The Pharmaceutical Journal
Vol 271 No 7265 p284
6 September 2003

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Still waiting for the lights to change [more]
Stay of execution [more]

Still waiting for the lights to change

After much delay the Department of Health has produced a discussion document outlining its proposals for the pricing and reimbursement of generic medicines in the National Health Service in England. Although one of the tenets of the proposals is to introduce greater transparency into the system, at first glance this can only be achieved by making the system much more complicated. The document makes clear that representatives of manufacturers, wholesalers and the Pharmaceutical Services Negotiating Committee were closely involved in drawing up the document, so it is reasonable to assume that these groups are content with the results.

Nevertheless, the devil is in the detail, and there are gaps in the proposals, the one of most concern to pharmacists being precisely how Drug Tariff prices will be set. The Government admits that, wherever possible, the arrangements for establishing the price for any given generic medicine should reflect existing market mechanisms. However, there will be more control on drugs in a sector with limited competition (see p295) “to ensure that the NHS pays a fair price for the medicines concerned”.

Pharmacists will also welcome the recognition in the proposal that there are financial benefits to be gained from the reimbursement system. “The new arrangements for the reimbursement … should include incentives for community pharmacies and dispensing doctors to enable them to benefit from procurement decisions where these also benefit the NHS.” This, at least, is a positive step after proposals that went out to consultation in July 2001, that reimbursements should more closely match prices paid.

However, whether any profits made from reimbursement will be tangible, or whether the proposal will just be followed in spirit, will depend on how the monies will be used in pricing the new community pharmacy contract — due in the next few months. Community pharmacists in England can do no more than hope that when the lights change, the green will be bright.

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Stay of execution

Following the publication of the “balanced package of measures” promised at the end of July, changes to the control of entry regulations for England have now been fleshed out further (p293). But all the indications are that the changes will only be temporary. The whole system is set for review in three years’ time and complete deregulation is just as likely by the end of the decade as it was when the Office of Fair Trading published its call to deregulate the market earlier this year. So the hard lobbying by the profession paid off in the short-term, but all that seems to have been achieved is a stay of execution.

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