19 April 2011

Community Pharmacy and the World of GP Commissioning - Prescribing Budgets

In previous articles in this series, we explored the consortia GP was, reason for which they were trained and we examined the relationship between the community pharmacy and primary care trusts (PCT).This article is the third in the series and explores the theme of "fix budgets" and how this has affected the community pharmacy.A budget of prescription is a sum of money established by the local health trust to pay the costs of drugs and devices. Each GP practice has an amount of money that it can use to buy drugs and devices for their patients. Current most prescribers budgets are "theoretical". This means that the real money is normally more often still with the PCT, but the GP practice is given a theoretical sum that he should try to join.While we enter the world of the GP commissioning, real money will rest with groups of practices GP (called consortia GP) to determine the best way to distribute the sum to the practices of members.Prescribe budgets run into several million pounds. For example, a consortium of approximately 20 practices can expect a budget limitation of anywhere between £ 20 m-£ 30 m. beyond this, there are a number of factors that affect the budget of the prescription. (Parmi:_1) changes in health need in the Area2) economic climate3) drug cost inflation4) expiration of the patent drugs5) local deprivation6) local prescribe General habitsIn, there is enormous pressure on the ECP and GP practices to reduce the cost of their budgets prescribers recently. Even a 1% savings in the budget of the consortium drug could save hundreds of thousands of books that could be reinvested in patient care.Up here, everything is going well - but what that this has to do with the community pharmacy?In 2005, the contractual framework of the community pharmacy (you can also known as the pharmacy contract) has been implemented at the national level. The contract put in place a new system of reimbursement, which means that the profits made on purchases of medicines by pharmacies are limited to a fixed amount using a system called "class M".This means that if the community pharmacists too profit in one year, it will be taken off the coast of the following year, profits and vice versa. The mechanism for this was the artificial price inflation (or deflation) a basket of some drugs to offset above or below funding - "class M".He soon realized that there are differences in the system. For example, by 2010, if a GP to prescribe "inhaler salbutamol" the pharmacist would be paid approximately £ 3 for the prescription and the GP for the equivalent amount from the budget of the prescription. However, if the GP prescribing the exact product by the mark "ventolin" inhaler pharmacist would be reimbursed to about £ 1.50 and the GP charged at the rate reduced on their budget. A number of different instances of existence of the same kinds of differences. This particular instance is known as "labelled prescribe."Another example is "switching" of drugs with similar - although chemical entities different. For example, have attempted to sustained change of atorvastatin to simvastatin patients. The savings that can be made by this single switch can be enormous, but may not be suitable for everyone.If you happen to be a pharmacist in a region where the GPs have been "hot" on these changes your income may be significantly different in a pharmacy equivalent in an area where GPs have been tune not so much in with prescription costs. This has led to regional differences in the income of the pharmacy, even if the total amount distributed to the national level is a level of play.This is a battle between representative groups of Pharmacy and the Government to ensure that the remuneration of the pharmacy is fairly distributed.In the next article in the series, we will explore the issues related to the "review of drugs" and how recent developments in the contract of the pharmacy in the course of the last years 5 sometimes lead some GPs will benefit from the issue of drug use reviews (walls) in community pharmacy.