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2/17/2012
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IPF chief laments “ridiculous” payment system which endangers pharmacy
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Fin McCaul, the chairman of the IPF.
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The rise in 100-hour pharmacies, dwindling numbers of prescriptions and a poor remuneration system will make independent pharmacy unsustainable, Fin McCaul, the chairman of the IPF, warned the Sigma Conference in Thailand.
McCaul pointed out that pharmacists have provided significant efficiency savings over the last 10 years through increasing volumes of prescriptions at cost efficient levels but insisted those are reducing in the wake of control of entry regulations and other factors which continue to cripple the profession.
“Be warned and be very, very wary. Scripts have been growing and pharmacy has provided huge amounts of efficiency savings for the last 10 years, with a 60% growth in script numbers, but actually, pharmacy has delivered that at very reasonable cost increases." he said.
“But the script volume stopped growing. At a national level, it’s tailing off. At a local level, in many areas, it’s going down.
"And it’s going down because of the control of entry and because of changes in prescribing habits. Doctors are becoming much more careful of what’s going on. They’re also extending periods of treatments.
"In the south, 84 days is the norm but up north, we’re very much in a 28-day prescribing pattern. That’s drifted out to 56 in 84 days. This is going to impact quite hard on (pharmacists) as the year goes on.
“Couple that with what’s going on with the control of entry and the growth in the number of pharmacies. Nationally, we’ve only had about a 12 and-a-half per cent increase, 1,200 contracts since 2007 to 2011.
“But if we look at some areas in particular (there has been as much as a 36% rise in contracts.) How can contractors and PCTs at a local level manage that and ensure quality in safety for patients? That’s not sustainable.”
McCaul lamented a payment system within pharmacy which he described as “absolutely ridiculous.” He added: “Our payment system is not working. We have a huge number of discrepancies in terms of what’s discountable and what’s not discountable. We don’t have a payment mechanism that we can trust.
“Can anybody here, hand on heart, stand up and say they’ve been paid what they’ve dispensed for? No. In this day and age that is absolutely ridiculous. From the supply aspect, we’ve actually got 44 different Direct to Pharmacy schemes and discounts to make. None of this is actually working for us.”
He also expressed his fear that the government’s Category M claw-back, due in October, will heap more pressure on pharmacies. Indeed, many independents have already considered closing.
“I’ve spoken to many contractors who don’t (have lots of money) but they feel things are ok. I want to warn you now, save that money because when Category M comes, possibly in April but most likely in October, it’s going to be quite large and I don’t think we’re making the money the government is going to claw back.”
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