APPENDIX 10
Memorandum by South Peterborough NHS Primary
Care Group (GD13)
1. INTRODUCTION
1.1 South Peterborough Primary Care Group
has responsibility for prescribing by General Practitioners for
a population of 90,000 in the South Peterborough area including
Yaxley, Oundle, Wansford, Whittlesey and Thorney. There are 12
practices including seven dispensing practices.
1.2 The Prescribing Manager for the Primary
Care Group has been working with the General Practitioners and
Finance colleagues to identify the reasons for the increased expenditure
in the drug budget observed particularly in the quarter April
to June 1999.
2. IMPACT OF
THE SUPPLY
SHORTAGES FOR
GENERICS
2.1 Drugs which have been in short supply
resulting in variable prices have been included in Category D,
a special category which will ensure that they are priced correctly
according to the manufacturer and pack size. They are not reimbursed
to dispensing pharmacists and GPs at basic list price.
2.2 In October 1999, the PPA issued a list
of the drugs included in Category D for each month from March
1998 to September 1999. This list was previously unavailable.
2.3 The PCG has carried out an analysis
of the cost of Category D drugs for the quarter from April to
June 1999 compared to the same quarter in 1998. The analysis showed
that the cost of category D drugs had increased by approximately
2 per cent during this period.
2.4 If the increase were projected to the
end of March 2000, it would amount to approximately £130,000
out of a budget of £7.5 million.
2.5 This increased cost was not accounted
for by an increase in the number of prescriptions dispensed during
the period.
2.6 The analysis is preliminary and does
not account for drugs that were not available as generics and
were dispensed and reimbursed as brands. This particularly applies
to prescriptions dispensed by dispensing doctors.
2.7 The information available from the PPA
fails to inform the PCG of the reasons for drugs being added to
the Category D list. The analysis of the impact of Category D
drugs cannot therefore take account of increased costs associated
with new patient packs and general increases in the price of generic
drugs unless the drugs were listed as category D.
2.8 The PPA has indicated that the number
of drugs listed in category D has risen from 138 in June 1999
to 190 by September 1999. The late receipt of monthly prescribing
figures and information from the PPA is delaying the ability of
the PCG to quantify the extent of the problem and take appropriate
action to address the escalating costs.
3. RECOMMENDATIONS
TO THE
HEALTH COMMITTEE
3.1 Health Authorities and Primary Care
Groups should be given information on the timescale and anticipated
impact of the supply problem for generic drugs.
3.2 Additional funding should be made available
to Health Authorities and Primary Care Groups to meet the current
and anticipated costs of the generic drugs supply problem and
the patient pack initiative.
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