The pharmacy minister has acknowledged that there are issues with the reimbursement system for specials that are not listed in the drug tariff.
According to the NHS Business Services Authority (NHSBSA), prescriptions for specials – also known as unlicensed medicinal products – that are not listed in the drug tariff are paid depending on ‘how they have been sourced’.
Responding to a question in Parliament on 28 June, Winchester MP Steve Brine said the Government recognised the ‘issues’ with reimbursement for specials, which he said are not regulated by a statutory scheme to regulate the cost of branded medicines.
The Government is developing proposals to remedy the issue, he added.
‘Not a vehicle for specials’ prices’
Mr Brine continued: ‘The statutory scheme regulates the cost of branded medicines. It is not the vehicle for setting reimbursement prices for special medicinal products – also known as “specials”.
‘However, we recognise that there are issues with the reimbursement arrangements for specials which do not have a reimbursement price listed in the drug tariff.
‘The powers in the Health Service Medical Supplies (Costs) Act 2017 enable the Government to reimburse for specials dispensed in primary care in different ways such as considering quotes of suppliers and not reimbursing pharmacies at all if, for example, they have been provided the medicine by a central service.
‘We are developing proposals, which will be subject to consultation with relevant stakeholders.’
Specials prices are based on information submitted by manufacturers with Medicine and Healthcare products Regulatory Agency (MHRA) specials licenses.
According to the Pharmaceutical Negotiating Committee (PSNC), prices are determined as below:
- If an unlicensed special or import listed in the drug tariff is prescribed, the contractor is reimbursed the set tariff price, no matter how the product is sourced
- If an unlicensed special not listed in the drug tariff is obtained under a manufacturer holding a MHRA specials licence, the contractor endorses the price on the prescription form
- If the unlicensed special is not listed in the drug tariff under the section 10 exemption of the Medicines Act 1968, the contractor is reimbursed for the cost of the product’s ingredients