The Specials Tariff is important to ensure confidence and best practice within the sector


In response to an article in The Daily Telegraph June 22nd, the APSM, Association of Pharmaceutical Specials Manufacturers, has spoken out in support of the Specials Tariff, a system that was introduced by the DOH to create a more transparent process for reimbursing specials, linking the cost of reimbursement to the cost of the product, while providing value for money for the NHS. 
Since the introduction of the Specials Tariff in November 2011, the average cost per item has fallen by 25% (from £180 to £135).  
The Specials Tariff was set using a system similar to that used for the calculation of the price of category M generics.  Under a memorandum of understanding (MOU), licensed specials manufacturers provided sales information to the DOH, which has been used to set a reimbursement price that includes margin.    
These prices take into the account the high quality manufacturing processes that must be adhered to by companies wishing to supply products listed on the Specials Tariff – all of whom must hold an MHRA licence and follow best practice such as quality assurance processes, batch testing, product labelling, adverse event reporting and customer support lines.   
The DOH used different sources to set the Tariff and we (the APSM) are confident that the Specials Tariff prices allow us to provide a high quality product at a fair price whilst keeping patient safety as our priority.   
The initial Specials Tariff list was relatively small but captured the majority of high cost, high volume specials prescribed. The list and the reimbursement prices of the products listed are reviewed regularly and the list has now expanded to 141 products.
The Daily Telegraph reported up to 20,000 unregulated items, but in reality the top 500 specials (by value) account for 96% of all spend.  Almost half of the top 100 specials (by value) are now on The Specials Tariff and there is a process in place to regularly review these in two ways. A rolling quarterly review reassesses prices and updates as appropriate and a six monthly review examines prescribing data to allow products to enter and exit the list.
A survey of pharmacists by the APSM this month shows that 64.4% (agree to strongly agree) are more confident dispensing now a Specials Tariff is in place - an increase from 47.8% in the same poll last year.  A similar survey of GPs shows a shift in confidence from 33% in 2012 to 41% in 2013.
We believe the Specials Tariff has been successful in reducing cost and improving transparency within the specials sector and we will continue to work with the DOH to ensure that confidence in this system is maintained.   



Sources:  NHS BSA
Survey of 200 pharmacists and 200 GPs conducted by Opinion Health on behalf of APSM

For more information please contact:  lyn@wallacehcl.com





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