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The liquid forms of common medicines are often forgotten about when the focus is on their big sister the solid dose forms. However, liquid forms of common generics have been shown
to maintain high prices for long periods because there is less competition between manufacturers for these more niche products.
One of the main objectives of the Windsor Framework is to provide a permanent solution to safeguarding the supply and access of medicines into Northern Ireland. We can see from our historical data that there has been a steady decline of the number of products that are available in Northern Ireland, will the trend be reversed once the new Green Lane is open?
With last week’s DHSC SSP announcements hitting Paracetamol 240g Suppositories, we’ve taken a look at long term pricing trends, and the most recent data in our Live system.
The prices pharmacists and dispensing doctors pay for antibiotics have risen in recent months amidst shortages and concessions. The product which rose the most between Jan 2022 and Jan 2023 was Co-Amoxiclav Tabs 500mg/125mg 21 which rose from an average price of £1.39 in Jan 2022 to £8.50 in Jan 2023, an increase of 512%.
VPAS continues to be one of the top priorities for the UK Pharma Industry. A week or so ago, we undertook some analysis on Originator Brands, assessing profitability and UK market attractiveness. If the rebate is unsustainable, and results in loss making products for manufacturers, we could see withdrawal from the market, driving supply challenges and increases in market pricing.
Although the aim of the VPAS scheme is to support innovation and better patient outcomes, alongside keeping a lid on the NHS drug budget, could the scheme actually be doing the opposite? If the rebate is unsustainable, and results in loss making products for manufacturers, we could see withdrawal from the market, driving supply challenges and increases in market pricing.
We’ve all read the latest from NICE on the revised recommendations for the use of Statins to reduce the risk of cardiovascular events. It’s been widely shared that there are currently 10 million eligible patients in the UK, and this could rise to as many as 25 million with the new advice. WaveData’s ScriptMap service tells us that a little over 95 million prescriptions were issued for Statins in the last full year of available data, so we could be looking at almost 240 million prescriptions under the new guidelines.
With the recent increase in bacterial infections and the shortage of Strep A antibiotic drugs such as penicillin and amoxicillin, Wavedata thought it worth looking at all the antibiotics used in the community in the UK to see which have experienced the greatest price rises.
Atorvastatin Tabs 20mg 28 was launched in the UK in May 2012 and since then the price has declined gradually. However, there have been some price rises along the way which have been very noticeable. The first of these happened in 2013, the second in 2020 and the third may be happening now.
Branded Procoralan first appeared on price lists sent to pharmacists and dispensing doctors in the UK in February 2008, followed 5 months later in July 2008 by parallel imported versions.
Branded Ezetrol first appeared on price lists sent to pharmacists and dispensing doctors in the UK in June 2004, accompanied in the same month by the first evidence of parallel imports.
Branded Cialis was launched in the UK March 2003, which was followed in July 2004, 16 months later, by the appearance of the first parallel import. The number of monthly offers for the PI peaked in October 2008 at 137 market offers in a single month.
Branded Crestor was launched in the UK June 2003, and this was followed by the appearance of the first parallel import just one month later. The number of market offers in price lists for parallel imported versions of Crestor follows a typical ‘whale’s back’, with a rapid introduction in 2004 and 2005, an erratic build up to a peak in 2011, and a gradual decline toward 2022.
Infections with the Group A Streptococcus (GAS ) are very common at the moment and can cause Scarlet Fever. This mainly affects children and Amoxicillin is the most common treatment. However, the availability of and prices of Amoxicillin products for pharmacies and dispensing doctors has been put under pressure by this outbreak.
Since price concessions were first granted in 2003, the number has been gradually increasing each month. During 2022 the number granted has equalled or exceeded 100 in 8 months out of 11. Additionally we have noticed that products likely to be granted concessions have very narrow pharmacy profit margins. This makes sense since it is the PSNC, representing pharmacies, which negotiates concession with the department of health DHSC. However, this increasing trend highlights a serious problem with the way these products are reimbursed. This is done using the drug tariff, and in order to supply good value for tax payers some products have their tariff squeezed as much as possible. This may be great for tax payers in the short term, but it’s not great for pharmacies, wholesalers and manufacturers. Pharmacies struggle to make a profit, despite the concession, as often it’s not high enough and they spend inordinate amounts of time chasing shortages.
Do combined, multi constituent products which contain more than one chemical, such as Levodopa + Carbidopa + Entacapone Tabs, suffer slower price decay after generic launch than normal single constituent products? It would make sense to assume so as we have previously found that products such as liquids, devices , creams and ointments all decay more slowly than solid dose generic products.
Are products which have received concessions (NCSOs) from the department of health and social care (DHSC) less profitable than non-concession receiving products? After Viatris’ round table on branded generics at the Palace of Westminster earlier this month we decided to investigate this, in the expectation of seeing a lower profitability for concession products. So we divided all the generics we have market prices for into two groups, those which had received concessions and those which had not, and compared the profitability of each. We used the English drug tariff and the average market price rather than the concession price to calculate the normal monthly profit, as we wanted to see if the drug tariff was at fault in some way. We expected to see a graph showing that non-concession products were more profitable than the concession products, and supposed that the graph of profit over time would feature two lines. The higher would be the non-concession products with a higher profit, and the lower would be the concession NCSO products with less profit. This might have told us that the drug tariff pricing for concession products was too aggressive and should be relaxed.
Where pharmacies are unable to purchase generic products at prices less than the drug tariff the DHSC sets price concessions in consultation with the PSNC using information derived from manufacturers and wholesalers. The number of price concessions granted in each month has been growing since they were introduced in 2003. The majority of the growth has occurred since 2013, and major spikes in the number of monthly concessions have occurred in Nov 2017, Feb 2019, May 2020 and Sept 2022.
In the UK a major part of the branded medicine supply is provided by manufacturers outside the UK. These products are made for use in the EU but imported into the UK as parallel Imports (PIs) appear in the market within a couple of years of brand launch, and gradually replace the UK supplied brand until they in their turn are replaced by generics. We have previously seen that the exchange rate is a key driver of import prices, but we thought we’d have another look at this and at market competition. As before we saw that the exchange rate is a driver of the market price of Abilify Tabs 10mg 28, but the relationship does not seem to work before March 2015.
Branded generics as well as originator brands are included in the VPAS (The Voluntary Scheme for Branded Medicines Pricing and Access) reimbursement scheme. This is agreed by Government, NHS and industry to ensure the consistent and affordable supply of branded medicines to UK patients. VPAS caps spending on branded medicines, but if there is an overspend, the additional amount is collected as a rebate from pharmaceutical companies. This rebate has increased over the last few years starting at 3.74% in 2014 and reaching 15% in 2022. However, the rebate being discussed for 2023 is forecast to be over 30%.