One year after the Tariff – Specials sector gains strength through quality

But specials scripts are not increasing says APSM

One year after the introduction of the Specials Tariff, the APSM (Association of Pharmaceutical Specials Manufacturers) reports that the Tariff appears to have been successful in restoring confidence to the market, but says there is little evidence to date that this is having a positive impact on prescribing levels.

A poll of pharmacists by Opinion Health showed that almost half are happier prescribing specials now that a tariff is in place.  But although latest figures from NHS Prescription Services show a gradual increase in the number of specials ordered month-on-month from November to June, the APSM challenges any interpretation that this is a sign of growth.  It is more likely a reflection of improved reporting by pharmacists and the DOH where prior to the Tariff, special scripts were frequently classified as ‘other’ rather than ‘unlicensed medicines’. 

Says Sharon Griffiths, Vice Chair of the APSM, “Our feedback from our members and the industry as a whole is that the specials market is static at best.  We think this is partly due to reorganisation and adjustment in the market as some pharmacists review their purchasing arrangements post-Tariff.”

“However, we are concerned that this could a sign of other factors at play, notably the continued pressure by PCTs to reduce prescribing of specials.  The NHS data also shows a corresponding decrease in the overall cost of specials over the same time period.  This is in part a reflection of the effectiveness of the tariff in levelling off the pricing of specials but it could also signal a reduction in specials prescribing overall.”   Research by the APSM suggests that as many of 40% of pharmacists have been asked to reduce specials dispensing, whilst more than 50% of GPs had been requested to reduce or review prescribing patterns. 

If PCTs continue to exert pressure to reduce prescribing, the end result could be that the patient suffers because they do not receive the medication they need. 

At the moment the signs are that prescribers recognise the vital importance of specials and are keeping patient need as their top priority.   A survey amongst 200 GP’s showed that 54% had been asked by their PCT to reduce specials prescribing – although not all had decided to act on this.

Pharmacists are telling APSM members that they are also being asked to review spend on specials, but most don’t want to shop around as they are concerned that this can be time consuming and potentially risky.  Many are dispensing less than 10 specials prescriptions a month and would prefer the consistency of a specials supplier or suppliers that they know and trust.

For this reason, the APSM believes that patient need and quality is as important as overall cost and this will ensure a sustainable and high quality specials sector that can continue to invest in the infrastructure needed to ensure patient safety remains a priority.

The APSM is embarking on new educational and promotional initiatives over the coming months, working with stakeholder groups to ensure that the knowledge and tools are available to help all those involved in specials from prescriber to patient.

The APSM has recently launched a fact sheet ‘what to look for in a specials manufacturer’. 

At the same time, membership of the APSM is stronger than ever and the commitment of members is to continue to share best practice and invest in manufacturing and quality processes.  Members as a whole have invested in excess of £150m in equipment and facilities across their UK manufacturing plants in recent years.