Page 13 - P4304.1-V104_PS Magazine - December 24

So how does this link in with concessions? PRESCRIPTION D
Well, understanding an endorsing a concession line is a waste
of ink is the first learning. Any brands or manufacturers written
in the margin will not be acknowledged so there is just no point
spending valuable time doing this.
The second learning is that if you select a brand which has
an indicative cost greater than the concession price then this Tramadol 150mg MR
(morning healthcare Ltd)
is the price you will be paid , BUT this must be the brand you Capsules
dispense as it is now a branded prescription not a generic. One to be taken twice a day
As concession prices are often not published until right at the x60
end of the month, first guessing branding a prescription is a
bit of a gamble and remember a brand purchased at the brand
price will still incur a loss of 11.18% (clawback) unless there is a
manufacturers scheme available.
Now I know at this point you are all thinking I am missing the
point, but I am not.
Let’s talk Apixaban as this seems to be the drug that has
sparked all the conversations.
Apixaban suffered from a shortage of supply earlier this year
and as there are currently limited suppliers of this generic you were all probably being supplied
the Sandoz brand.
Sandoz brand of Apixaban has an NHS price of in excess of £50. Here lay the ‘opportunity’.
So, let’s go through the scenario.
The table below analyses the financials for you as a PSUK member.

APIXABAN ANALYSIS July – September 2024
APM price (after
Month DT Price Concession price Margin
6% loyalty)

2.5mg 5mg 2.5mg 5mg 2.5mg 5mg 2.5mg 5mg
July £2.55 £2.59 £3.89 £3.74 £2.22 £2.00 43% 47%

August £2.48 £2.21 £14.99 £14.99 £12.82 £12.82 14% 14%

September £2.48 £2.21 £14.99 £13.98 £8.36 £8.36 44% 39%

So the analysis shows you remained in profit on Apixaban with no intervention from yourselves.
For me that is a good result but of course you did have a choice. You could have branded all your
prescriptions to Sandoz along with the prescribers’ signature (as this is a prescribing change
and the prescriber takes responsibility for that prescribing decision). Right enough – the only
brand available was Sandoz brand and you probably were supplying Sandoz brand but you didn’t
pay the Sandoz list price, so is this the right thing to do? It is your choice though and hence I
want you to understand how these decisions should be made with the correct understanding.
One other point which I think is useful to share. Your ghost branding activity is not invisible.
Open prescribing drills down to practice level on where practices are costing the NHS more with
regard to unnecessary ghost brand prescribing.

13
or call us on 01904 558 350 Concessions Myth Buster | PS Magazine 13

P4304.1-V104_PS Magazine - December 24.indd 13
14/11/2024 16:04:52
P4304.1-V104_PS Magazine - December 24.indd 13 14/11/2024 16:04:52