Friday, 1 November 2013


A November boost and why it’s good for payors, patients and APSM members

29th October 2013. In the latest (November) update to the Specials Tariff 51 new products have been added, bringing the total number of specials regulated under the Tariff to 188.  The addition was widely anticipated by the APSM members and includes both larger prescribed specials as well as smaller volume specials.

Although there are potentially thousands of different formulations of specials, the top 500 (by value) account for 96% of all spend.  It is these 500 where much of the focus has been and now around half of the Top 100 specials are captured in the Tariff.   Amongst the latest round of changes more than half are in the Top 500 and represent around 3,500 prescriptions each quarter. 

Says the APSM, “Creating a workable Tariff for specials was not an easy process. Partly due to the sheer variety and number of formulations involved, but also because of the highly bespoke nature of production and the importance of responding quickly to patient need.”

“Two years on, we feel that the Tariff has achieved this and allows us to provide a high quality product at a fair price whilst keeping patient safety as our priority.”  

At the same time, customer confidence has improved considerably. A survey of pharmacists by the APSM this summer showed that 63.7% (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 showed a shift in confidence from 33% in 2012 to 41% in 2013.

Since the introduction of the Specials Tariff in November 2011, the average cost per item has fallen by 25% (from £180 to £135).   The APSM acknowledge that some pharmacists are still under pressure to reduce spending on specials, but this is by no means unique to their sector.  Says the APSM, “Every single area of spend within the NHS has come under scrutiny in recent years and we are just a part of that process.  It is up to us to continue to demonstrate our value by delivering a high quality product even through difficult economic times.”  

“Over the last 2 years, APSM members have continued to invest £millions in process, facilities and infrastructure to ensure we have a specials sector that is unparalleled compared with most other countries in the world.”


The price set for specials takes 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 including feedback from APSM and its members.

Quality Commitment from a licenced Specials Manufacturer

  • Premises inspected by MHRA for compliance to GMP (good manufacturing practice)
  • A pharmaceutical quality assurance system, e.g. pharmacopoeia monograph, stability tests
  • Batch testing / certificates of analysis provided
  • Certificates of compliance (for single products)
  • Best practice labelling
  • Customer support line
  • Unique product codes on all products
  • Innovation – e.g. clearer patient labelling
  • Yellow card adverse event reporting
  • Investment in facilities for medicines manufacture

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