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How generous are branded respiratory manufacturers with discounts?
WaveData conducted a comparison of the average market prices given to accounts (pharmacies and dispensing doctors) by respiratory product manufacturers.
Pharmacy First and Urinary Tract Infections (UTIs)
The newly launched NHS Pharmacy First service recommends that uncomplicated urinary tract infections in women be treated with antibiotics by pharmacies. However, are these critical products profitable for pharmacies to buy and dispense?
How to create a shortage…….
We were chatting about shortages with some peers last week at the HDA conference. This got us playing devil’s advocate, how would we create a shortage?
Firstly, we’d cut the reimbursement price of a commonly used generic product to a fraction of its former value. That would do the trick quite nicely, provided it was done quickly. It might help if this price cut happened just before the CPHI conference which last year was in late October in Barcelona. This would give manufacturers a chance to take the product off their requirements list and for contract manufacturers to remove it from theirs. Then make another even more drastic cut to the reimbursement price shortly after the conference to make sure that any foolishly optimistic manufacturers took it off their lists and incurred legal costs at the same time.
VPAG and Older Medicines
The Department of Health and Social Care DHSC has for many years being receiving a rebate from the manufacturers of branded prescribed drugs. This is intended to keep a cap on the growth in the medicines bill whilst allowing manufacturers to make sufficient profits to keep them supplying the NHS.
Previous schemes have included PPRS (prescription price regulatory scheme) which ran until the end of 2013 and VPAS (voluntary scheme for branded medicines pricing and access) which ran from 2014 till the end of 2023. These were both voluntary, but there are and were statutory schemes which manufacturers are entered into if they do not wish to join a voluntary scheme.
For the 2024 to 2028 VPAG scheme, medicines are classed as older if there is now more than 12 years since the first marketing authorisation for the active substance. These older medicines have two rebates. The first is the 10% basic rebate, and the second is the % top-up which can be up to 25%. Therefore ‘older medicines’ includes both the originator and follow-on branded generic medicines.
Are generics cheaper in England than the three devolved nations?
WaveData’s MD, Charles Joynson looks at generic products sold in England, Scotland, Northern Ireland, and Wales, in August, September and October of this year, focusing in on the top 500 most commonly advertised products. We only included products whihc were available in all four nations for consistency.
Does competition drive lower prices?
Wavedata looked at the average prices of generic products sold to pharmacies and dispensing doctors between August and October 2023 and compared this with the number of price list offers for the same products in the same time period.
Typical and atypical long term pricing after loss of exclusivity
The first generic versions of Zonisamide Caps 25mg 14 were launched after loss of exclusivity in November 2015. However, in the run-up to this, the prices being offered to pharmacists and dispensing doctors for the brand declined from about £8.00 to about £7.40. This may be because of parallel import competition against the UK brand.
Eplerenone Tabs unstable long term pricing
Eplerenone Tabs were launched in September 2014 after the loss of exclusivity of Pfizer’s Inspra brand. Eplerenone is one of those products which is subject to regular price bounces, concessions and shortages. Each of the two packs has experienced three price bounces and three concessions over the last 10 years.
Are concessions and shortages caused by the DHSC?
It would seem sensible to assume that profitable products are less likely to suffer shortages, concessions and price spikes than products where profit is hard to come by. Charles Joynson, WaveData MD, compared the reimbursement price and the average market price for all the products in the English drug tariff over the last 10 years.
Dispensing Doctor Price Rises
When we compare the average prices paid by pharmacies and Dispensing Doctors for their medical supplies, we see that the pharmacy costs have not risen appreciably, thought dispensing doctor have done exactly the opposite.
What’s the future for my brand post loss of exclusivity (LOE)?
Charles Joynson, WaveData MD, puts a spotlight on Lustral Tabs as we explore the product lifecycle post LOE.
Before generics were launched in November 2005 there was a high degree of similarity between the price of the UK and PI (parallel import) packs of Lustral Tabs 50mg 28. However, as soon as generics were launched the market became much more erratic.
A closer look at Tramadol Caps 50mg 100
With the MAX market price being almost 3 times higher than the MIN market price, we thought we’d take a closer look at Tramadol Caps 50mg 100.
Charles Joynson, WaveData MD, investigates Mebeverine Suspension S/F 50mg/5ml 300ml, DHSC Price Concessions and Pharmacy Profits.
At first we struggled to understand why this product had been added to the list of DHSC Concessions in July. Actually it had the highest concession price at £214.96, but the market price had remained high as had the reimbursement price. However it was only when we began to think about pharmacy profitability that the penny dropped.
Charles Joynson, WaveData MD, investigates Ivabradine price trends.
In August, this product has had the highest concession price of any of the 76 products with concessions granted. We’ve looked at the trends in the minimum prices by supplier since the beginning of 2022 to see if there is a relationship between the different suppliers and the minimum prices, the English drug tariff and concession prices.
Diagnostic Blood Test Strips. Are they Maintaining Their Pharmacy Prices?
Normally we expect branded devices to maintain their pharmacy purchase prices over long periods of time. However, here this is not the case. Charles Joynson, WaveData MD investigates further. Looking at the long term market price trends of Freestyle Optium Test Strips...
Increases in the prices pharmacists have to pay for Atorvastatin have been much in the news recently. However, are other statins also increasing in price?
Charles Joynson, WaveData MD decided to investigate further.
Firstly all packs of Atorvastatin Tabs have seen price increases in recent weeks except the 60mg 28 and the 30mg 28 packs. It may be that they are used less frequently and the pressure on supply is less intense. The four main 28 Tablet packs of Rosuvastatin have all seen price increases, but Simvastatin and Pravastatin have not.
Long term price cycles in Olanzapine Orodispersible Tablets
This group of schizophrenia medications recently occupied half of the top positions in the Generics Bulletins biggest risers list as discussed by the editor Dave Wallace recently. Looking at the long term there does appear to be a super cycle in place with a period of about 72 months or 5 years between each price spike.
How fast can generic prices recover after a price rise?
It is well known that UK generic prices tend to be lower than those in Europe and that the UK recovers faster after shortages and price rises. Typically this recovery takes months, but here is a case where a product recovered in days. Charles Joynson, WaveData MD, puts a spotlight on Letrozole pricing over the last couple of months.
Morphine Sulphate Solution for Injection Amps 30mg/1ml 10 Long Term UK Market Price Trend
Since Feb 2022 the market price for this Category C product has risen from around £9 to over £20. However, for the eight years prior the prices were stable and the drug tariff remained on or just above the average UK market price. Despite an increase in reimbursement at the end of 2017 there was very little profit to be squeezed from this critical care pain killer.
Long Term UK Market Price Trend of Gentamicin Ear / Eye Drops 0.3% 10ml
Until May 2021 this Category C product had stable pricing and very little profit potential. The average market price between July 2013 and April 2021 was £2.08 and the tariff £2.39, giving pharmacies £0.31, and manufacturers and wholesalers even less. In May 2021 prices rose substantially and since then the average tariff has been £24.10 and the average market price £12.30, leaving a healthy profit of £11.80 for pharmacies and the rest of the supply chain.
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