The Pharmaceutical Journal
Vol 277 No 7422 p449
14 October 2006

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· E-commerce
· EPS
· Pfizer products (3)
· Drug misuse
· Pharmacy ownership
· Statutory Committee
· The profession
· Superdrug
· Retention fee
· Job satisfaction

Letters to the Editor

Drug misuse

New instalment prescriptions put contractors in difficult position

From Mr M. Bennett, FRPharmS

I would like to express my concern about the recent changes to the way that “instalment prescriptions” (FP10MDA) for treating drug addiction are being priced. These changes have placed contractors in a difficult position and would seem to encourage a potentially hazardous means of supply.

Two situations regularly occur in my pharmacy:

· Instructions from a prescriber for three times a week pick up with the note “supervise on day of collection”. This makes sound clinical sense in that the prescriber can be confident that the patient is regularly taking the prescribed dose. In addition, the amount of medicine being taken away from the pharmacy throughout the week is reduced by over 40 per cent thus reducing the risk of diversion and accidental poisoning.

· Patients on “take home” maintenance doses of methadone mixture 1mg/ml. The Department of Health’s recommended dose regimen is between 60 and 120ml. In my mind it is essential that these amounts are supplied in daily, measured amounts rather than in a bulk container supplied with a 5ml spoon.

We received information about how FP10MDAs would be priced both from the Pharmaceutical Services Negotiating Committee and the Prescription Pricing Division/NHS Business Services Authority. However, I think that most contractors would have expected a degree of flexibility. From the manner in which our July prescriptions were priced I suspect that there is no flexibility at all. It appears that no matter how the prescriber writes the instructions, unless the supply relates to a time when the pharmacy is closed, the contractor will receive one fee only — no matter how many dispensings are necessary.

If this continues, I can see many contractors being forced towards “bulk supply”, resulting in patients taking inaccurate doses and with a far higher risk to children from a large container with the closure left off.

I would ask whoever is responsible for this change in interpretation of pricing rules, be that the DoH, the PPD/NHSBSA or the PSNC, to reconsider the matter urgently and to take account of the above scenarios.

Martin Bennett
Managing Director
Associated Chemists (Wicker) Ltd,
Sheffield

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