Pharmacies!

[Biddy51]

Hi does anyone know if pharmacies get fully reimbursed by the NHS for prescriptions? I like many other people I’m sure are getting grief. Every time I pick up my medication from my pharmacist it’s a polite battle! Either he can’t order the same brand or the company has stopped producing it, are some of the excuses I’ve been given, but on further investigation I’ve found him to be wrong. It’s really not fair all this stress on top of having auto immune disease and being menopausal.

[wobblybee Administrator Pioneer]

🤔

Many medicines have at least 2 different names:

the brand name – created by the pharmaceutical company that made the medicine

the generic name – the name of the active ingredient in the medicine

For example, sildenafil is the generic name of a medicine used to treat erectile dysfunction. But the company that makes sildenafil, Pfizer, sells it under the brand name Viagra.

Companies take out exclusive rights called patents on each new drug they discover. If a company has a patent on a drug, only that company can market it under their brand name once it's been granted a licence.

Once the patent expires, other manufacturers can market generic versions. The generic versions will be the same as the branded medicine because they contain the same active ingredients.

They are used more often by the NHS because they're just as effective but cost far less. It's similar to buying branded goods or a supermarket's own label – the supermarket's version is usually cheaper.

If the name of your prescription medicine keeps changing, it might be because you're being given the generic version rather than the branded one.

An extract from nhs.uk

[Cooper27 in reply to wobblybee]

I'm pretty sure pharmacies get reimbursed, but I think they just have it drummed into them to find the cheapest or that they themselves get pushback if they order something else. Depending on the illness, the medication brand does make a difference for some people (due to the binders normally), but I think pharmacists often operate under the impression that they're all the same thing.

Sorry didn't mean this as a reply to you Wobblybee, it was meant to be a new comment! I'll leave it here though.

[Biddy51 in reply to Cooper27]

I would love to know for sure. It shouldn’t be like this if your really ill. It’s classed as a chronic illness. Perhaps I should write him a letter. I’m keeping track of all the times he’s tried to fob me off with something else or tell me what he’s ordering me is too expensive! Just making me miserable for being poorly.

[Biddy51 in reply to wobblybee]

Sorry but the NHS article is a bit long winded. It is a known fact that if you are doing well on a particular type of levothyroxine then you should stick to what works for you. Not be swapped over two or three years down the line! What I’m really trying to get at here is are pharmacies fully reimbursed for or meds? If so then I have something to throw back at him. I’m fed up with being made to feel bad about being ill.

[bantam12 in reply to Biddy51]

I take Actavis Levo which the Boots pharmacist said they don't get paid for ordering it in hence it must be stated on my repeats that I only want Actavis otherwise Boots will give me a cheaper brand. Another med I'm on was changed to a cheaper generic which didn't work for me so I was given back my normal expensive brand, this was done by my GP not the Pharmacist.

[Biddy51 in reply to bantam12]

I’ve just about got my Levo sorted with the pharmacist - touch wood. I’m on Actavis too, but they changed the packaging a few months ago. I was told Actavis had stopped making it! Which yet again I found to be untrue. It’s HRT I’m having problems with.

[bantam12 in reply to Biddy51]

There is a massive supply issue with most HRT's, I'm on a selective oestrogen receptor drug which is new to the uk and no generic equivalent, Boots have terrible trouble getting it but it's a manufacturer/supply problem so nothing they can do about it, if they can't get it I'm stuck but so far I haven't had to go without 🤞

[Ellie-Louise in reply to bantam12]

It IS stated on mine but that doesn’t stop them trying to give me anything they feel like! It is also on their own computer.

I get so aggravated having to check it every wretched time I pick it up. Seriously thinking of changing pharmacy but that one is so convenient.

[bantam12 in reply to Ellie-Louise]

Your pharmacy is wrong, if the brand is printed on the prescription they have to dispense it, obviously if there was a supply issue with the brand you have it complicates things but if not they can't give you anything else. Luckily we don't have any problems now.

[wobblybee Administrator Pioneer]

🤔 Something else longwinded. It does refer to generic meds, refunds may differ on brands.

Generic medicine reimbursement: adjustment to prices

While NHS England is responsible for commissioning pharmaceutical services and determining the amount paid to pharmacy contractors for those services under the Community Pharmacy Contractual Framework (CPCF), the Secretary of State remains responsible for determining the NHS reimbursement prices for the products dispensed.

Payment for services within the CPCF is delivered through a combination of fees and allowances, and the medicine margin. The Department of Health and Social Care (DHSC), with the Pharmaceutical Services Negotiating Committee (PSNC) and NHS England, assesses the medicine margin achieved by pharmacy contractors (through a medicines margin survey) and adjust reimbursement arrangements, as necessary.

Previous Year Adjustments to the CPCF from 2018/19 Onwards

2018/19: November 2018 to March 2019 adjustment

As announced by DHSC, the funding agreement reached between NHS England and PSNC for the CPCF in 2018/19 was £2.592bn, with £1.792 billion being delivered through fees and allowances, and £0.800 billion delivered through the medicines margin.

With effective from 1st November 2018, an agreement was reached between DHSC and PSNC which resulted in a reduction in Category M reimbursement prices by £10 million per month. This was due to:

the results of the 2015/16 and 2016/17 medicine margin survey and

provisional results of the 2017/18 medicine margin survey

which indicated an over-delivery on the £800 million per year medicine margin commitment for these financial years.

At the time, it was highlighted that this recovery would be made over the final 5 months of the current financial year, resulting in community pharmacy medicines costs being £50m less (i.e. £10m per month * 5 months) than would otherwise be the case.

Whilst this reduction in Category M prices would assist in helping mitigate any cost pressures arising from price concessions in the short term, it was emphasised that this was to be a temporary measure only. To this effect, the £10m per month Category M adjustment was restored with effect from 1 April 2019.

2019/20: August 2019 to March 2020 adjustment

For 2019/20, it was agreed that the previous year’s funding agreement be rolled forward for a 6-month interim period whilst negotiations between PSNC, DHSC and NHSE&I about the future CPCF global sum continued. As such, the medicines margin remains at £0.800 billion.

However, recent discussions with DHSC have drawn attention to an under-delivery in the medicines margin in 2018/19, and also highlighted the likelihood of a significant under-delivery for and by the end of the financial year 2019/20.

To address this, it has been agreed that – with effect from August 2019 – the medicines margin will be increased by £15m per month to the financial year end, an increase of £120m in total (i.e. £15m per month * 8 months).

This agreement is subject to a revisiting of the arrangement in October / November 2019 when the final outturn position for the 2018/19 medicines margin should be available (along with a further update on 2019/20 projections).

Please note that the changes mentioned above will also affect dispensing doctors.

[Biddy51]

Thank you! Will read this when I can get my brain engaged! 😉

[Servi]

I don't know the answer to your question Biddy. Could you change pharmacies if you are having problems with one or is the one you use the only one available locally? Boots also do an online prescription service with it delivered to your door - although you have to be in to sign for it. You shouldn't be made to feel bad for getting your medication. Hope you get it sorted.

[Biddy51]

I have moved! It’s the second one I’m with. I’m keeping a log of all the times I’ve been messed around and details of what has gone on. When this HRT shortage is sorted I’m going to talk to my GP. Show her what I have to put up with. The pharmacy that was attached to the GP’s surgery was just as bad! It’s bad enough having Auto Immune without the menopause on top!