Pharmacy management and business Flashcards
who does the responsibility of profitability of community pharmacy lie with?
entirely the pharmacy owners- NOT NHS. private business with a contract with the NHS
What do you need the NHS contract for?
NHS services
how is profit made in pharmacy?
payment for services- NMS, local services
dispensing Rx
quality payments
cost containment
accurate remuneration and reimbursements- lots of money lost with inaccurate claims
what remuneration
payment for NHS services
global sum for community pharmacy
who determines remuneration?
department of health and social care
what is reimbursement?
arrangements for repayment of costs of medicines dispensed against NHS prescriptions, determined by the DH
where are the prices for the drugs
drug tariff
who deals with the reimbursement?
NHSBSA
what do the NHSBSA not do? who does this?
actually pay
CCG
what is the price at which community pharmacy is reimbursed for dispensing NHS medicines? for branded products?
the manufacturers NHS list price- manufacturers can set their own price
what is the price at which community pharmacy is reimbursed for dispensing NHS medicines? for generic products?
drug tariff published by NHSBSA
what is the price at which GP prescribing budgets are charged for NHS prescriptions?
same as CP reimbursed for NHS medicines
does NHS reimbursement price paid to CP change for individual products?
its fixed regardless of the actual price the CP paid for It
listed in drug tariff
determined and updated monthly by DH
problems due to stock shortages?
substitution- confusion/ safety issues reduced compliance inconvenience to patient increased pharmacy workload- double dispensing, owings decreased patient satisfaction
what’s parallel importing/ exporting?
trading of medicines within the EU
how does parallel trading arise?
due to price differences between member states
explain the discount deduction scale
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
Equation for discount deduction scale?
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
what does the % discount deduction depend on?
total monthly value of products dispensed
ways CPs try to gain more profit?
bulk purchasing
parallel importing/ exporting
increase level of discount beyond NHS scale (which is reviewed annually)
minimise stock levels
costs involved in running a community pharmacy?
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
hospitals are non profit organisations. TF
TRUE
How do hospitals receive income?
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
what is CQUIN
Commissioning for quality and innovation
get money for reaching CQUIN targets- can make £230,000,000
