Appliance reimbursement system to change
The system of payments for medical appliances in England that has remained unchanged for nearly 20 years is being reviewed by the Department of Health.
The proposed changes, which went out for consultation (PDF 210K) this week, are an attempt to bring an end to the current practice
where appliance
contractors
are paid more than pharmacists to dispense the same items.
The DoH is keen to introduce a code of practice that would include issues
such as product marketing aimed directly at patients and the sponsorship
of specialist nurses.
It also wants to stop the practice of what is known as “agency
agreements” between pharmacists and appliance contractors. Under
these arrangements, pharmacists give the appliance prescription to the
appliance contractor who passes it on to the Prescription Pricing Authority
with both sharing the subsequent payment.
The proposals cover both the short and long term.
In the short term the DoH proposes reducing the average reimbursement
to contractors by up to 15 per cent to reflect market prices more accurately
and remunerating appliance contractors on a similar basis to pharmacy
contractors.
The DoH has come up with a series of options that include setting reimbursement
prices by tender, amending the current Drug Tariff, and paying all pharmacies
a dispensing fee but offering an additional payment if extra services
for patients are provided.
Pharmaceutical Services Negotiating Committee head of finance, Mike Dent,
said: “We warmly welcome the proposal to create a level playing
field for pharmacy contractors and appliance contractors by creating
a common system of reimbursement and remuneration for the supply of items
in Part IX of the Drug Tariff.
“
PSNC has been pressing the Government on this issue for a number of years.
The consultation does raise a number of concerns though, in particular,
the proposal to adjust the reimbursement price of items in Part IX of
the Drug Tariff. This is something that we will have to analyse and consider
carefully in relation to the new contract funding arrangements.”
The consultation closes on 23 January 2006. |
The
Pharmaceutical Journal
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