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SCOTTISH EXECUTIVE EFFICIENCY TECHNICAL NOTES: MARCH 2005: page 34

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SCOTTISH EXECUTIVE EFFICIENCY TECHNICAL NOTES: MARCH 2005

1. Portfolio/Number/Name:H/C9-Drugs pricing

2. Programme/Activity: Please include a short description

This programme relates to supply side activities to improve value for money in national arrangements for the pricing of drugs by NHSScotland

3. Planned Savings

2005-06

2006-07

2007-08

Cash (m)

42

42

42

Time Releasing (m)

0

0

0

4. Accountable Officer for delivery

K.Woods

5. Project Manager

C.Naldrett

6. EGDG account manager

G.Woolman

7. Quality Impact

Describe any impact on the quality of service delivery. Be specific and explain if the expectation is positive, negative or neutral.

The immediate impact on quality of service provision is likely to be neutral.

There is a risk that an overambitious cost reduction exercise could work through to reduced service provision if drug suppliers were to decide that it were not cost effective for them to supply the NHS at prices determined according to new arrangements.

On the other hand a formal agreement with the industry on branded drugs pricing, which individual companies can live with, provides them with a fair return and a continuing incentive to develop new products that will improve patient care.

8. Dependencies

Explain if your savings are dependant on legislation or other structural changes being achieved.

There are no legislative implications.

Reimbursement prices for drugs are set by Directions through the Scottish Drug Tariff which itself is enabled by the Pharmaceutical Services Regulations (Scotland) 1995.

9. Description of efficiency and actions to be taken

9.1 How will the saving be made? Be specific about number/size of contracts, staff, posts dates etc.

In the main by implementation of a revised Pharmaceutical Prices Regulation Scheme negotiated on a UK basis with the industry. These impact on the prices of 'branded' products used in Primary Care, i.e. drugs still protected by licence. These account for around 2/3rds of Primary Care drug costs. Opportunities for savings in other areas will continue to be pursued.

9.2 What action is critically needed to secure delivery of this saving? Be specific, and name the key action managers if they are outwith your immediate management chain (e.g. in an NDPB.)

Finalisation of revised PPRS arrangements.

These are now largely in place, with only one small element, where the financial impact is marginal, relating to so called standard branded generics is still to be clarified.

SEHD representative in negotiations on PPRS has been Prof. Scott, CPO.

10. Impact on Staffing to achieve the efficiency gain

If there are to be any changes in staff numbers (at activity level) to achieve the efficiency gain, please indicate how many full time equivalents and how far you expect savings to be achieved by natural wastage (show additions as + and reductions as -).

2005- 06

2006- 07

2007- 08

+

-

Net

Explanation

No change in complement planned.

11. Benefits

In general, the benefits of the Scottish Executive Efficiency Plan are the enhanced outputs from the resources Ministers have been able to allocate in SR04. But if there is a direct connection between this efficiency saving and the enhancement of a particular service please describe it here.

N/A

12. Gross/Net Cash Savings

12.1 Please set out the gross recurring saving and any offsetting recurring expenditure.

Gross Target- 42m

12.2 Against what budget does this expenditure and saving fall?

Health Boards' Unified Budgets

12.3 Has this saving been built into your budget?

Yes, in that there is an assumption that Boards and prescribers will automatically benefit from any supply side generated savings (and conversely absorb any cost increases) achieved through nationally set arrangements to offset rolling cost increases associated with greater use of effective therapies and costs of new drugs, which in the recent past have always generated a gross pressure above the rate of inflation.

12.4 If so, what is the maximum allowable expenditure against the budget data, in each year, for that saving to be delivered?

The rate of saving will depend on the rate of prescriptions of prescribed drugs.

12.5 If not, how do you propose to invest the additional cash back into public services?

N/A

12.6 What plans do you have to exceed the required saving? Explain by how much in each year.

We are continuing to review the other areas of drug and prescribable items purchasing to identify and deliver further savings. It is too early to be more specific about the potential extent of savings at this stage.

13. Time - release savings

13.1 Please explain any time-releasing savings indicated at question 3

N/A.

13.2 Please describe the method you plan to use to calculate the cash equivalent of those time release savings.

N/A

14. Measurement and Monitoring

14.1 How are you proposing to measure the expected efficiency benefits (e.g. in terms of costs, level of output or quality of service)?

To monitor the effects of the PPRS target 7% price cut across all branded drugs purchased in Primary Care.

14.2 What monitoring & reporting procedures will be put in place to measure the efficiency savings (How often will progress towards the target be monitored? Who will have lead responsibility for reporting progress and what procedures will be in place?)

There is extensive and reliable data available from NHSNSS Information Services to allow the costs of Primary Care prescribing to be monitored. Availability however lags prescribing by 3-4 months. Monitoring will be quarterly -after availability of data- and will be by NHSNSS.

14.3 Monitoring Data: Sources, validation and risks

  • What data will be used to measure progress? Is all the required information quantifiable and readily available? If not what action will be taken to rectify this?

  • What measures will be in place to validate the accuracy of the data? Who will take responsibility for this?

  • Are there any issues or risks relating to how you plan to use the data? (e.g. accuracy, difficulties in collection)

    See answer to previous question
    .

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