News

HDA UK Media and Political Bulletin – 15 November 2021

Media Coverage

EU welcomes ‘change in tone’ from UK at Northern Ireland Brexit talks
The Guardian, Lisa O’Carrol, 12 November 2021

The Guardian reports on hope for a solution to the dispute over the Northern Ireland Brexit arrangements after a fourth week of talks.

The European Commission Vice-President Maroš Šefčovič said that there had been a change of tone from the UK’s Brexit Minister, David Frost, confirming the UK had stepped back from the brink of triggering Article 16 of the Northern Ireland Protocol. Talks are continuing for a fifth week.

Šefčovič highlighted the importance of finding a solution for the people of Northern Ireland, particularly “as regards the issue of medicines. An uninterrupted long-term supply of medicines from Great Britain to Northern Ireland is the Protocol-related issue on everyone’s mind in Northern Ireland.” However, the issue over the European Court of Justice remains.

A UK Government spokesperson said that it was important to bring new energy and impetus to the discussions and “accordingly, intensified talks will take place between teams in Brussels next week on all issues, giving particular attention to medicines and customs issues”.

Šefčovič said that clearing barriers for medicine supplies could create momentum in talks.

This was also reported in The Telegraph and BBC News.

DHSC’s response to 2016 hub and spoke consultation paves way for a new discussion
Pharmacy Business, Shilpa Sharma, 12 November

Pharmacy Business reports that the Department of Health and Social Care (DHSC) has published its response to the 2016 hub and spoke consultation which has paved the way for a new discussion following engagement with community pharmacies and other stakeholders this year.

The response showed that many respondents supported use of hub and spoke dispensing models in independent pharmacies but expressed concerns about some practicalities related to it. They raised concerns around “patient data, liability, implications for the supply chain, and risks to the existence of small community pharmacies.” There were furthermore raised concerns about accountability and governance of the process.

The Pharmaceutical Services Negotiating Committee (PSNC) had opposed introduction of hub and spoke dispensing but has since accepted its launch on the basis that fair models for all contractors will be agreed with DHSC.

This was also reported in P3 Pharmacy

Technical changes to Drug Tariff in England to go ahead
P3 Pharmacy, Editorial Staff, 12 November 2021

P3 Pharmacy reports that the Government is to progress all of the proposals put forward in a 2019 consultation on technical adjustments to the way it reimburses community pharmacy contractors in England for items dispensed against NHS prescriptions.

Currently manufacturers’ and wholesalers’ price lists are used to set prices, and these do not necessarily reflect actual selling prices to pharmacy contractors. The Government says its proposed system would not be so dependent on the retrospective medicine margin survey to find the retained medicine margin or adjust reimbursement prices as needed to deliver the agreed amount of margin.

The Government also plans to split the discount deduction scale into 2 separate scales, one for generic medicines and one for branded medicines. This will, on average, improve fair access to the medicine margin for community pharmacies, it claims.

Parliamentary Coverage

There was no parliamentary coverage today. 


Full Coverage

EU welcomes ‘change in tone’ from UK at Northern Ireland Brexit talks
The Guardian, Lisa O’Carrol, 12 November 2021

A glimmer of hope of a solution to the dispute over the Northern Ireland Brexit arrangements has emerged after a fourth week of talks ended on Friday.

After a week of recriminations and the threat of a trade war, the European Commission vice-president Maroš Šefčovič said there had been a change in tone from the UK’s Brexit minister, David Frost, confirming the UK had stepped back from the brink of triggering article 16 of the Northern Ireland protocol.

He confirmed talks would continue for a fifth week but said serious headway was still needed with the UK’s red line over the European court of justice was still an obstacle.

“I acknowledge and welcome the change in tone of discussion with David Frost today, and I hope this will lead to tangible results for the people in Northern Ireland,” he told reporters at news conference in London after the talks.

In a statement, Lord Frost’s office said “significant gaps remain to be bridged” and that the threat of article 16 remained on the table. But it noted that Frost’s preference was “to find a consensual way forward”.

Šefčovič told reporters at a news conference that the people of Northern Ireland deserved a solution from politicians. “That is why I raised forcefully that we need to make serious headway in the course of next week,” he said.

“This is particularly important as regards the issue of medicines. An uninterrupted long-term supply of medicines from Great Britain to Northern Ireland is the protocol-related issue on everyone’s mind in Northern Ireland.”

However, he added: “On the European court, on our side definitely nothing has changed.”

A UK government spokesperson said the “talks had so far been conducted in a constructive spirit” and that it had been “underlined that in order to make progress, it was important to bring new energy and impetus to discussions”.

“Accordingly, intensified talks will take place between teams in Brussels next week on all issues, giving particular attention to medicines and customs issues,” said the spokesperson.

After a week of brinkmanship involving threats to trigger article 16 and a retaliatory trade war, Šefčovič appeared more upbeat about the chance of a rapprochement. He also revealed he had a mandate from member states to “look for solutions”.

He said the chance of a deal on clearing barriers for medicine supplies was “quite low-hanging fruit” and could “create momentum in talks”.

Earlier on Friday, Boris Johnson’s former special adviser Dominic Cummings suggested that the prime minister had a poor grasp of the meaning of the Brexit withdrawal agreement he had signed in January 2020, questioning what the departure from the EU’s customs union meant at a meeting 10 months later with Frost.

“It wasn’t until October 2020 that [Boris Johnson] even vaguely realised what the customs union is,” Cummings tweeted, a reference to a key part of the withdrawal agreement through which the UK would get a clean break from the EU outside the single market and its special customs club.

He wrote that the PM’s “face was priceless” when Frost explained.

“I will never forget the look on his face when, after listening to Frost in a meeting on the final stage of the [trade deal] negotiation, he said, ‘No no no Frosty, fuck this, what happens with a deal?’ and Frost looked from his paper and said, PM this is what happens with a deal, that’s what leaving the customs union means.”

As the EU and the UK appeared to step back from the brink of a trade war, Šefčovič said he and Frost agreed that “we should focus like a laser beam” next week on the issues relating to medicines and customs.

“I’ve done a lot of this type of negotiations and my experience tells me that if you want to have success at the end of the negotiations, we need a stocktaking of what the problems are, we should try to solve them one by one,” he said. “We should take away problems from the table and not bring new ones to an already very complicated stack of issues.”

This was also reported in The Telegraph and BBC News.

DHSC’s response to 2016 hub and spoke consultation paves way for a new discussion
Pharmacy Business, Shilpa Sharma, 12 November

The Department of Health and Social Care (DHSC) has published its response to the 2016 hub and spoke consultation which has paved the way for a new discussion following engagement with community pharmacies and other stakeholders this year.

The response showed that many respondents supported use of hub and spoke dispensing models in independent pharmacies, but expressed concerns about some practicalities related to it.

Respondents raised concerns around “patient data, liability, implications for the supply chain, and risks to the existence of small community pharmacies.”

They also raised question about the speed of access to medicines in an emergency and security of data transfers between hubs and spokes, DHSC stated.

Apprehensions about accountability and governance of the process, as well as responsibility for dispensing errors were also raised.

PSNC’s position

In 2016, the Pharmaceutical Services Negotiating Committee (PSNC) had opposed introduction of hub and spoke dispensing, but has since accepted its launch on the basis that fair models for all contractors will be agreed with DHSC.

In 2019, a 5-year deal national pharmacy contract was agreed between DHSC, NHS England and NHS Improvement (NHSE&I) and PSNC.

In the deal it was decided that with PSNC’s support, the government will “pursue legislative change to allow all pharmacies to benefit from more efficient hub and spoke dispensing, enabling increased use of automation and all the benefits that that brings,” the negotiator said.

Having new legislative provisions on hub and spoke dispensing is vital to establishing a level playing field in practice for all contractors, PSNC said.

This was also reported in P3 Pharmacy

Technical changes to Drug Tariff in England to go ahead
P3 Pharmacy, Editorial Staff, 12 November 2021

The Government is to progress all of the proposals put forward in a 2019 consultation on technical adjustments to the way it reimburses community pharmacy contractors in England for items dispensed against NHS prescriptions. The eight proposals are to be discussed in detail with the PSNC.

The proposals include using actual purchase, sales and volume information already obtained in the quarterly collection under the Health Service Products (Provision and Disclosure of Information) Regulations 2018 to set Category A reimbursement prices.

Currently manufacturers’ and wholesalers’ price lists are used to set prices, and these do not necessarily reflect actual selling prices to pharmacy contractors.

The Government says its proposed system would not be so dependent on the retrospective medicine margin survey to find the retained medicine margin or adjust reimbursement prices as needed to deliver the agreed amount of margin.

The Government also plans to split the discount deduction scale into 2 separate scales, one for generic medicines and one for branded medicines. This will, on average, improve fair access to the medicine margin for community pharmacies, it claims.

Around 40 per cent of expenditure on specials are on imported tablet and capsule products, the prices of which vary enormously, says the Government. It plans to include special capsules and tablets with a reimbursement price in Part V111 of the Drug Tariff.

To address the issue where suppliers of branded generics price them below the Category M price – making them appear cheaper and encouraging CCGs and prescribers to prescribe the product by brand rather than generically – the Government plans to add less medicine margin to those generic medicines for which branded equivalents are available, and add more medicine margin on all other Category M medicines.

Two options are to be explored for Category C products where the product is prescribed generically but there is more than one supplier. To ensure the Tariff price more accurately reflects the purchase price the Government proposes to use a weighted average of suppliers’ list prices, or use actual sales and volume data from suppliers.

Full details of the consultation and responses can be found here.

HDA UK Media and Political Bulletin – 15 November 2021

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