NHS England excludes GPs from cheaper drug deals due to ‘confidentiality concerns’

GPs have been excluded from an agreement on access to cheaper medicines due to concerns about “sharing confidential information” with primary care, NHS England says.

In a letter published last week, NHS England outlined its position on which providers can access the Medicines Procurement and Supply Chain (MPSC) framework, which offers “confidential prices” for certain medicines for the treatment of NHS patients.

In order to access the framework’s drug prices, organizations must only use the drugs for NHS patients and keep the prices confidential.

Whereas access was previously granted or refused on a case-by-case basis, NHSE’s official position is now that hospital trusts, mental health organizations and ambulance providers can access the framework, but primary care and private providers cannot.

NHS England said this position was developed in consultation with various stakeholders, including the Association of British Pharmaceutical Industry (ABPI) and the primary care team within NHS England.

The rationale for excluding healthcare from this pharmaceutical agreement is that “no stakeholder supported universal access to MPSC framework prices in healthcare”.

“Stakeholders were concerned about sharing confidential information about prices through framework agreements with health care managers, doctors and pharmacists,” NHS England said.

The policy statement, which was first published in March and took effect from January this year, also said GPs could misunderstand drug prices which would “create unintended consequences”.

According to the NHSE, this is because “models of procurement for primary and secondary care are very different”.

“For example, a GP may believe that generics for primary care are more cost-effective in secondary care, but this may be because the primary care price they can see is the drug tariff, which includes discretion to operate community pharmacies, as well as distribution margins ,” said the sheriff.

NHS England said it “will keep this situation under review”.

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UK Medical Association spokesman Dr Steve Taylor said it “seems odd” that primary care would be excluded from the framework as it already has a “broad access group”.

He said that “GPs involved in dispensary or PCN pathways may need or want access”, but in general GPs do not contribute much to drug costs.

Dr Taylor told Pulse: “Generally speaking, GPs have little to do with costs other than prescribing the cheaper option that is already set. However, it would be useful to have free access in light of the lack of a check.’

Dr Richard West, chairman of the medical association’s board, told Pulse that if GPs could access “cheaper prices” it would ultimately “save the NHS money”.

He said: “The dispensary agreement provides that dispensaries can receive an 11.18% discount on drug prices for all drugs. So a cheaper price would be very helpful as about 30% of strategies lose on purchases.’

The deal between the government and the pharmaceutical industry, which includes generics and brand names, is aimed at “efficiency” within the NHS.

The MPSC administers several framework agreements for:

• generics, including newly available generics used in hospitals;
• brand-name drugs, biologics, and IV fluids;
• blood products, dose-dependent chemotherapy and influenza vaccine for hospitals;
• home care.

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