Generics/Branded products

[imaginegenerous]

Could somebody please clarify for me rules/regulations (if there are any) regarding supplying a branded products againt generic scripts. That probably didn't make an awful lot of sense but I'm thinking along the lines of instances were doctors prescribe products generically e.g diclofenac/co-codamol and the patient is adamant they have to have the branded product such as voltarol or kapake. We've had an incident in our pharmacy recently were a lady was adamant that hert GP wanted her to have Voltarol but had prescribed generically (the PCT has advised them it's cheaper and the receptionist had even written a note to the lady to say it was the same thing). Normally we will try and accomadate the patient as we'd rather not lose the customer but in this case we didn't have any Voltarol in stock only generic and she's now very unhappy, having gone back to the GP saying we'd refused to supply her.

I guess what I'm getting at is while we do try and accomadate patient's who request specific brands I find it a bit irritating that the GP can prescribe generically so it looks better money wise on their budget but if we dispense a branded product against the generic script we are, in most cases, losing money.

Has anyone else got any suggestions or have I completely got the wrong end of the stick about how we're paid? I just remember the last company I worked for was very up on brand support deals and you had to give certain brands if the script was written generically e.g. salamol rather than ventolin (that caused so many problems as all the patients had been on Ventolin for years!) - I know there are probably much more important things to be worrying about but I'm feeling quite a lot of pressure to improve the money side of my branch and a few tips/ides/opinions would be much appreciated

[womble]

I also have this problem - dependant on what else the patient is on it is soooo tempting to just let them know that we have to dispense generically if the GP prescribes generically - however those on many other items generate too much income to loose like that.
I have found one way to get GP support in prescribing more clearly is to copy a dispensed script and write beside the item on the copy the cheaper alternative with the cost saving worked out for the GP - they then soon start writing the cheaper alternative clearly to keep more money in their own pocket. After a while this makes the GP realise you are helping them out and they are more willing to come to the party and help you out with the few customers who 'need' the branded product.
I also worked for the company who pushed the Salamol brand - what a nightmare that was, and we lost a lot of prescriptions because of it!!

[Zoggite]

Originally Posted by imaginegenerous

I'm feeling quite a lot of pressure to improve the money side of my branch and a few tips/ides/opinions would be much appreciated

The only way to do that in a Lloyds dispensary is to be on the ball with the "Special containers/Calendar packs" regs from the PSNC, as Sapphire Court won't give you any manoevering space for anything else: because AAH is their Sister-company, they don't really care what price a branch pays for a particular drug (or rather what price the invoice says you pay...!), and that's also why you can't return incorrect orders to AAH for credit, even if it's their mistake... your branch just has to bear the cost of AAH's picking errors, unless it's worth more than £50.
However, Lloyds' computer systems are rubbish with Special containers and calendar packs, especially their new Compass software, so be aware: it won't stop you from dispensing 30 enalapril tabs, for instance, but you'll only get paid for 28 because it's supposed to be a calendar-pack...
I regularly have locums who dispense 28 asasantin, endorse the script "28/60", and I have to bin the remaining 32 caps after 2 months... Or they dispense a single risedronate 35mg tablet...
But the main way to keep the pressure at bay is to play the management game and do whatever target-number of MURs you've been set...

[Pharmanaut]

At the risk of being a tariff bore.

Look in the drug tariff Part VIII, or Part 7 in Scotland.
If the drug list listed in there then that is what you get paid.
If you see a C against it, the price is based on a manufacturer or brand listed in brackets. You can endorse whatever you like but you will only get paid that price.

Some of the larger pharmacy chains negotiate price deals (brand equalisation) which means that you can supply the brand against all scripts. The PMR is usually set up to do this for you. However, if in part VIII or 7, you will still only get paid the tariff price.

If you get a script that is for a non-multiple of the calendar pack you can supply the exact quantity on the script but you must endorse the quantity given. Some pharmacies still continue to supply exact quantity which means you end up with split packs. The split packs can be used mainly for MDS and the occasional emergency supply. For my part I would always dispense calendar packs.

Remember, if there is only the one pack in the tariff and you do not need to add information to tell the PPA how you have interpreted the script (ie the script can be dispensed exactly how it was written) you need not endorse at all.

Watch out for special containers.
Also watch out for drugs that look like the are drugs but are in fact classed as devices. This was covered in the "When is a drug not a drug?" Thread in earlier postings.

Final point, as I'm getting bored with the Tariff as well, check the PSNC website regularly for updates to tariff matters. If I remember correctly, if you have Cegedimrx Pharmacy Manager there are some FAQ leaflets about tariff matters. Look in Tools>Enquiry>Leaflets and search on FAQ.

The latest NPA quide to the drug tariff is not as helpful as previous editions - anyone agree?

[imaginegenerous]

Thanks for that eveyone - I'm with Lloyds and I have noticed the problems re: not being able to send stuff back to AAH even if it's their mistake very annoying! We're also on the MUR drive - if anyone's got any tips fopr recruiting patients that would be great - our lot don't seem at all interested. I don't mind actually doing them but we are struggling to get the patient in the consultation room in the first place!

But thanks for all the other tips though - I'll certainly try and make use of them!

[johnep]

1) Anyone who requests a loan needs an MUR as not managing their medicines, make it a condition.
2)Anyone who queries anything -- MUR
3) Anyone who wants a specific brand ---MUR
4) Anyone who asks when their script will be ready--MUR.

johnep

[Zoggite]

My tips for MURs:
1. Forget about giving them appointments: it doesn't work, they just don't stick to them. You need to catch them when they come in to collect their meds, and have the pre-populated form attached to their bags.
2. anyone with more than 8 meds: forget it, you'll be there for ages, and Lloyds won't thank you for it.
3. If you provide any enhanced services, such as EHC or smoking cessation: tag an MUR onto those consultations.
4. as for doing an MUR on anyone requesting a loan: in my branch it's not because the patient is disorganised that he/she needs a loan, it's because their surgery is! they regularly send scripts to the wrong pharmacy, or forget them in the printer, or the GP forgets to sign them, or they cancel a branch surgery without any warning...
And finally: whatever you do, don't do more than your weekly target, or Lloyds will get greedy and increase your target rather than patting you on the back... In the end, you'll make dispensing mistakes because you're rushing to do all those MURs...
Oh, and don't forget you have to get the patient to sign the MUR form, now (according to Lloyds' latest MUR SOP...)

[Jeff]

Originally Posted by Zoggite

And finally: whatever you do, don't do more than your weekly target, or Lloyds will get greedy and increase your target rather than patting you on the back

Is there any reason to do more than 400 MUR's per year?

Jeff

[Zoggite]

Originally Posted by Jeff

Is there any reason to do more than 400 MUR's per year?

Not at present, no; but Lloyds set you a "weekly target" that is higher than just 400/52, to allow for things like Xmas week, Easter week, your holidays, etc... when they know you'll fall behind; Also, I suspect they're hoping that the 400-threshold will be increased again before the end of the financial year, and that if more than 8 MURs/week have already conducted they'll be ready to squeeze some more in...

[kemzero]

Originally Posted by Zoggite

My tips for MURs:
1. Forget about giving them appointments: it doesn't work, they just don't stick to them. You need to catch them when they come in to collect their meds, and have the pre-populated form attached to their bags.
rushing to do all those MURs...
Oh, and don't forget you have to get the patient to sign the MUR form, now (according to Lloyds' latest MUR SOP...)

I agree with zoggite
Just take them into the consulting room....pleasantly informing them that you want to talk to them about their meds....it works for me all the time...I do at least 2-3 a day....tried the formal (recommended) way before but it didn't work ..then a colleague showed me the light...and suffice to say I'm churning 'em out!