The Department of Health and Social Care (DHSC) will ‘top-up’ the reimbursement prices for certain medicines dispensed at a loss in October and November, Community Pharmacy England (CPE) has revealed.
Usually, if a manufacturer changes the NHS list price of a branded product, depending on the date the new list price became effective, it could take up to two months before the price change is reflected in the drug tariff reimbursement.
But CPE told The Pharmacist it had asked DHSC to make an exception for several specific branded products that were either commonly dispensed or had become much more costly for contractors to purchase from manufacturers.
CPE asked for the increase in the NHS list price to be applied to the reimbursement prices of these products in the month the list price change took place, rather than contractors having to wait and dispense at a loss.
This means that contractors that have dispensed these medicines in October and/or November can expect to receive a ‘top-up’ payment to account for the difference between the old and new list prices.
For instance, the NHS list price for lithium brand Priadel 200mg modified-release tablets (100 pack) increased from £12.46 to £16.42 in October 2024.
However, any prescriptions dispensed in October were reimbursed at £12.46, with the new list price applied to prescriptions dispensed from November.
Following the retrospective 'top-up' agreed by DHSC, contractors can expect to receive an extra £3.98 per pack dispensed in October.
CPE said the 'top-up' payments are planned to be included in the January 2025 Schedule of Payments, with a payment date of 1 April 2025.
And they will appear as a combined total, listed as ‘Adjustment drugs’ and ‘Adjustment fees’.
Suraj Shah, CPE drug tariff and reimbursement manager, told The Pharmacist that the negotiator was pleased to have secured these retrospective price adjustments as ‘exceptions to the normal price change rules’, so as not to disadvantage contractors who may have dispensed these lines affected by price increases.
And he said that the negotiator is still awaiting responses from DHSC on similar requests for adjustments to other products affected by NHS list price increases between October 2024 and February 2025.
But he suggested that the process shone a light on a wider question of whether the current price change mechanism was working for contractors.
And he said that the negotiator was ‘looking at changing’ the process so that contractors do not have to wait an extra month for reimbursement prices to reflect NHS list price changes for branded products.
The community pharmacy sector has long been warning of the impact of dispensing at a loss on contractors, with the National Pharmacy Association (NPA) suggesting in 2023 that nine in 10 contractors were dispensing at a loss.
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