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· Controlled drugs
Letters to the Editor
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Specials
Price is not the only factor to consider
From Dr A. D. Tittershill, MRPharmS
I should like to respond to Nahman
Raja’s letter (PJ, 26 November,
p662). Mr Raja argues that the NHS should insist that hospital manufacturing
departments are the first port of call for pharmacists ordering extemporaneous
products and makes this statement solely on the basis of his analysis
of prices. In doing so he gives a partial view.
The commercial specials industry provides the ultimate level of flexibility,
responsiveness and choice. It has developed in part because the hospital
and community pharmacy sectors have required additional support to help
cope with the increasing demand for non-standard medicines.
In order to be able to meet this demand for high quality, made-to-order,
patient-specific medicines the commercial specials industry consistently
invests and reinvests in its manufacturing facilities and quality assurance
to create the leading specialist manufacturing sites in Europe. At the
time of the last internal audit, investment in terms of capital and stocks
totalled some £32.3m, with £1.2m invested in staff training
and development.
Members of the Association of Commercial Specials Manufacturers (ACSM)
hold thousands of formulations and continue to develop new products.
Each of these bespoke medicines is delivered via a controlled and safe
delivery system to the point of need, with a minimum of delay.
Price variability does indeed exist in the specials market. It is part
of the competition that exists between manufacturers who compete with
each other and NHS hospital manufacturers to attract and retain customers
and provide the highest quality service.
ACSM members aim to be extremely responsive to customer and patient needs.
They are happy to be subject to fair comparison, which, in addition to
price, takes quality, customer service, formulation advice, flexibility
and response levels into account.
Andrew Tittershill
Association of Commercial Specials Manufacturers
Least expensive is not always the best
From Mrs A. Halbert, MRPharmS
With regard to the letters from David
Turner (PJ, 12 November, p607) and
Nahman Raja (PJ, 26 November, p662) I suspect that any of the specials
suppliers concerned would be able to justify their prices if challenged.
I do not imagine we, as purchasers, would agree with each and every one.
Although the price of hypromellose eye drops seems excessive for just one
bottle, this is probably because the product has to be manufactured aseptically.
From my experience, the charges relate to time in the cleanroom (as well
as material costs) so that one bottle costs almost as much to produce as
several bottles.
I would also like to suggest to Mr Raja that the least expensive is not
always the best. I spent some time as a locum at a local children’s
hospital where the number of specials used was vast and the NHS, or ex-NHS,
units were not always the cheapest and were often the ones who appeared
unable to meet supplier demand in the same way a fully commercial company
could. These units were also less inclined to advise of problems but rather
waited until they were contacted about when an order would be received.
Commercial companies did seem to provide better customer service. NHS units
must still provide an adequate level of service to the customer to gain
business.
I also found that most of the commercial companies either supplied certificates
with each batch, or dispatch, or immediately upon request. This applied
to most NHS units as well but the only company to charge for a certificate
was an NHS unit and the cost was £30 per document. How is this justified
(I bet they could but I would not agree)?
I am not trying to justify costs of specials and I do agree with Mr Raja
that, as an NHS pharmacist myself, it would be a good thing to support
NHS specials manufacturers but I believe that a blanket system would not
help the customer, just yet.
Adrienne Halbert
Senior Pharmacist, Aseptic Services
Golden Jubilee National Hospital,
Clydebank, Dunbartonshire |
The
Pharmaceutical Journal