The clinical decision must always come first, the patient must receive treatment according to their clinical need and prescribing decisions always need to be based on clinical need. In my experience of working with dispensing doctors for over twenty five years, it is generally accepted that for patients on a modified release medicine, continuity of a specific manufacturer “brand” of the medicine should be dispensed to the patient each time.
In a dispensing practice this can lead to opportunities to benefit the patient by giving them a continuous supply of medicine, which is the same brand each month, and ensure an income supply for the dispensary.
For example, where the Drug Tariff reimbursement price is based on the original brand, there may be newer manufacturers who have come into the market with a lower NHS list price and may even offer a discount to dispensing doctors.
This is how it works, lets use some round numbers to make it as simple as possible.
The Drug Tariff price for modified release product A is £20.00 per pack.
The NHS List price for a branded version of modified release product A is £15.00 per pack.
The actual purchase price of branded version of modified release product A is £10.00 per pack.
So where the prescription is written generically for modified release product A the default reimbursement price is the Drug Tariff price of £20, but where the branded version has been dispensed, at a purchase price of £10, then the margin on dispensing is £10 less clawback.
The patient gets continuity of supply and the dispensary assures its income stream which in turn funds rural healthcare provision.
Tip of the week – look at your modified release dispensing and prescribing, especially where the purchase price and Drug Tariff prices are high. Check your high volume modified release dispensing as well, target your top five modified release “generics” and work out if there are alternatives to the original brand or the “generic” as supplied by your wholesaler.
For a couple of examples of modified release brands which are priced at well below the Drug Tariff price email me firstname.lastname@example.org and I will send you the details free of charge
For an informal FREE chat about your dispensary profitability just contact me by the above email – always happy to help.