The prices of certain generic drugs are “seeing another surge” which could have a significant impact on the finances of NHS commissioners, a pharmacy body has warned.
The Pharmaceutical Services Negotiating Committee, which represents community pharmacies, has also said Brexit could “trigger further price increases” which could impact patient safety.
In a letter to the health and social care committee, it said: “Following major shortages in the generics market in 2017, the number of concessions being granted each month has slowly decreased (53 in April 2018 as compared to 109 in November 2017).
“However, we are now seeing another surge in the number of generics unavailable to purchase at drug tariff price… [In November] the number of price concessions jumped up to 72 and the number in December 2018 is likely to be higher.”
Generic drugs are generally bought through nationally set tariff prices. But pharmacies can apply for price concessions that enable them to temporarily pay more when the drugs are in short supply.
Clinical commissioning groups may be particularly worried about the rising number of concessions, as last year’s generic price increases resulted in a bill of around £315m.
NHS England reimbursed some, but not all, of the costs to CCGs. Many CCGs received no rebate at all.
Following an intervention by the Department of Health and Social Care, NHS England and NHS Improvement said in planning guidance for 2018-19 that “CCGs should assume that the current high level of discretionary prices for generic drugs in short supply will not persist in 2018-19”.
The PSNC also said in its letter: “The current system for setting price concessions could be at risk in the immediate post-Brexit era. The generics market is particularly vulnerable to actual or perceived drug shortages which would trigger price increases.”
The PSNC blamed the current shortages on a combination of factors including Brexit planning and stockpiling.
It said: “Any further disruption to the supply of medicines to the UK following Brexit, for example if delays at border crossings disrupt the flow of medicines from Europe, could create a real risk of further medicines shortages, or perceived shortages (which can be just as problematic, in pricing terms).”
The letter also warned price increases could “potentially impact on patient safety and care”, because the uncertainty of when and by how much pharmacies would be reimbursed for buying drugs could force some to “go out of business”.
The committee called for legal changes so that it could legally ration patient’s prescriptions.
It said this would allow pharmacists to “refuse” to give patients their prescriptions if they are seeking several months’ worth at once or already have enough medicines left from their previous prescriptions.
Health and social care secretary Matt Hancock announced last week that he intends for pharmacists to be given the power to dispense an alternative drug to the one prescribed without referring the patient back to their GP.
Article originally published at www.hsj.co.uk