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Pharmacy funding cuts

Community pharmacists should be able to substitute cheaper drugs, says PSNC in proposals to counter government cuts

Giving community pharmacists more power to dispense cheaper generic alternatives to branded medicines or cheaper drugs of greater therapeutic benefit could save the NHS millions of pounds and prevent the need for planned government cuts of £170m from the community pharmacy budget in England, according to national negotiators.

Allowing pharmacists to dispense urgent medicine supplies routinely to patients out of hours without the need for a prescription from a GP, or following a pharmacy referral via the NHS 111 service, could also save money and offset the proposed cuts for 2016 and beyond, the Pharmaceutical Services Negotiating Committee (PSNC) is suggesting.

The negotiators have released a list of counterproposals, which they claim would meet the government budget cuts that are now at the centre of their confidential negotiations with ministers.

The PSNC’s counter proposals include a move to reduce medicines waste where pharmacists would not dispense repeat prescriptions for medicines or appliances to patients in cases where, following discussion, both sides agreed that they already had sufficient current stocks of drugs or other medical products.

A national therapeutic substitution service linked to a specific list of medicines with options for cheaper and more clinically effective alternative products is also being discussed.

The PSNC, in its briefing paper, says the list should also include specials where alternative licensed products could be dispensed instead.

A similar national list of generic alternative drugs would also be drawn up as part of the PSNC’s plans, which it says could mirror a scheme running in Ireland since 2013.

Other proposals include a community pharmacy-led review of prescribing in care homes.

The paper makes it clear that negotiators also oppose government plans to bring in a new pay system linked to a single fee for each prescription item supplied.

The new system, says the PSNC, is a backward step because it would incentivise pharmacists to increase medicine supplies. The negotiators suggest instead an alternative payment system that rewards pharmacies providing more clinical services. 

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2016.20201075

Readers' comments (1)

  • How many prescriptions for branded products (for which a cheaper generic is available) do we actually see in community pharmacies?! A far better way of saving the NHS money would be to put a prescription charge of 10p or 20p per item payable by everyone. And make 28-day or at most 56-day prescriptions the norm, so that these prescription charges are paid monthly / bimonthly This would be the same kind of charge as the "excess" we have to pay on any insurance policy. If there is going to be an issue with some folks not having a few pence a month available from their income / benefits, the government could just add on a nominal 50p a month to those benefits to reduce the impact. This charge would be expected to have the same effect as the "bag charge", i.e. folks would think long and hard about whether they need to spend 10p on their repeat prescription. And if they really do want to benefit from their prescribed medication, they would then be more likely to take that medication for which they have paid. And this will at a stroke stop patients stockpiling their Ventolin / Seretide inhalers, etc just because they are "free". But would the politicians ever have the courage to do this ... so long as they are more concerned about being re-elected than actually doing something sensible about the burgeoning drugs budget, then nothing will change. Do these politicians not see that treating symptoms rather than addressing the causes of preventable diseases just means that no-one ever gets better on their medication; they just rattle on, leading a miserable existence.

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