From Mr V. Patel, MRPharmS
SIR,-I recently had the honour of receiving a prescription for potassium permanganate solution 0.1 per cent. My computer informed me this was in Category E in the Drug Tariff. On looking up what I would be paid to make this item, I found the grand sum of 1p/100ml (I assume the National Health Service computer had to round up to obtain this) plus an 85p extemporaneous preparation fee. To obtain a "market value" I asked BCM for a price. I was quoted £51.36 plus postage, packaging and VAT.
No wonder the politicians ignore the profession, if our own Pharmaceutical Services Negotiating Committee agrees to a price of 1p plus 85p for a product that has to be extemporaneously prepared. It may be argued that it is a simple preparation. No such thing. Every preparation has to have a professional input, and there are severe legal consequences if things go wrong. Maybe the person at BCM who prices the preparations should go to the PSNC and bring some reality to it.
Could the PSNC please explain how it, or the NHS, came to the sum of 1p plus 85p, and BCM £50-plus for the same item?
V. Patel
Tadworth, Surrey
Dr GORDON GEDDES (head of information and technical services, PSNC) writes: Part VIII of the Drug Tariff allows for Category E entries which are extemporaneously prepared items for which an additional fee is automatically paid. The basic price of the extemporaneously prepared preparation is the cost of the ingredients. In the case of potassium permanganate solution 0.1 per cent, the ingredient cost is 0.073p but, because there is a rule of never pricing less than 1p, this figure is rounded up, as your letter writer suggests. If potassium permanganate BP had to be purchased specifically to meet an order for potassium permanganate solution 0.1 per cent, then broken bulk could be claimed on the Drug Tariff pack of 500g.
That takes care of the reimbursement part of the payment. So far as remuneration is concerned, each order will receive a standard professional fee of 97.5p plus an additional fee of £1.55 (85p is the extemporaneous fee for a straightforward dilution).
In 1998, approximately 7,000 prescriptions for potassium permanganate solution 0.1 per cent were dispensed in England. The average quantity ordered was 420ml. Since there is clearly a demand for this extemporaneously prepared preparation, the PSNC has no basis for negotiating its deletion from Part VIII. From time to time reviews are carried out and if a Category E entry shows low usage figures then it can be deleted from Part VIII.
The PSNC is not in a position to explain how BCM arrived at its quoted price of £51.36 plus postage and packaging.