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EXCLUSIVE: Cat M reimbursement prices ‘six months behind true picture’, wholesaler says 

By Léa Legraien

12 Jun 2018

Category M reimbursement prices often reflect medicines prices from six months previously, a major wholesaler has said.

Speaking at our sister event Pharmacy Forward in Birmingham on 10 June, Sigma Pharmaceuticals Plc director Bharat Shah said the Category M system needs an overhaul, as these prices are often ‘six months behind’ in terms of the price pharmacists originally pay for a drug.

His comments come after the Department of Health and Social Care (DHSC) announced it will recoup £86m in concessionary prices ‘overpayment’ from pharmacists last week.


‘Six months behind’


Mr Shah continued: ‘At the time [in 2007, when Category M was introduced], it was a good solution to [replace] Category D.

‘The problem with Category M is that it’s six months behind the true picture. Category M [prices] that will be announced on 1 July will reflect funding in January.

‘Sometimes you get some drugs at 60p a pack and some for £10, which you hardly dispense. There should be a formula to have minimum price offers. It’s ridiculous to have a life saving drug at 60p a pack when a chocolate bar can cost 60p.’


Solving the crisis


In July, a new regulation called health service products provisional disclosure of information will come into force. Mr Shah argued that it might solve problems with the supply chain as the DHSC will have powers to get data from wholesalers within 48 hours about their stock, who they sell to and how much stock is sold at.

‘If the DHSC get that information, then it can give the correct reimbursement price’, Mr Shah added.

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