Society and PSNC oppose DoH patient pack plan
Plans from the Department of Health to allow community pharmacists in
England to dispense patient packs that contain a different number of
doses to that prescribed have been opposed by the Royal Pharmaceutical
Society and the Pharmaceutical Services Negotiating Committee (PDF 170K).
The proposals (PJ, 17 September, p329) will bring pharmacists into conflict
with both prescribers and patients, who will suspect pharmacists’ motives
for dispensing smaller amounts than prescribed, the Society said.
The Society also warned that the proposed system, which would allow pharmacists
to dispense a patient pack containing the nearest amount to that prescribed
while being paid for the actual amount on the prescription, might not
be cost neutral. Pharmacists would be tempted only to round quantities
down and never up, it said.
Instead, the Society suggested that prescriptions should always be written
in multiples of a month’s supply, unless they were for discrete
courses of treatment. It added that the DoH should broker an agreement
with the pharmaceutical industry over whether a prescription month was
28 days or 30 days. “It seems ridiculous that there is no standardisation
on the length of a month.”
The PSNC has told the DoH that it believes that the proposals are damaging
to patients. It also said that they are likely to undermine the funding
arrangements of the new pharmacy contract and will lead to financial
inequities among pharmacy contractors.
The PSNC’s view is that patient pack dispensing — and the
provision of patient information leaflets — will not increase because
paying for prescribed amounts will discourage pharmacists from rounding
dispensed quantities up to the nearest whole pack. It agrees with the
Society that the DoH should try to achieve standardisation of pack sizes
with the pharmaceutical industry.
Concern is also expressed by the PSNC that the proposals will give primary
care trusts an incentive to manipulate the system to achieve cash savings.
For example, they could ask doctors routinely to prescribe 56 ranitidine
150mg tablets, which would have to be dispensed as 60 tablet calendar
packs, leading to a loss to contractors, and a saving to PCTs of £1.5m
a year. The PSNC claims to have evidence that some PCTs are already encouraging
the prescription of certain products to the detriment of contractors.
Overall, the PSNC takes the view that basing payment on amounts dispensed
is no harder for the Prescription Pricing Authority than basing it on
amounts prescribed.
“
In any event,” it concludes, “the convenience or efficiency
gains of the PPA cannot be used as justification for failing to reimburse
pharmacy contractors accurately and fully for products that have been
supplied.” |
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