go to have medicines dispensed from their prescription. ask anyone why they go to their local pharmacy and the most popular answer will be ‘to get my prescription’. now the very raison d’être of community pharmacy is being challenged.


community pharmacies are reimbursed for the medicines they dispense in accordance with prices listed in the northern Ireland drug tariff, published monthly. northern Ireland introduced a 30-day payment cycle in april 2013 whereby a pharmacy submits its prescriptions at the end of the month for payment at the end of the following month, eg, January prescriptions are submitted at the end of January for payment at the end of february. When a pharmacist purchases medicines, they anticipate that the drug tariff reimbursement price will cover what they are being charged to buy the medicine.


however, this is increasingly not the case, with drug tariff prices failing to cover the cost of many common medicines.


the distortion of prices caused by shortages in generic medicines is not new and has been recognised as a problem by government with a concessionary price arrangement, drawn from the English model, first introduced in northern Ireland in april 2011.


Within this arrangement price, concessions can be granted by the department of health in london throughout the course of a month to supersede the drug tariff price if it is not deemed adequate.


however, what is new is the rapidly growing number of lines, with over 100 generic medicines currently experiencing pricing issues. the English concessionary price system,


based on their 60-day payment cycle, is now failing community pharmacy in northern Ireland.


Every day community pharmacists in northern Ireland are struggling to obtain many of the medicines they dispense on a daily basis. Medicines shortages have grown at an alarming rate over recent months and, if pharmacists finally manage to source the medicine they require, they often have to pay more than ten times the usual price.


the main problems with current arrangements are threefold. firstly, the delay in granting concessionary prices until late in the month or sometimes into the next month, by which time contractors here have already submitted their prescriptions for payment. this means pharmacy owners could have dispensed a month’s worth of prescriptions without knowing how much they will be reimbursed.


Secondly, the price concessions granted are often inadequate, with community pharmacists unable to source the medicine even at the concessionary price level.


and, thirdly, the worst-case scenario when concessionary prices for some medicines fail to be granted at all. community pharmacy has no way of knowing what is being considered for a concessionary price - or what they will be paid. no other health service professional or business would be expected to work under these circumstances.


‘the current concessionary price arrangement is not working in northern Ireland,’ says cPnI chief Executive, gerard greene. ‘With every month that goes by, this failing system, alongside the underlying underfunding of community pharmacy, is causing a deepening crisis within our pharmacy network.


‘The time taken to source supply, dealing with distressed patients waiting for vital medicines and the uncertainty over remuneration is adding to the heavy burden on our pharmacies’


We are extremely concerned that this situation may lead to real harm, either to patients not being able to access vital medicines, or through the detrimental effect the whole situation is having on the health and wellbeing of community pharmacists. cPnI has made repeated representations to the department of health (nI) requesting a change in these arrangements, learning from the Scottish experience and developing a reimbursement system to reflect the specific circumstances of northern Ireland.’


adrienne clugston, operations Manager at Uca is increasingly concerned about the growing list of medicines that are on short supply, prices rising well above tariff and concessionary prices lagging behind.


‘the time taken to source supply, dealing with distressed patients waiting for vital medicines and the uncertainty over remuneration is adding to the heavy burden on our pharmacies,’ she said. ‘We receive


calls to our Prescription Payment Support Service on a daily basis asking for advice on remuneration for various medicines or devices from pharmacists.’


For items that are given a concessionary price, pharmacies must continue to code and submit in the normal way.


Payments may be allocated ‘in month’ but, for those concessionary prices allocated retrospectively, adjustments will be made in the following month and payment may be made separate to your main BSO payment. For more information and advice, please contact UCA on 028 9065 6576.


Check the UCA’s Concessionary Price Tracker in the Prescription Payment Support section of www.uca.org.uk. Prices are tracked over the last six months to allow you to check previous months.


PharMacy In focUS - 25


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