HDA Media And Political Bulletin – 7 December 2015

NPA and readers reject push for online pharmacy services

C&D, James Waldron, 4 December 2015

Chemist and Druggist’s readers in cooperation with the National Pharmacy Association (NPA) denounce the government’ call for online and click-and-collect services in policy document published by the Treasury on Monday 30 November. The NPA stated that the model was “unevidenced” and the organisation will communicate its concerns to the government.


UK paying less for cancer drugs than other EU countries

PharmaTimes, George Underwood, 4 December 2015

PharmaTimes reports on the study published by The Lancet Oncology which finds that the UK pays on average less than other European countries for cancer drugs. The research highlights that price differences range from 28 to 388%. Dr. Sabine Volger, lead author of the study, adds that the evidence should encourage policy-makers to tackle high prices and ensure more transparency.

The ABPI also responded to the Lancet Oncology article on cancer drugs pricing


Drug Tariff listing changes

PSNC, 4 December 2015

Changes to the Drug Tariff impact on reimbursement so it’s important to take note when amendments are made to product listings. Below are some changes which took effect recently.

Part VIIIB change to Chloral hydrate listing

Chloral hydrate 500mg/5ml oral solution has been added to Part VIIIB of the November Drug Tariff and the listing for the Chloral mixture has been removed in line with the BP nomenclature change.

Please note that any prescription for Chloral hydrate 500mg/5ml mixture will be reimbursed at the Part VIIIB listed price for the oral solution as of the November prescription bundle.

Did you know the listing for Benzoyl peroxide 5% / Clindamycin 1% gel has changed?

The pack sizes 25g and 50g of Benzoyl peroxide 5% / Clindamycin 1% gel have been removed from the Drug Tariff and replaced with 30g and 60g.

For generically written prescriptions, you will be paid based on the Drug Tariff listed price, but, for prescriptions written by brand, ensure you dispense the pack size written on the prescription and endorse it.

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UK paying less for cancer drugs than other EU countries

PharmaTimes, George Underwood, 4 December 2015

The UK is paying less for new cancer drugs than most other countries in Europe, a new report has found.

The study in The Lancet Oncology also reveals that the prices of such drugs vary widely – from 28 percent to 388 percent – between high-income European countries, Australia, and New Zealand.

The study looked at 31 originator (under patent) drugs and found that overall the UK and Mediterranean countries such as Greece, Spain, and Portugal pay the lowest average unit manufacturer prices for them, whereas Sweden, Switzerland, and Germany pay the highest prices.

“Public payers in Germany are paying 223 percent more in terms of official prices for interferon alfa 2b for melanoma and leukaemia treatment than those in Greece,” says lead author Dr Sabine Vogler from the WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies. “For gefitinib to treat non-small-lung cancer, the price in Germany is 172 percent higher than in New Zealand.”

The research also highlighted the overall high prices of new cancer treatments in Europe. None of the 31 drugs reviewed had a unit price lower than €10. Almost a quarter (twenty-three percent) had an average unit price higher than €1000. Four drugs (thirteen percent) had an average price between €250 and €500; for two drugs (six percent) it was between €500 and €1000.

The difference between the prices of drugs between the highest and lowest priced countries ranged from 28 percent to 50 percent for a third of the drugs sampled, between 50 percent and 100 percent for half of the drugs, and between 100 percent and 200 percent for three drugs (ten percent).

A particular problem noted by the authors is that patient access discounts on these prices – which are increasingly used to gain approval in the UK and some other countries – are usually confidential, meaning that other countries risk overpaying as they can only use the official undiscounted prices as a benchmark.

Volger adds: “We hope that our findings will provide concrete evidence for policymakers to take action to address high prices and ensure more transparency in cancer drug pricing so that costs and access to new drugs does not depend on where a patient lives.”


ABPI response to the Lancet Oncology article on cancer drugs pricing

ABPI Statement, 4 December 2015

“The study is further evidence that newer medicines are at prices which are affordable in the UK, and it acknowledges the difference between the often quoted ‘list price’ and the lower prices actually paid for medicines by the NHS.” said David Watson, Director – Pricing and Reimbursement at ABPI.

“This suggests that the UK is getting a fair deal with regards to medicines pricing and that the NHS can be assured that it is getting good value for money”.

“In addition the UK also has the benefit of a unique scheme where the pharmaceutical industry pays hundreds of millions of pounds back to the Government each year; money which is meant to go back into supporting the cost of medicines in the NHS.    ​

“Despite this we know patients are still not getting access to some new and innovative medicines.  The UK has poor outcomes for cancer care compared to some of these comparable countries.  If we really want our hospitals here in the UK to provide World class cancer care, we need to invest and ensure our system can accelerate the use of clinically and cost effective medicines.  Government has a key role to play in allowing this to happen.”

Click here to view the Lancet report.​

Pharmacy Voice accuses Government of crude Amazonisation of medicines supply

Pharmacy Business, Neil Trainis, 3 December 2015

The Treasury published a report to encourage people to use online click and collect services. Pharmacy Voice, in response to this report, expressed fears that it would change the pharmacy network and drive patients and pharmacists further apart. In addition to patient-focused concerns, Pharmacy Voice highlighted that the supply and delivery of medicines has particular requirements such as refrigerated storage or safe custody.


Britain is offered best cancer drug prices

The Times, Chris Smyth, 4 December 2015

A World Health Organisation study of 18 Western countries found that Britain gets some of the best deals for cancer drugs with 80% of them cheaper than the world average. This prompts the question of the NHS’s failure to ensure access to the latest treatments for patients.


UK pays among ‘lowest prices’ for cancer drugs

BBC News, 4 December 2015

BBC News also reports on the World Health Organisation study’s findings. The authors of the report are calling for a more transparent drug pricing process to mitigate the risk of some countries overpaying for cancer drugs. Though official list prices are available to the public, discounts are confidential, resulting in potential overpayment.

This data was covered by Press Association, published by The Daily Mail.


MHRA company-led drug alert—Pioglitazone 30mg Tablets—Accord Healthcare Limited

PSNC, 3 December 2015

The Medicines and Healthcare products Regulatory Agency (MHRA) has issued a company-led drug recall for:

Pioglitazone 30mg Tablets (Accord)

MA no: EU/1/11/722/012

Batch no: P05615

Expiry date: 01/2017

This batch, distributed in the UK, is being recalled because it is labelled for the Portuguese market.

To view the alert please visit the MHRA website.

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Pharmacy Voice accuses Government of crude Amazonisation of medicines supply

Pharmacy Business, Neil Trainis, 3 December 2015

Pharmacy Voice has accused the government of trying “to create a crude Amazonisation of medicines supply and pharmacy services” following publication of a report by the Treasury which pushed the case to get more people using online click and collect health services.

Responding to the report which lays out a series of market reforms aimed at reducing household bills by £470 a year, Pharmacy Voice said it was concerned by the proposals which it fears will alter the pharmacy network and drive a wedge between the pharmacist and the patient.

The government said it is keen to ensure that the NHS keeps pace with what it described as “the digital revolution.”

“We would be concerned that any changes to the pharmacy network would distance the relationship between pharmacy and patients,” Pharmacy Voice said.

“We have grave concerns for any moves to create a crude ‘Amazonisation’ of medicines supply and pharmacy services. Several aspects make online delivery considerably more complex and more costly than for standard items of commerce.

“For example, many medicines require refrigerated storage or safe custody. Medicines can’t simply be pushed through the letterbox due to patient safety issues such as children or pets being able to access them.

“There are also very important issues around patient confidentiality. A medicine is not an ordinary item of commerce and the process of dispensing is much more than a supply transaction.

“In healthcare, the public particularly values face-to-face contact. Patients benefit significantly through contact with a pharmacist and it is vital that we maintain this choice.

“This is especially relevant for older people who are often on multiple medicines. There is already far too much avoidable medicine wastage that can be addressed by pharmacy teams having more, not less, contact with their patient to support medicines use.”


Britain is offered best cancer drug prices

The Times, Chris Smyth, 4 December 2015

Britain gets some of the best deals on cancer drugs in the western world, according to data that prompted fresh questions about why so few are approved for routine NHS use.

More than 80 per cent of drugs are cheaper in Britain than the world average. Prices here are never the highest, a World Health Organisation study of 18 countries says. Only Greece pays consistently less for a sample of 31 drugs. The study found, however, that only half of them had been approved for everyday NHS use.

Pharmacy industry spokesmen said the findings showed that rationing was too often denying NHS patients the latest medicines. Prices varied greatly around Europe, with sceptics saying that companies were charging what they could get away with for medicines that often had only marginal benefits.

Ministers have acknowledged that Britain’s system for assessing cancer drugs is failing, with a string of the latest expensive therapies rejected as poor value for money by the National Institute for Health and Care Excellence (Nice).

At the same time, David Cameron’s Cancer Drug Fund will no longer offer access to medicines rejected by Nice after repeatedly overspending its budget.

The analysis compared the list prices for drugs in Europe, Australia and New Zealand, finding big differences between similar countries. The largest variation was for gemcitabine, used for cancers including those of the breast, ovaries and lung. It costs €43 in Australia but €209 in New Zealand.

Avastin, used for cancers including those of the bowel and ovary, costs 50 per cent more in Switzerland than in Britain. “The UK manages to get consistently lower prices,” Sabine Vogler, of the WHO collaborating centre for pharmaceutical pricing in Vienna, which carried out the study, said. “Companies have their strategies and they consider what the country can pay.”

David Watson, director of pricing at the Association of the British Pharmaceutical Industry, said the figures showed the UK was getting a fair deal. “Despite this we know patients are still not getting access to some new and innovative medicines,” he said.

Karl Claxton, a health economist at the University of York, said the real problem was that companies gave priority to expensive drugs offering a few months of extra life over genuinely innovative medicines. Professor Claxton said: “What’s really required is for healthcare systems to make sure they pay prices that reflect what they can afford for the benefits they can offer.”

Andrew Wilson, chief executive of the Rarer Cancers Foundation, said the study posed serious questions for Nice while the government planned to give it more responsibility. He said: “They owe it to patients to get this right.”

Cost comparisions

Avastin (bowel, lung, ovarian cancer)Switzerland €1,505, Germany €1,326, Denmark €1,167, UK €1,085. Abiraterone (prostate cancer) Germany €37, Sweden €29, UK €25. Interferon alfa 2b (leukaemia) Germany €339, Switzerland €299, Sweden €269, UK €128. Herceptin (breast cancer) New Zealand €809, Switzerland €788, Germany €677, UK €478. Source: The Lancet (all prices per tablet/vial)


UK pays among ‘lowest prices’ for cancer drugs

BBC News, 4 December 2015

The UK is paying less for new cancer drugs than a number of other high-income countries, according to a report in The Lancet Oncology.

While the UK, Greece, Spain and Portugal pay the least, on average, for the drugs they use, Germany, Sweden and Switzerland pay the most.

The authors said more transparency was needed because some countries risked overpaying for drugs.

The pharmaceutical industry said the UK was getting a fair deal on medicines.

Prices of cancer drugs have risen steeply in recent years, placing major stress on many healthcare systems, including the NHS.

The report said drugs had accounted for nearly a third of the EU’s 51 billion euro (£37bn) cancer healthcare spending in 2009.

And the researchers then compared the 2013 price of 31 cancer drugs in 18 high-income countries, including the UK, Australia, New Zealand, France, Greece, Switzerland, Sweden and Portugal.


Open pricing

Prices in Greece were the lowest for 14 out of the 24 cancer drugs available there.

The price of drugs in the UK was also low.

Prices of drugs in Switzerland, Germany and Sweden were frequently the highest – and for some drugs, such as interferon alfa 2b to treat leukaemia and skin cancer, were twice as high.

The price figures come from the Pharma Price Information service in Austria, which details what manufacturers charge per unit – a single tablet or vial of a drug, for example.

But although the official list prices published in this report are freely available, any further discounts – which are often negotiated by organisations in different countries – remain confidential.

Sabine Vogler, report author and researcher at the Austrian Public Health Institute, said some countries risked overpaying for drugs as a result.

“The discounts should be open to everyone, but industry doesn’t want to do it. However, it would allow some countries to see that they are overpaying.”

David Watson, director of pricing and reimbursement at the Association of the British Pharmaceutical Industry, said the report was evidence that newer medicines “are affordable in the UK”.

He said the UK was “getting a fair deal with regards to medicines pricing” and the NHS was “getting good value for money”.

From Factory to Pharmacy

As part of our mission to build awareness, understanding and appreciation of the vital importance of the healthcare distribution sector, we developed an infographic explaining the availability of medicines. It identifies the factors that can impact drug supply, as well as the measures that HDA members undertake day in, day out to help mitigate the risks of patients not receiving their medicines.

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