GPs have been excluded from an agreement to access cheaper medicines due to concerns about ‘sharing confidential information’ with primary care, NHS England has said.
In a letter published last week, NHS England laid out its position on which providers can access the ‘Medicines procurement and supply chain’ (MPSC) framework, which offers ‘confidential’ prices on certain drugs for the treatment of NHS patients.
In order to be granted access to the framework’s medicine prices, organisations must use the medicines for NHS patients only and must keep the prices confidential.
Where before access was granted or denied on a ‘case-by-case’ basis, NHSE’s official position is now that hospital trusts, mental health trusts and ambulance services can access the framework, but primary care and private providers cannot.
NHS England said that this position was developed in consultation with various stakeholders, including the Association of British Pharmaceutical Industry (ABPI) and the primary care team within NHS England.
The rationale for excluding primary care from this medicines deal is that ‘no stakeholder supported general access to MPSC framework prices in primary care’.
‘Stakeholders were concerned about sharing confidential information about prices through framework agreements with primary care commissioners, doctors and pharmacists,’ NHS England said.
The policy note, which was first published in March and came into effect from January this year, also said that GP practices may misunderstand the medicines prices which would ‘create unintended consequences’.
According to NHSE, this is because the ‘models of procurement for primary and secondary care are very different’.
‘For example, a GP practice may believe that for a primary care generic medicine, a secondary care framework price is more affordable, but this may be because the primary care price they can see is the Drug Tariff, which includes the margin to run community pharmacies, as well as the distribution margin,’ the commissioner said.
NHS England said it ‘will keep this position under review’.
Doctors’ Association UK GP spokesperson Dr Steve Taylor said it ‘seems odd’ that primary care would be excluded from the framework given it already has a ‘wide access group’.
He said that ‘GPs involved in dispensing or PCN leads might need or want access’, but that more generally GPs are not heavily involved in medicines costs.
Dr Taylor told Pulse: ‘Generally speaking GPs have little to do with costs other than prescribing the cheaper alternative which is already set. Having availability access would be useful however given the shortages when prescribing.’
Dr Richard West, chair of the Dispensing Doctors’ Association board, told Pulse that if dispensing doctors can access ‘cheaper prices’ it will ultimately ‘save the NHS some money’.
He said: ‘The dispensing contract assumes that dispensing doctors can get a 11.18% discount off drug tariff price across all drugs. So cheaper prices would be very helpful as about 30% of practices make a loss on purchasing.’
The deal between the Government and the pharmaceutical industry, which includes generic and branded medicines, aims to ‘deliver efficiencies’ within the NHS.
MPSC manages several framework agreements for:
- generic medicines including newly available generic medicines used in hospitals;
- branded medicines, biosimilar medicines and intravenous (IV) fluids;
- blood products, dose-banded chemotherapy and flu vaccines for hospitals;
- homecare.
Which organisations can access the medicines framework
In scope
- NHS secondary care trusts
- NHS mental health trusts
- Hospices
- Prison services
- HIV/PrEP prescribing centres
Out of scope
- Independent sector providers – irrespective of the volume of NHS patients supported
- General primary care providers and community pharmacies
Source: NHS England
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The unintended consequence is that secondary care initiates a drug that is cheaper to them, and supplies 1-2 weeks’ worth of it; but then in primary care, that particular drug is very much more expensive, and GP budgets get hit with the following 10 years’ worth at the very much higher price, bankrupting the NHS and pulling the blame onto GPs fro prescribing cost-INefficiently !
So NHSE think they are clever doing a deal on drugs in hospital and are convinced by the drug company “partners” not to share these cheap deals with primary care. Of course the drug companies wouldn’t be loss leading to hospitals knowing they can gouge money out of the ongoing prescribing in primary care. Oh no those GP’s are to inferior and stupid to understand this. No wonder we are in a parlous financial state.