The government has carried out a consultation on the subject, but the proposed new scheme remains controversial, with “much work to be done and many questions to be answered,” according to the Association of the British Pharmaceutical Industry. Reductions in list prices could put security of supply under strain, PSNC has warned, which is why it wants manufacturers to pay ‘valuebased rebates’ to the NHS. Changes in the medicines supply chain have led to unacceptable waste and inefficiency, said Sue Sharpe, PSNC chief executive. To avoid this in future, she suggested that pricing arrangements for branded medicines must take supply chain costs into account, and incentivise the efficient supply of medicines to pharmacies.

Wholesalers are concerned that value based pricing could lead to a “postcode lottery” pricing system, increasing the chances of medicines trading and a resultant two tier system. This could reduce the supply of medicines, while increasing the cost of other medicines, so that the system fails to deliver value for the NHS.