Pricing query

[Steve G]

Ok, so I know how the PPA operate with regards to pricing scripts and paying pharmacies, but does anyone know how they work out the cost to the GP? A couple of examples:
There is only one listing for each strength of perindopril in the drug tariff, so that would be charged at £11.36 per 30 to the GP.
Dispersible aspirin 75mg has two listings: 100s cost £1.87, 28s cost £1.52 (=£5.42 per 100 ex28). So how do they work out how much to take from the GPs budget - do they just take it from our endorsement, or do they use an average of the two prices, or do they do it in some other way?

[Jeff]

Re: Pricing query

From our endorsement.

Jeff

[Steve G]

Re: Pricing query

My GPs are going to be happy when they get their next lot of PACT data through then. Since I started managing the pharmacy in January I have switched from aspirin 75mg ex 100 to ex 28 and thyroxine ex 1000 to ex28, which will have pushed their costs up a bit. Why the previous pharmacist was dispensing from larger, less profitable pack sizes is a good question.

[Raju]

Re: Pricing query

My GPs are going to be happy when they get their next lot of PACT data through then. Since I started managing the pharmacy in January I have switched from aspirin 75mg ex 100 to ex 28 and thyroxine ex 1000 to ex28, which will have pushed their costs up a bit. Why the previous pharmacist was dispensing from larger, less profitable pack sizes is a good question.

Some pharmadcists base their decision more on acquisition costs - which is of course short sited. They are like "it costs less to buy the larger pack size so I'll buy that". They miss the fact that they would achieve better margins dispensing smaller pack sizes, because the difference in acquisition cost between small and large sizes is dwarfed by the difference in tariff return.

BTW, I keep profit chasing within reason, because I don't want the pharmacy to get red flagged by the PPA. So I wouldn't give out 32,32,36paracetamol against a prescription of a hundred, i woud give out and endorse only packs of hundred. But if the quantity was 60 or whatever I would tell the staff to give out in 32s and enorse likewise.

[admin]

Re: Pricing query

BTW, I keep profit chasing within reason, because I don't want the pharmacy to get red flagged by the PPA. So I wouldn't give out 32,32,36paracetamol against a prescription of a hundred, i woud give out and endorse only packs of hundred. But if the quantity was 60 or whatever I would tell the staff to give out in 32s and enorse likewise.

Most of the shops I have been working at are buying paracetamol in 32's, so you have to give 32,32,36 out.

[Steve G]

Re: Pricing query

Most of the shops I have been working at are buying paracetamol in 32's, so you have to give 32,32,36 out.

Sod that! Give 3x32 - I avoid cutting whenever possible.

[admin]

Re: Pricing query

Sod that! Give 3x32 - I avoid cutting whenever possible.

But then you're not giving the amount the Dr wants the patient to get aren't you? I'm too scared the inspector would call it fraud!

[Steve G]

Re: Pricing query

But then you're not giving the amount the Dr wants the patient to get aren't you? I'm too scared the inspector would call it fraud!

Its only fraud if you claim for 100 ex 32. If you supply 96 ex 32 its not fraud because you are only claiming payment for what you have supplied. What do you give if a Dr asks for 30 atenolol, 30 bendroflumethiazide or 30 lipitor?

[admin]

Re: Pricing query

Its only fraud if you claim for 100 ex 32. If you supply 96 ex 32 its not fraud because you are only claiming payment for what you have supplied.

That's true, but don't the scripts bounce back from the PPA?

What do you give if a Dr asks for 30 atenolol, 30 bendroflumethiazide or 30 lipitor?

I give 28, but that's because they are in calendar packs, and paracetamol aren't. Having said that, I am a locum, so I just tend to follow what's usualy done at the branch. All the branches I work at with 32's always give 32,32,36. Having said that, I'm not gonna argue about 4 paracetamol tabs.

[Steve G]

Re: Pricing query

That's true, but don't the scripts bounce back from the PPA?

no, never had a script bounced back for that reason

[admin]

Re: Pricing query

no, never had a script bounced back for that reason

Ok, thanks - it's been a long time since I had to correct a bunch of scripts from the PPA.

[Pharmanaut]

Re: Pricing query

If there is a 'common pack' then you are paid on that pack unless you endorse another pack. Common packs are usually brands. (not sure if common packs are still in the tariff?)

If there is only one pack in the tariff of a generic then you get paid that price no matter what you endorse.

If there are two or more packs you get paid for the pack that you endorse. If the pack that you endorse is not a tariff pack your payment is based on the next larger pack that is in the tariff.

PI are priced pro-rata on the UK pack. If there are two UK packs then you are priced on the next larger pack.

Broken Bulk is paid on the two-thirds rule.
If you dispense more than one prescription and it takes you over two-thirds of a pack in the month of the claim, then the claim is cancelled. (Keep BB scripts together until the month end for this purpose - easy to find them!) If you only have one script for whatever quantity that leaves you with a residue you can have a rolling claim forever. However, if you dispense another script the claim is cancelled for that month.

Aren't these rules Simple!

[Raju]

Re: Pricing query

Questions for Steve:

Regarding not cutting strips: if you had aspirin 75mg dispersible tablets (100) - would you cut 28,28,44 - or do some other thing.

And: would you give out 30 coversyl tabs when Rx stated 28?

Just curious.

[Steve G]

Re: Pricing query

no, aspirin would get 98 - 3x28, 1x14, so no cutting most of the time, and if you do have to cut its easy to get rid of the left overs.

coversyl would get given 28. firstly because giving 30 would lose money, and also it's an illegal supply, strictly speaking (as not calendar pack/special container)

[Raju]

Re: Pricing query

OK cheers for that.

By the way, with lipitor, if 60 was prescribed, by default the pharmacy would get paid for 9*7 = 63, as a strip of seven constitutes a calendar strip for this product, and is closer than 56 to the presribed quantity.

I'd just give 60 though.