Pharmacy management and business

Question 1

who does the responsibility of profitability of community pharmacy lie with?

Answer 1

entirely the pharmacy owners- NOT NHS. private business with a contract with the NHS

Question 2

What do you need the NHS contract for?

Answer 2

NHS services

Question 3

how is profit made in pharmacy?

Answer 3

payment for services- NMS, local services
dispensing Rx
quality payments
cost containment
accurate remuneration and reimbursements- lots of money lost with inaccurate claims

Question 4

what remuneration

Answer 4

payment for NHS services

global sum for community pharmacy

Question 5

who determines remuneration?

Answer 5

department of health and social care

Question 6

what is reimbursement?

Answer 6

arrangements for repayment of costs of medicines dispensed against NHS prescriptions, determined by the DH

Question 7

where are the prices for the drugs

Answer 7

drug tariff

Question 8

who deals with the reimbursement?

Answer 8

NHSBSA

Question 9

what do the NHSBSA not do? who does this?

Answer 9

actually pay

CCG

Question 10

what is the price at which community pharmacy is reimbursed for dispensing NHS medicines? for branded products?

Answer 10

the manufacturers NHS list price- manufacturers can set their own price

Question 11

what is the price at which community pharmacy is reimbursed for dispensing NHS medicines? for generic products?

Answer 11

drug tariff published by NHSBSA

Question 12

what is the price at which GP prescribing budgets are charged for NHS prescriptions?

Answer 12

same as CP reimbursed for NHS medicines

Question 13

does NHS reimbursement price paid to CP change for individual products?

Answer 13

its fixed regardless of the actual price the CP paid for It
listed in drug tariff
determined and updated monthly by DH

Question 14

problems due to stock shortages?

Answer 14

substitution- confusion/ safety issues
reduced compliance 
inconvenience to patient 
increased pharmacy workload- double dispensing, owings
decreased patient satisfaction

Question 15

what’s parallel importing/ exporting?

Answer 15

trading of medicines within the EU

Question 16

how does parallel trading arise?

Answer 16

due to price differences between member states

Question 17

explain the discount deduction scale

Answer 17

community pharmacies buy medicines at less than list price through wholesaler discounts etc
DH estimates differences between actual costs and list prices
applies discount deduction scale to the reimbursement at the end of the month- CLAWBACK

Question 18

Equation for discount deduction scale?

Answer 18

total cost of branded products dispensed (at NHS list price) + total cost of generic products dispensed (at drug tariff price)

TO ALL THIS
minus- appropriate % discount deduction

Question 19

what does the % discount deduction depend on?

Answer 19

total monthly value of products dispensed

Question 20

ways CPs try to gain more profit?

Answer 20

bulk purchasing
parallel importing/ exporting
increase level of discount beyond NHS scale (which is reviewed annually)
minimise stock levels

Question 21

costs involved in running a community pharmacy?

Answer 21

staff- training 
rent 
utility bills 
insurance 
IT systems 
equipment 
stock loss- out of date 
incorrect claims 
collection and delivery services not paid for by NHS and is free to patients

Question 22

hospitals are non profit organisations. TF

Answer 22

TRUE

Question 23

How do hospitals receive income?

Answer 23

payment by national tariff

• NHS decides prices for a service e.g. hip replacement
• monitor sets the price e.g. for everything, nurses, surgeon, equipment etc
• mechanism for reimbursing hospitals for their activities
• tariff contained fixed prices that reflect national average prices for hospital procedures

Question 24

what is CQUIN

Answer 24

Commissioning for quality and innovation

get money for reaching CQUIN targets- can make £230,000,000