rebate principles and process · recommendation to the derbyshire prescribing dpg will review...
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September 2019
Rebate Principles and Process
Background Primary care rebate schemes (PCRS) are contractual arrangements offered by pharmaceutical companies, or third-party companies, which offer financial rebates on prescribing expenditure. Under the terms of such a scheme, the NHS is charged the Drug Tariff price for primary care prescriptions dispensed, the manufacturer then provides a rebate to the primary care organisation based on an agreed discount price. Such schemes are being offered to Clinical Commissioning Groups by the pharmaceutical industry in relation to named products. Rebate agreements usually take the form of legal agreements between the manufacturer and CCG. It is important that NHS Derby and Derbyshire CCG has a process to support evaluation and sign off of rebate schemes to ensure that schemes are only signed off where they provide good value for money to the public purse and the scheme’s terms are in line with organisation vision, values, policies and procedures and to ensure that the CCG is transparent in its process for considering these schemes. This rebate process provides a framework for managing rebates in a legal and ethical way. The principles outlined in this document allow for the objective evaluation of schemes submitted to the CCG and a clear process for approving and scrutinising agreements. Principles for Assessing Rebate Schemes NHS Derby and Derbyshire CCG will adopt the following principles when deciding whether to participate in a PCRS or not. Product Related Any medicine considered under a PCRS must be licensed in the UK. Where there is more than one licensed indication for a medicine, a scheme should not be linked to a particular indication for use.* Any device or nutritional supplement considered under a PCRS should be included within the relevant chapter of the Drug Tariff. Products should not have a negative decision by NICE, or be included in the Joint Area Prescribing Committee Red or Black traffic light list. Rebate schemes promoting unlicensed or off label uses will not be entered into. All recommendations for use of a medicine within a PCRS must be consistent with the Marketing Authorisation of the medicine in question. PCRS are not appropriate for medicines in Category M and some medicines in Category A of the Drug Tariff. This is due to the potential wider impact on community pharmacy reimbursement. Rebate Scheme Related Ideally the PCRS should not be linked directly to requirements to increase market share or volume of prescribing. A volume based scheme should only be agreed if clinically appropriate. However, the administrative burden of monitoring such a scheme should be carefully considered. The primary care rebate scheme will not preclude the CCG from considering any other schemes subsequently offered by manufacturers of competitor drugs, should they wish to do so.
September 2019
Suppliers should not make guideline or formulary positioning conditional to any rebate offer. The administrative burden to the NHS of setting up and running the scheme must be factored into assessment of likely financial benefit of the scheme. Consideration should be given to audit requirements, financial governance, data collection, any other hidden costs and practical issues such as the term of agreement. PCRS agreements should include a right to terminate on notice (without having to have any reason for doing so) with a sensible notice period e.g., three or six months. There will be no requirement to collect or submit to the manufacturer any data other than volume of use as derived from ePACT data. Primary care rebate schemes will not be entered into that requires provision of patient specific data. Primary care rebate schemes will be subject to Freedom of Information (FOI) requests. The CCG will publish a list of the schemes it participates in on the CCG website. The full terms of the scheme may not be published depending on the nature of the rebate scheme contract.
September 2019
Approval and Rebate Management Process
PrescQIPP is a CIC NHS Programme to support
quality, optimised medicines management
within the NHS. Their Pharmaceutical industry
scheme governance review board assesses any
rebate schemes for clinical, financial and
contractual issues to support CCGs in
addressing the risk of perverse incentives from
such schemes.
PrescQIPP
It is expected that the majority of rebates will be
considered following the Prescqipp assessment.
Rebates outside of the Prescqipp process will be
considered on an individual basis.
Rebate Offer
Senior Medicines
Management Team
(SMMT)
The SMMT will assess schemes against the
Derbyshire rebate principles, making a
recommendation to the Derbyshire Prescribing
Group.
DPG will review rebate recommendations from
the SMMT, providing oversight and assurance.
Derbyshire Prescribing
Group
(DPG)
Chief Finance Officer
(CFO)
The CFO has designated responsibility for the CCG.
The CFO will ensure that due process has been
followed and will sign off all contracts.
Medicines Management
Team
(MMT)
The MMT will activate and monitor contracts with
the company supported by the CCG finance team.
Approved rebate schemes will be published on the
Derbyshire Medicines Management website. MMT
will liaise with SMMT, DPG, CFO regarding contract
expiries, renewals and terminations.
September 2019
Current rebate agreements within Derbyshire Date updated September 2019 Inclusion of any medicine or appliance on to this list does not in any way endorse prescribing of the product. See traffic lights for local status of the drug.
Brand Name Generic drug name Pharmaceutical
company
Date original rebate contract effective from
Type of discount
SD
CC
G
Ere
wash
CC
G
ND
CC
G
Hard
wic
k
CC
G
Derby &
Derbyshire CCG
Abtard Oxycodone Hydrochloride
Prolonged Release
ETHYPHARM UK LTD Tel: 01483 662805 e-mail: [email protected]
Ju
ly 2
017
Ju
ly 2
017
Ju
ly 2
017
Ju
ly 2
017
*CS
AirFluSal Forspiro Salmeterol/ Fluticasone
Combination Inhaler
SANDOZ LTD TEL: 01276 698020 e-mail: [email protected] M
arc
h 2
017
Ma
rch
2017
Ma
rch
2017
Ma
rch
2017
*CS
AirFluSal MDI Salmeterol/ Fluticasone Propionate
SANDOZ LTD TEL: 01276 698020 e-mail: [email protected] O
cto
be
r 2
018
Octo
be
r 2
018
Octo
be
r 2
018
Octo
be
r 2
018 *CS
Apidra Insulin Gluisine SANOFI TEL: 01483 505515 e-mail: [email protected] O
cto
be
r 2
017
Octo
be
r 2
017
Octo
be
r 2
017
Octo
be
r 2
017 April 2019 *CS
September 2019
Brand Name Generic drug name Pharmaceutical
company
Date original rebate contract effective from
Type of discount
SD
CC
G
Ere
wash
CC
G
ND
CC
G
Hard
wic
k
CC
G
Derby & Derbyshire
CCG
Aproderm Barrier Cream
Dimethicone and Trimethysiloxysilicate
4%
FONTUS HEALTH LTD TEL: 0121 6614615 e-mail: [email protected]
Sep
tem
be
r 2017
Sep
tem
be
r 2017
Sep
tem
be
r 2017
Sep
tem
be
r 2017 April 2019 Flat rate discount
Aquamax Cream n/a INTRAPHARM LABORATORIES Ltd TEL: 01628 771800 e-mail: [email protected]
Ma
rch
2017
Ma
rch
2017
Ma
rch
2017
Ma
rch
2017
April 2019 Flat rate discount
Aymes Oral Nutritional
Supplements
n/a AYMES TEL: 07921 403818 e-mail: [email protected]
Jan
ua
ry 2
019
Jan
ua
ry 2
019
Jan
ua
ry 2
019
Jan
ua
ry 2
019
April 2019 *CS
Biquelle XL Quetiapine ASPIRE PHARMA LIMITED TEL: 01730 231148 e-mail: [email protected]
Ap
ril 2018
Ap
ril 2018
Ap
ril 2018
Ap
ril 2018
April 2019 Flat rate discount
September 2019
Brand Name Generic drug name Pharmaceutical
company
Date original rebate contract effective from
Type of discount
SD
CC
G
Ere
wash
CC
G
ND
CC
G
Hard
wic
k
CC
G
Derby & Derbyshire
CCG
Carbocisteine sachets
n/a INTRAPHARM LABORATORIES LIMITED TEL: 01628 771800 e-mail: [email protected]
Fe
bru
ary
2016
Fe
bru
ary
2016
Fe
bru
ary
2016
Fe
bru
ary
2016
April 2019 Flat rate discount
Clenil Modulite CFC-free Beclometasone
Dipropionate inhaler
CHIESI LTD TEL: 01553 615540
Email: [email protected]
July 2019 *CS
Clexane - injection Enoxaparin SANOFI Email: [email protected]
April 2019 *CS
ConvaTec Wound Care Portfolio
n/a CONVATEC LTD TEL: 01244 284882 e-mail: [email protected]
Octo
be
r 2
018
Octo
be
r 2018
Octo
be
r 2
018
Octo
be
r 2
018
April 2019 *CS
September 2019
Brand Name Generic drug name Pharmaceutical
company
Date original rebate contract effective from
Type of discount
SD
CC
G
Ere
wash
CC
G
ND
CC
G
Hard
wic
k
CC
G
Derby & Derbyshire
CCG
Fencino Fentanyl matrix patches
ETHYPHARM formerly D B ASHBOURNE LTD TEL: 01483 662805 e-mail: [email protected]
Ju
ly 2
014
Ju
ly 2
014
Octo
be
r 2
014
No
vem
be
r 2014
Flat rate discount
Fobumix Easyhaler Budesonide with Formorterol
ORION PHARMA UK Ltd TEL: 07775 816401 e-mail: [email protected]
Au
gu
st
2018
Au
gu
st
2018
Au
gu
st
2018
Au
gu
st
2018
April 2019 *CS
Glucophage SR Metformin SR MERCK SERONO LIMITED TEL: 020 88187373 e-mail: [email protected]
Octo
be
r 2
017
Octo
be
r 2
017
Octo
be
r 2
017
Octo
be
r 2
017
April 2019
Flat rate discount
Insuman products NPH Insulin SANOFI TEL: 01483 505515 e-mail: [email protected]
Jan
ua
ry 2
015
Jan
ua
ry 2
015
Jan
ua
ry 2
015
Jan
ua
ry 2
015 April 2019 *CS
September 2019
Brand Name Generic drug name Pharmaceutical
company
Date original rebate contract effective from
Type of discount
SD
CC
G
Ere
wash
CC
G
ND
CC
G
Hard
wic
k
CC
G
Derby & Derbyshire
CCG
Januvia Sitagliptin MERCK SHARP & DOHME LIMITED TEL: 01992 467272 EMAIL: [email protected]
Ap
ril 2
018
Ap
ril 2018
Ap
ril 2018
Ap
ril 2018
April 2019 *CS
Lantus Insulin Glargine SANOFI TEL: 01483 505515 e-mail: [email protected]
April 2019 *CS
Lixiana Edoxaban DAIICHI SANKYO UK LTD. TEL: 01753 893600 e-mail: [email protected]
Ma
y 2
018
Ma
y 2
018
Ma
y 2
018
Ma
y 2
018
*CS
Luventa XL Galantamine FONTUS HEALTH LTD TEL: 0121 6614615 e-mail: [email protected]
Ap
ril 2015
Ap
ril 2015
Ap
ril 2015
Ap
ril 2015
Flat rate discount
September 2019
Brand Name Generic drug name Pharmaceutical
company
Date original rebate contract effective from
Type of discount
SD
CC
G
Ere
wash
CC
G
ND
CC
G
Hard
wic
k
CC
G
Derby & Derbyshire
CCG
Mezolar Matrix Fentanyl Patch SANDOZ LTD TEL: 01276 698020 e-mail: [email protected]
Ap
ril 2016
Ap
ril 2016
Ap
ril 2016
Ma
y 2
016
*CS
Mintreleq XL Quetiapine ARISTO PHARMA LIMITED TEL: 0330 0245565 e-mail: [email protected]
Ju
ly 2
017
Ju
ly 2
017
Ju
ly 2
017
Ju
ly 2
017
April 2019 Flat rate discount
Monomax XL n/a CHIESI LTD TEL: 0161 4885555 e-mail: [email protected]
Ma
rch
2018
Ma
rch
2018
Ma
rch
2018
Ma
rch
2018
*CS
Prostap SR DCS
Prostap 3 DCS
Leuprorelin DCS 3.75mg
Leuprorelin DCS 11.25mg
TAKEDA UK Ltd TEL:01628 537900 e-mail: [email protected]
Ap
ril 2012
Ap
ril
2012
Ap
ril
2012
Ap
ril
2012
*CS
September 2019
Brand Name Generic drug name Pharmaceutical
company
Date original rebate contract effective from
Type of discount
SD
CC
G
Ere
wash
CC
G
ND
CC
G
Hard
wic
k
CC
G
Derby & Derbyshire
CCG
Reletrans Buprenorphine Patches
SANDOZ LTD TEL: 01276 698020 e-mail: [email protected]
Ma
rch
2017
Ma
rch
2017
Ma
rch
2017
Ma
rch
2017
April 2019 *CS
Relevtec Buprenorphine Tranosdermal
Patches
SANDOZ LTD TEL: 01276 698020 e-mail: [email protected]
Ju
ne
2018
Ju
ne
2018
Ju
ne
2018
Ju
ne
2018
*CS
Sereflo Fluticasone / Salmeterol
CIPLA (EU) Ltd Managed by Insypher Ltd e-mail: [email protected]
Au
gu
st
2018
Au
gu
st
2018
Au
gu
st
2018
Au
gu
st
2018
April 2019 *CS
Seretide Accuhaler & Evohaler
Fluticasone / Salmeterol
GLAXOSMITHKLINE UK LTD TEL: 020 89909000 e-mail: [email protected]
Sep
tem
be
r 2015
Sep
tem
be
r 2015
Sep
tem
be
r 2015
Sep
tem
be
r 2015 April 2019 *CS
September 2019
Brand Name Generic drug name Pharmaceutical
company
Date original rebate contract effective from
Type of discount
SD
CC
G
Ere
wash
CC
G
ND
CC
G
Hard
wic
k C
CG
Derby & Derbyshire
CCG
Sevodyne Buprenorphine Patches
ASPIRE PHARMA LIMITED TEL: 01730 231148 e-mail: [email protected]
Ap
ril 2017
Ap
ril 2017
Ap
ril 2017
Ap
ril 2017
April 2019 Flat rate discount
Stocare Stoma Accessories
n/a RHODES PHARMA LTD TEL: 01772 647440
Au
gu
st
2017
Au
gu
st
2017
Au
gu
st
2017
Au
gu
st
2017 Mixed model of flat
rate discount
Xaggitin® XL Methylphenidate Prolonged Release
Tablets
ETHYPHARM UK LTD TEL: 01483 662805 e-mail: [email protected]
Ma
y 2
018
Ma
y 2
018
Ma
y 2
018
Ma
y 2
018
*CS
Xarelto Rivaroxaban BAYER PLC [email protected]
April 2019 *CS
September 2019
*CS – The pharmaceutical company consider this information to be commercially sensitive
Brand Name Generic drug name Pharmaceutical
company
Date original rebate contract effective from
Type of discount
SD
CC
G
Ere
wash
CC
G
ND
CC
G
Hard
wic
k
CC
G
Derby & Derbyshire
CCG
Zaluron XL Quetiapine FONTUS HEALTH LTD TEL: 0121 6614615 e-mail: [email protected]
Ap
ril 2015
Ap
ril 2015
Ap
ril 2015
Ap
ril 2015
Flat rate discount