AQW 14340/22-27
Mr Danny Donnelly
Alliance Party
East Antrim
Tabled Date: 03/09/2024
Answered On Date: 06/08/2025
Priority Written: No
Question:
To ask the Minister of Health to detail the support being provided to pharmacies in relation to the fluctuation in prices in respect of long-term medications such as Apixaban.
Answer:
The Department of Health (DoH) NI has a statutory duty to remunerate providers of pharmaceutical services in a fair, accurate and prompt manner. It has a statutory obligation under Regulation 9 of the Pharmaceutical Services Regulations (NI) 1997, to compile and publish a statement known as the Northern Ireland Drug Tariff (NIDT). The NIDT, published monthly, sets out the range of dispensing fees available to pharmacists (remuneration), and details the reimbursement figures paid to community pharmacy contractors towards the actual cost of drugs and appliances supplied against health service prescription forms. Given that prices for reimbursement are set at the start of the month, if there is significant price instability or price fluctuations in-month for drugs, there is a mechanism to reset the price during the month – this is called the “concessionary price” mechanism. In August 2024, there were 151 concessionary prices awarded, which included both strengths of apixaban (2.5mg and 5mg), the medication detailed in Mr Donnelly’s question. From April’24, the previous Health Minister (Swann) determined that all drugs on concession would be Zero Discount i.e. discount clawback will not be applied. In Northern Ireland, unlike other parts of the UK, a special advance is in the system for drugs on concession in acknowledgement of the volatility of the pharmaceutical supply chain. This has been in place since January 2018, and has been flexed upwards and downwards over the last 6 years. it is currently £3,000 per contractor. SPPG continue to keep this special advance under review. In Northern Ireland, as in other parts of the UK, reimbursement is not on an item per item basis but rather a target amount of margin or retained purchase profit is adopted such that overall, there will be a level of income associated with the reimbursement of medicines i.e. a cost of drugs plus target margin. The levels of margin delivered over the last three years are detailed below and these have been significantly above the (previous) minimum threshold of at least £26.5million: | 2020/21 | 2021/22 | 2022/23 | Retained Margin (£m) | 45.4 | 38.1 | 37.6 |
In April 2024, Minister Swann agreed to increase this minimum threshold from £26.5m up to £31.5m along with a move towards new processes in 2024/25 to ensure more timely OMS result reporting.
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