HDA Media And Political Bulletin – 3 June 2016

Bitter Pills

3 June 2016, The Times, Leader Comment


The Times comments on an investigation into drug pricing practices led by the publication which reveals that the price to the NHS of medicines reaching a mature stage of the retail cycle is increasing. It particularly questions the loopholes in the NHS’s drug-purchasing policy.


Counterfeit medicines are a growing threat to global health, WHO meeting hears

2 June 2016, The Pharmaceutical Journal


The Pharmaceutical Journal reports on a session at the WHO annual assembly Zuzana Kusynova, policy adviser at the International Pharmaceutical Federation (FIP) warned of the increasing threat of substandard and counterfeit medicines to global health. While there are no good estimates on the frequency of falsified medicines, more information on the frequency of substandard medicines is available. Member states should report incidents to the WHO in a systematic manner.


Chemist and Druggist and The Pharmaceutical Journal review the responses published by pharmacy bodies to the Department of Health consultation on its proposed efficiency savings.


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Bitter Pills

3 June 2016, The Times, Leader Comment


The National Health Service deserves better than this. When prescription drugs come out of patent they are supposed to start costing the NHS less than they did during the period when they were available from only one supplier. Our investigation today, however, reveals that the price to the NHS of some of the medicines reaching a mature stage of their long and complex retail cycle is actually increasing. Increasing, furthermore, dramatically, and in some cases scandalously. Over the past five years, 32 drugs have gone up in price by more than 1,000 per cent.


The extra cost to the NHS of these hikes is in excess of £262 million a year. No relevant authority appears to have identified the trend towards what one expert has called, with evident justification, “extortionate” price rises. Even if these extraordinary figures have been noted among the myriad number-crunchers both in Whitehall and the upper echelons of the service itself, no effective remedial action on their part is yet detectable.


Politicians, managers and quangocrats, who are paid handsomely to deliver value for money to taxpayers, seem remarkably relaxed about pills costing 5p each one year, then costing £3 each five years later. They should be anything but. As our story explains, £262 million a year is equivalent to hiring another 7,000 junior doctors. The NHS is a huge, some would say unwieldy, organisation. Its £116 billion budget accounts for almost one fifth of annual public expenditure in the UK. There is a temptation to view what is in absolute terms an enormous sum as a relatively insignificant percentage of overall costs. This temptation must be resisted.


Just as its custodians must be monitored to ensure the NHS is as cost-efficient as possible, the service’s suppliers cannot be allowed to exploit its size nor its mission. Clearly a degree of exploitation has taken place. The various pharmaceutical entrepreneurs involved have not broken the law. What they have done, however, realising spectacular profits in the process, is to make use of a loophole in the NHS’s drug-purchasing policy. This loophole exists not because of a failure to employ market forces but rather because, in a system predicated on the smooth operation of those forces, they are nowhere to be seen.


The government is mindful of the dangers of monopoly provision and has correctly insisted that drugs under patent and some branded drugs should be subject to a profit cap, albeit a voluntary one. Drugs out of patent, once their generic name has been substituted for their brand, become free from these controls. If any firm can supply any product, the reasoning goes, competition will suppress the price of that product.


The reality is that some entrepreneurs have bought up the exclusive rights to market certain drugs. Typically those which, superseded by modern versions, no longer provide sufficient profit to interest big pharma yet which nonetheless continue to be prescribed by GPs. Such physicians are acting out of legitimate, indeed, quite possibly lifesaving, concern. Some victims of chronic conditions, hypertension or malfunctioning thyroid glands, for example, suffer side-effects from the new generation drugs. They must therefore remain on the original medication supplied by a manufacturer who can name his price. An unforgivably high price, as it turns out.


The solution to this is straightforward. Suppliers of out-of-patent niche medicines to the NHS should be contracted on the basis of tendering for the business at an agreed price. The issuing of blank cheques should cease. As for the entrepreneurs in question, we note that some make much of their credentials as philanthropists. Let them now go about proving those credentials, many times over.


Counterfeit medicines are a growing threat to global health, WHO meeting hears

2 June 2016, The Pharmaceutical Journal


Substandard and counterfeit medicines pose a growing threat to global health and greater global efforts are needed to counter the problem, experts have warned at an international forum.


Speaking at a session on 27 May 2016 at the annual assembly of the World Health Organization, Zuzana Kusynova, policy adviser at the International Pharmaceutical Federation (FIP), which represents pharmacists and pharmaceutical scientists, said it was important to safeguard the legitimate supply chain of medicines.


“It was vital for pharmacists to refer cases to authorities if they find suspected cases of substandard, spurious, or counterfeit medicines,” she added.


These products are known as SSFFC — substandard, spurious, falsely labelled, falsified and counterfeit medicines — and can affect both branded and generic products.


Hans Hogerzeil, professor of global health at the University of Groningen in the Netherlands, pointed out that there are no good estimates on the frequency of falsified medicines, but that “we have some information on the frequency of substandard medicines”.


The WHO says there are many estimates of the scope and scale of the market in SSFFC medical products but little validated evidence to underpin those estimates.


Since 2013, when the WHO asked member states to report SSFFC incidents in a systematic format, more than 1,114 medical products have been reported covering main therapeutic categories. If any of the notifications pose a serious threat to global health, the WHO issues a global medical product alert.


PSNC, RPS and Pharmacy Voice to join forces and publish forward view for community pharmacy

2 June 2016, The Pharmaceutical Journal, Ingrid Torjesen


The Pharmaceutical Services Negotiating Committee (PSNC) has announced it is working with Pharmacy Voice, a trade association which represents community pharmacy in England, and the Royal Pharmaceutical Society to develop a ‘Community Pharmacy Forward View’ that will articulate how they believe “the community pharmacy network can best support the high performing, affordable health and care system envisaged in the NHS’s ‘Five year forward view’”.


The new plans for the future of community pharmacy, for which no publication date has been given, come after the PSNC says its counterproposals for making savings to the community pharmacy budget, submitted to the Department of Health in April 2016, have been rejected by the government.


The UK government’s proposals, announced in December 2015, involve slashing £170m from England’s community pharmacy budget from October 2016, sparking fears that around 3,000 pharmacies could close as a result.


The PSNC, the negotiating body for community pharmacy contractors in England, has since sought to examine the plans in more detail, but says its efforts “have been thwarted” by the government’s reluctance to be forthcoming about its policies.


Alastair Buxton, director of NHS services at the PSNC, says: “The forward view is not a piece of work designed as an alternative to the counterproposal that the PSNC presented as part of its discussions with the Department of Health and NHS England. Instead, it provides a broader and longer term shared vision for community pharmacy.”


The PSNC says its original counterproposals urged officials to consider for the first time the potential demand on the NHS that would result if patients could no longer rely on their local pharmacy for urgent medicine supply.


“We have been unable to obtain confirmation from the government of the scale of closures of community pharmacies it wishes to achieve,” the PSNC says, adding that it is willing to discuss a reduction in numbers where this could be done without detriment to patient choice and access to pharmacy services.


“The reluctance to explain the policies is, we believe, driven by a desire to avoid the opposition that they would provoke, and to forestall the argument that pharmacies that become unviable should be compensated.”


It has also sought access to information on the anticipated cost savings associated with the plan to drive automated remote dispensing and a reduction in pharmacies. “Officials have said informally that there is none,” the PSNC says.


In its response to the government’s planned cuts, published on 26 May 2016, the Royal Pharmaceutical Society (RPS) emphasised that the proposed cut in contractual funding will reduce the potential for community pharmacists to deliver additional value in the community with a knock on effect of increasing pressure on GPs, hospital emergency departments and other urgent care services.


Sandra Gidley, chair of the RPS England Pharmacy Board, says: “We are in no doubt that hastily implemented funding cuts to community pharmacy will mean greater costs for the NHS in the long term. There is a strategic imperative for the NHS to improve capacity and capability to support older people and those with long-term conditions.


“This, coupled with an emphasis on prevention of ill health, means we need to invest in community pharmacy, expand roles and enable better care,” she adds.

HDA Media And Political Bulletin – 3 June 2016

From Factory to Pharmacy

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