Media And Political Bulletin – 27 March 2020

Media and Political Bulletin

27 March 2020

Media Summary

Ventilator crunch looms after snubbing EU action

The Times, Francis Elliott, 27 March 2020

The Times reports that Boris Johnson is facing criticism for his failure to join an EU-wide ventilator procurement scheme as hospital chiefs warn that Britain will be desperately short of the life-saving machines when the number of coronavirus cases peaks.

The NHS has 8,000 ventilators in service but pandemic modelling suggests that it will need up to 20,000 more in two to three weeks, when infection levels are at their highest.

The European Union’s plan to bulk-buy ventilators, face masks and protection equipment for medical staff involves 26 countries. Over the past week, 25 EU countries and Norway opened negotiations to purchase supplies using their combined purchasing power to keep prices down.

HSJ also reported that Trust chiefs fear ventilator delays ahead of crucial week.

Two strengths of ranitidine among further March price concessions

C+D, Valeria Fiore, 26 March 2020

C+D reports that the Department of Health and Social Care and the National Assembly for Wales have agreed concessionary prices for 19 items for March 2020 prescriptions.

The list included in this article was first published by the Pharmaceutical Services Negotiating Committee on March 19. An initial 24 price concessions were announced on March 13.

 

Parliamentary Coverage

There was no parliamentary coverage today.

 

Full Coverage

Ventilator crunch looms after snubbing EU action

The Times, Francis Elliott, 27 March 2020

Boris Johnson is facing criticism for his failure to join an EU-wide ventilator procurement scheme as hospital chiefs warn that Britain will be desperately short of the life-saving machines when the number of coronavirus cases peaks.

The NHS has 8,000 ventilators in service but pandemic modelling suggests that it will need up to 20,000 more in two to three weeks, when infection levels are at their highest.

NHS Providers, which represents hospital trust leaders, said that the health service had “major concerns about how quickly [the new ventilators] can reach the front line”.

Mr Johnson launched an appeal across Britain to scale up production during a conference call on March 16, setting business leaders a target of delivering 30,000 devices in a fortnight.

There are doubts about industry’s ability to plug the gap, however. Sir James Dyson, the vacuum cleaner entrepreneur, was accused of “jumping the gun” after claiming that he had signed a contract to produce 10,000 machines for the NHS.

Britain did not take up an invitation to join the EU-wide procurement scheme for ventilators launched at the same time as Mr Johnson’s appeal to British industry. Asked why, the prime minister’s spokesman initially said that “we are no longer members of the EU”, adding that this was an “area in which we are making our own efforts”.

A government spokesman later blamed an email mix-up as accusations grew that Mr Johnson had put Brexit ideology ahead of the national interest. The spokesman added: “Owing to an initial communication problem, the UK did not receive an invitation in time to join four joint procurements in response to the coronavirus pandemic.

“As those four initial procurement schemes had already gone out to tender we were unable to take part in these but we will consider participating in future procurement schemes on the basis of public health requirements at the time.”

Jon Ashworth, the shadow health secretary, said the explanation of a mix-up would “astonish NHS workers”. He said: “We need a detailed, clear procurement plan for ventilators, PPE [protective, personal equipment] as a matter of urgency.”

The government’s explanation for its failure to respond to the invitation was met with scepticism in Brussels. The European Commission made clear on March 17 that Britain was free to participate. The information was passed to the government and the deadline passed two days later on Thursday. The European tendering process for manufacturers closed at midnight. Brussels sources have suggested that it went well and there would have been no obstacle to the UK conducting its own procurement drive in parallel. “Many member states are doing their own things too,” an EU official said. “It is complementary to the national level.”

Hospital bosses are increasingly anxious about the looming shortage of ventilators. Chris Hopson, chief executive of NHS Providers, said that the health service was dealing with huge numbers of critically ill patients while “having to focus on utilising the equipment they already have in the best way”.

An executive at a London NHS trust told the Health Service Journal: “Ventilators are the big thing the front line are waiting for. Lots of lives depend on it. It’s going to be a key week for the NHS.”

Provincial trusts said that they were reliant on central management for the supply of ventilators and there were concerns that London hospitals would be given priority. The chief executive of an acute hospital trust in the Midlands told the HSJ that there was a lack of transparency. The trust was prevented from buying ventilators directly and had not been told when it could expect to receive more units.

Dyson, the technology company, hopes to begin producing a newly designed ventilator within weeks. Staff and resources have been redirected to set up two production lines at a former RAF base at Hullavington, Wiltshire, where the company had planned to manufacture an electric car.

Sir James told his staff: “This new device can be manufactured quickly, efficiently and at volume. It is designed to address the specific clinical needs of Covid-19 patients. The race is now on to get it into production.”

Downing Street said that the purchase of the machines was subject to approval by the regulator. The prime minister’s spokesman said: “Their machines must meet the necessary safety and regulatory standards. If they do not, they will not be bought.”

One industry source said: “This isn’t a competition about who can produce the first ventilator or the most ventilators — it’s a race against time. The more ventilators we can all make, the better. It doesn’t matter if it’s Dyson or the consortium as long as they get made.”

Britain back of the queue

The European Union’s plan to bulk-buy ventilators, face masks and protection equipment for medical staff involves 26 countries.

Over the past week, 25 EU countries and Norway opened negotiations to purchase supplies using their combined purchasing power to keep prices down. Under the Brexit withdrawal treaty, Britain is eligible to take part but, by staying out, has been pushed to the back of the queue.

The plans are thought to include orders for tens of thousands of ventilators, with tenders for contracts due to close at midnight last night. Deliveries are set to begin in the next fortnight. Ursula von der Leyen, the European Commission president, declared the initiative a success for securing “concrete offers of considerable scale on shortest notice”.

HSJ also reported that Trust chiefs fear ventilator delays ahead of crucial week.

Two strengths of ranitidine among further March price concessions

C+D, Valeria Fiore, 26 March 2020

The Department of Health and Social Care and the National Assembly for Wales have agreed concessionary prices for 19 items for March 2020 prescriptions.

The list included in the article was first published by the Pharmaceutical Services Negotiating Committee on March 19. An initial 24 price concessions were announced on March 13.

Media and Political Bulletin

23 January 2018

Media Summary

DH proposes new system to decide concessionary prices

Chemist and Druggist, Grace Lewis, 22 January 2018

 

Chemist and Druggist reports that the Department of Health and Social Care (DH) has set out “proposals” to change the current system for agreeing price concessions, according to the PSNC.

The Pharmaceutical Services Negotiating Committee (PSNC) “discussed proposals from the DH on changing the system for setting price concessions” at a committee meeting in the second week of January.

Under the current system, PSNC submits claims for price concessions to the DH, which the government then verifies using data from wholesalers and manufacturers, the negotiator explained in a statement. At its January committee meeting, the negotiator agreed “key principles” for a “fair” system of price concessions. These principles include “any data used to set prices must relate to the period for which a concession is given”, and “PSNC must be able to challenge proposed price concessions”.

 

Parliamentary Coverage

Health Committee – Secretary of State to be questioned today on the impact of Brexit for patients – 23 January 2018

Today the Health Committee will hear from the Secretary of State for Health, Rt Hon Jeremy Hunt MP, on the impact of Brexit on medicines, medical devices and substances of human origin.

If you would like to watch live coverage of the session, please follow the following link: http://www.parliamentlive.tv/Event/Index/70452f3d-4f8b-4db0-9177-fd8e7fda9343

 

Commons Tabled Written Question – Alex Sobel – 22 January 2018

Alex Sobel, MP: To ask the Secretary of State for Exiting the European Union, what steps he is taking to ensure that licensing for new drugs in the UK is not slowed down by leaving the EU and the European Medicines Agency.

 

Lords Tabled Written Question – Baroness Masham of Ilton – 22 January 2018

Baroness Masham of Ilton: To ask Her Majesty’s Government what assessment they have made of the impact of the European Medicines Agency relocating to the Netherlands; and how many jobs they estimate will be lost as a result.

 

 

Full Coverage

DH proposes new system to decide concessionary prices

Chemist and Druggist, Grace Lewis, 22 January 2018

 

The Department of Health and Social Care (DH) has set out “proposals” to change the current system for agreeing price concessions, according to PSNC.

The Pharmaceutical Services Negotiating Committee (PSNC) “discussed proposals from the DH on changing the system for setting price concessions” at a committee meeting in the second week of January, the negotiator said in a statement last Thursday (January 18).

Under the current system, PSNC submits claims for price concessions to the DH, which the government then verifies using data from wholesalers and manufacturers, the negotiator explained.

PSNC would not confirm to C+D what the DH’s proposals for a new system entail. C+D has also contacted the DH for details of the proposals.

“Key principles” of a “fair” system

At its January committee meeting, the negotiator agreed “key principles” for a “fair” system of price concessions.

These include “any data used to set prices must relate to the period for which a concession is given”, and “PSNC must be able to challenge proposed price concessions”.

C+D reported in December that contractors in England were “highly stressed” waiting for concessionary prices for items including levetiracetam, amlodipine and felodipine. Contractors were then left “sickened” by the final 53 concessionary prices for November, when they were announced on December 14.

“Purchasing medicines for the NHS is a huge part of what the sector offers,” PSNC said last week.

However, “contractors must not be the victims of adverse events or activity further up in the supply chain”, and “any pricing system must fairly balance contractors’ duty to supply with a reasonable purchase risk”, the negotiator added.

PSNC said it will continue to “press for immediate improvements to the price concessions system” and will keep contractors updated with its progress.

Last week, PSNC director of NHS services Alastair Buxton told delegates at a pharmacy seminar that the negotiator will “present [its] ideas” for a service-based pharmacy contract to the DH and NHS England in its upcoming funding discussions.

Media and Political Bulletin

18 December 2017

Media Summary

Launch of new medicines in UK face two-year delay post-Brexit, MPs told

The Pharmaceutical Journal, 15 December 2017

 

The Pharmaceutical Journal underlines that, according to evidence presented to the House of Commons Health Committee, the launch of new medicines in the UK may be delayed by two years after Brexit as it is “relegated” in the global medicines market.

The predicted delay will also have a “significant” knock-on effect on the UK’s involvement in clinical trials. “If medicines are going to be delayed by two years, then standards of care will change. And if your comparator is unlikely to be available in the UK, why would you set up a clinical trial here?” Leslie Galloway, chair of the Ethical Medicines Industry Group, a trade association for life science companies, told MPs.

Galloway was giving evidence to the committee’s ongoing inquiry into the impact of Brexit on the medicines supply chain, and on medicines and devices regulation.

 

 

Drug shortages cost NHS £38m as patients struggle

The Times, Chris Smyth, 18 December 2017

 

The Times reports that medicine shortages cost the NHS £38 million last month, as officials say they are largely powerless to solve a problem that is leaving patients struggling to obtain essential drugs.

Attempts to force down prices have led pharmacists to warn that they cannot carry on supplying patients with drugs that lose them money. A total of 91 emergency price increases have been approved for November, but pharmacists have said that these are not enough to cover the cost of crucial cancer and anti-psychotic medicines.

Worsening shortages of medicines have cost the NHS more than £200 million since April, the publication reports, because it has had to approve a series of price rises of up to 4,000 per cent.

 

 

Contractors ‘sickened’ by final 53 November concessionary prices

Chemist and Druggist, Thomas Cox, 15 December 2017

 

Chemist and Druggist reports that contractors were unimpressed by the final 53 concessionary prices for November, announced by the Department of Health (DH) and National Assembly for Wales on Thursday.

While the Pharmaceutical Services Negotiating Committee (PSNC) chief executive Sue Sharpe said her organisation “is pleased that further November prices have finally been issued”, she stressed that “many are lower than we had sought, and some concessions we applied for have not been granted”.

 

Parliamentary Coverage

 

There is no parliamentary coverage today.

 

Full Coverage

Launch of new medicines in UK face two-year delay post-Brexit, MPs told

The Pharmaceutical Journal, 15 December 2017

 

The launch of new medicines in the UK may be delayed by two years after Brexit as it is “relegated” in the global medicines market, MPs on the House of Commons Health Committee were told on 12 December.

The predicted delay will also have a “significant” knock-on effect on the UK’s involvement in clinical trials.

“If medicines are going to be delayed by two years, then standards of care will change. And if your comparator is unlikely to be available in the UK, why would you set up a clinical trial here?” Leslie Galloway, chair of the Ethical Medicines Industry Group, a trade association for life science companies, told MPs.

Galloway was giving evidence to the committee’s ongoing inquiry into the impact of Brexit on the medicines supply chain, and on medicines and devices regulation.

Galloway’s warnings were endorsed by Steve Bates, chief executive of the BioIndustry Association, the trade association for the sector. He said he was worried that, post-Brexit, the UK would no longer have access to new medicines — including generic products — which would have “implications for the NHS”.

Funding streams — from both the private and public sectors — essential to maintain a “vibrant life sciences sector” were also at risk, according to Bates.

Uncertainty over the future regulation of medical devices because of Brexit was creating anxiety in the sector, Suzanne Halliday, head of medical devices at the British Standards Institution, told MPs.

A no-deal Brexit would be “devastating for patients” in terms of access to new medical devices. “It could mean no access to any [new] medical devices after March 2019,” she admitted.

Some device manufacturers were already moving their manufacturing out of the UK to Switzerland and to Ireland, she revealed.

At the same time drug companies were also moving their marketing authorisation to “mainland Europe” because of Brexit, Galloway added. “They will not come back to the UK,” he warned MPs.

 

 

Drug shortages cost NHS £38m as patients struggle

The Times, Chris Smyth, 18 December 2017

 

Medicine shortages cost the NHS another £38 million last month, as officials say they are largely powerless to solve a problem that leaves patients struggling to obtain essential drugs.

Attempts to force down prices have led pharmacists to warn that they cannot carry on supplying patients with drugs that lose them money. A total of 91 emergency price increases have been approved for November, but pharmacists have said that these are not enough to cover the cost of crucial cancer and anti-psychotic medicines.

Worsening shortages of medicines have cost the NHS more than £200 million since April because it has had to approve a series of price rises of up to 4,000 per cent. Patients are still experiencing delays getting medication and have sometimes had to switch drugs.

The government has moved to setting temporary prices based on manufacturers’ selling prices, rather than those charged by wholesalers, in an effort to squeeze margins. Manufacturers have accused wholesalers of inflating prices, but wholesalers have denied that they are manipulating the market.

Sir Chris Wormald, the permanent secretary at the Department of Health, told MPs last week that government had limited powers to resolve this. “There isn’t an obvious solution because it is a question of supply and demand,” he said.

Despite temporary rises for 20 more drugs than the previous month, over-payments in November totalled £38 million, down from £56 million the month before. This is because the government reduced the excess prices it pays for some drugs. For example, it will pay pharmacists £27 for olanzapine tablets, an anti-psychotic, well above the usual price of £1, but down from £62 in October. Mark Burdon, a member of the Pharmaceutical Services Negotiating Committee, which makes requests for price rises, said the reaction of some colleagues was that officials were “having a laugh” because wholesale prices had not come down this much.

Ben Goldacre, whose University of Oxford data team produced the November estimates, said: “We have pharmacists issuing drugs to patients, which the pharmacies have purchased a price set by the market, but those pharmacists have no idea what the NHS will pay them for it . . . The entire system needs a rethink and an overhaul.”

 

 

Contractors ‘sickened’ by final 53 November concessionary prices

Chemist and Druggist, Thomas Cox, 15 December 2017

 

Contractors were unimpressed by the final 53 concessionary prices for November, announced by the Department of Health (DH) and National Assembly for Wales yesterday.

While Pharmaceutical Services Negotiating Committee (PSNC) chief executive Sue Sharpe said her organisation “is pleased that further November prices have finally been issued”, she stressed that “many are lower than we had sought, and some concessions we applied for have not been granted”.

PSNC revealed last week that it requested 67 price concessions in total – 14 more than have been granted (see table below).

C+D reported earlier this month that contractors in England were “highly stressed” waiting for concessionary prices for items including levetiracetam, amlodipine and felodipine – the latter of which did not make the list.

Responding to the latest concessionary prices, the superintendent pharmacist of Broadway Pharmacy in Preston, Michael Ball, tweeted: “I honestly feel like giving up. It’s just one blow after another, beyond sickening.

“I feel like I need to determine how substantial the loss is, but then I’ll just be even more depressed and not spending the time productively,” he continued. “[I’m] honestly flabbergasted. Scary times.”

Excluding felodipine was “a joke”

Contractor Nat Mitchell from Cockermouth, Cumbria said it was “a joke” that felodipine was not among the 53 items, and that bicalutamide’s concessionary price was as low as £4.99 for 28 150mg tablets. “I feel like I’m being defrauded,” he added.

Fellow Cumbria pharmacist Ben Merriman said one wholesaler had priced bicalutamide at £39.

Newcastle-upon-Tyne pharmacy manager Rani Rehan said “thankfully” her pharmacy does not have patients on felodipine or bicalutamide, but described her reaction to the £53.63 concessionary price for 60 tablets of quetiapine 300mg as: “Ouch.”

Contractor Tony Schofield – also based in Newcastle – said “all the major wholesalers” are offering quetiapine at £136, and “the best [price] we could get” occasionally is £73.

Supplying at a loss?

Contractor Suketu Patel from Cheshire said he will “have to seriously consider” whether to supply medicines not granted a concessionary price at “below actual purchasing price”, or not at all.

Reacting to the news, Wyvern Pharmacy contractor Andrew Grierson tweeted: “Show of hands how many small contractors didn’t submit items for fear of losing out on a crippling amount of money, and now have to wait with fingers crossed for December.”

PSNC’s Ms Sharpe said she hopes the DH will respond to requests for December price concessions – submitted earlier this month – in a “more timely manner”.

Media and Political Bulletin

11 October 2017

GIRP have released their Wholesale Brief for October. To view this brief, please click here.

Media Summary

October 2017 Price Concessions/NCSO

PSNC, 10 October 2017

The PSNC reports on the Department of Health’s list of price concessions for October. A full list of the medicines that have received price concessions can be found here. The PSNC has said that if wholesalers have any problems obtaining a Part VIII product or problems obtaining the product at the Drug Tariff price then they should report this issue to the PSNC using their online feedback form on the PSNC website.

The PSNC also highlighted that if wholesalers have been able to source the product, they should provide full details of the supplier and price paid. The PSNC will then investigate the extent of the problem and if appropriate discuss the issue with the Department of Health.

HM Treasury release a whitepaper on a new Customs Bill

HM Treasury, 10 October 2017

The whitepaper outlines the Government’s plans for legislating for the UK’s future

customs, VAT and excise regimes. The whitepaper sets out the government’s approach to legislating for a future customs regime, and to creating a framework that supports intra-European trade.

As well as providing for the implementation of a negotiated settlement with the EU, the Bill will provide for a range of other possible outcomes. The whitepaper therefore also sets out how the government would manage leaving the EU without an agreement on customs, in the event of no deal being reached.

Parliamentary Coverage

HM Treasury, 10 October 2017

HM Treasury have released a whitepaper on a proposed new Customs Bill. To view this whitepaper, please click here.

MHRA – Decision: suspended and revoked licences for manufacturers and wholesalers of medicines, 10 October 2017

The MHRA have updated their public list of companies in the UK who have had their licence to manufacture or wholesale medicines revoked or suspended. To view this list in full, please click here.

Full Coverage

 

October 2017 Price Concessions/NCSO

PSNC, 10 October 2017

 

The Department of Health has granted the following price concessions for October 2017:

Drug Pack size Price Concession
Amiloride 5mg tablets 28 £9.25
Amlodipine 5mg tablets 28 £3.75
Amlodipine 10mg tablets 28 £3.99
Anastrozole 1mg tablets 28 £14.45
Atorvastatin 80mg tablets 28 £2.40
Betahistine 8mg tablets 84 £5.06
Betahistine 16mg tablets 84 £8.50
Bicalutamide 50mg tablets 28 £1.90
Bicalutamide 150mg tablets 28 £6.50
Buspirone 10mg tablets 30 £9.00
Chlorpromazine 25mg tablets 28 £41.00
Chlorpromazine 50mg tablets 28 £41.00
Chlorpromazine 100mg tablets 28 £41.00
Citalopram 10mg tablets 28 £1.69
Citalopram 20mg tablets 28 £3.09
Citalopram 40mg tablets 28 £3.29
Colecalciferol 400unit capsules 28 £4.99
Dapsone 50mg tablets 28 £42.00
Duloxetine 20mg capsules 28 £8.95
Duloxetine 30mg capsules 28 £6.00
Duloxetine 40mg capsules 56 £10.50
Duloxetine 60mg capsules 28 £15.49
Enalapril 5mg tablets 28 £2.59
Enalapril 10mg tablets 28 £2.59
Enalapril 20mg tablets 28 £2.59
Eplerenone 25mg tablets 28 £42.72
Eplerenone 50mg tablets 28 £12.60
Exemestane 25mg tablets 30 £63.50
Gabapentin 300mg capsules 100 £13.95
Gabapentin 400mg capsules 100 £12.00
Gabapentin 600mg tablets 100 £7.20
Haloperidol 1.5mg tablets 28 £12.00
Hydroxychloroquine 200mg tablets 60 £16.50
Levetiracetam 250mg tablets 60 £28.01
Levetiracetam 750mg tablets 60 £61.50
Mefenamic 500mg tablets 28 £55.00
Olanzapine 10mg tablets 28 £62.00
Olanzapine 15mg tablets 28 £84.00
Olanzapine 2.5mg tablets 28 £16.00
Olanzapine 20mg tablets 28 £108.99
Olanzapine 5mg tablets 28 £31.00
Olanzapine 7.5mg tablets 28 £45.00
Oxazepam 10mg tablets 28 £19.97
Oxazepam 15mg tablets 28 £19.97
Pregabalin 150mg capsules 56 £8.50
Pregabalin 200mg capsules 84 £12.00
Pregabalin 225mg capsules 56 £8.95
Pregabalin 25mg capsules 56 £7.50
Pregabalin 300mg capsules 56 £8.96
Pregabalin 50mg capsules 84 £11.70
Pregabalin 75mg capsules 56 £7.75
Quetiapine 100mg tablets 60 £70.00
Quetiapine 150mg tablets 60 £72.00
Quetiapine 200mg tablets 60 £71.00
Quetiapine 25mg tablets 60 £24.95
Quetiapine 300mg tablets 60 £136.00
Rasagiline 1mg tablets 28 £13.95
Rizatriptan 10mg tablets 3 £13.37
Sodium Cromoglicate 2% eye drops 13.5ml £9.72
Sumatriptan 100mg tablets 6 £22.00
Sumatriptan 50mg tablets 6 £15.00
Terbinafine 250mg tablets 14 £12.49
Tramadol 50mg capsules 30 £1.20
Tramadol 50mg capsules 100 £3.20
Tranexamic Acid 500mg tablets 60 £14.30
Trimethoprim 50mg/5ml oral suspension SF 100ml £3.99
Valsartan 160mg capsules 28 £12.00
Valsartan 80mg capsules 28 £9.99
Vitamin B Co Strong tablets 28 £6.19
Zolmitriptan 2.5mg orodispersible tablets sugar free 6 £18.27
Zolmitriptan 2.5mg tablets 6 £18.00

Please note that PSNC cannot provide details of generic products that are suspected of being affected by generic supply problems unless and until the Department of Health grants a concession. No additional endorsements are required for price concessions. The price concession only applies to the month that it is granted.

If you have problems obtaining a Part VIII product or problems obtaining the product at the set Drug Tariff price, please report the issue to PSNC using the online feedback form on the PSNC Website.

If you have been able to source the product, please provide full details of the supplier and price paid. PSNC will investigate the extent of the problem and if appropriate discuss the issue with the Department of Health.

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