Dear Contractor
In response to the interest shown in the three upcoming workshops aimed at outlining the outworkings of the Windsor Framework and the implications for community pharmacy here, NICPLD has increased the number of spaces available.

Contractors are urged to ensure that appropriate member(s) of their dispensary teams attend one of these sessions which will also include discussions on supply against EEA prescriptions and the movement of medicines to and from Northern Ireland.

Background

The implementation of the Windsor Framework (WF) from 1 January 2025 will have implications for the medicines supply chain across the United Kingdom and in Northern Ireland in particular. The outworkings of the Framework will introduce new packaging and licensing arrangements for medicines placed on the Northern Ireland market and will have implications for the Falsified Medicines Directive.

NICPLD has arranged three workshops for pharmacists and pharmacy technicians to be hosted by a range of experts in the field of medicines regulation.

Details

Workshops are offered as follows:

  • 22nd October 2024, Riddel Hall, Belfast
  • 23rd October 2024, City Hotel, Armagh
  • 24th October 2024, City Hotel, Derry/Londonderry

Register now at NICPLD: Workshops

Speakers

  • Canice Ward: Head of Medicines Regulatory Group, Department of Health
  • Sean Curley: Principal Pharmaceutical Officer, Department of Health
  • Catherine Lenihan: Head of Regulatory Reform, Medicines and Healthcare products Regulatory Agency (MHRA)
  • Fionn Craig: Deputy Director of EU Regulations, Devolution and the Union, Department of Health and Social Care
  • Noah Thorold: Northern Ireland, Gibraltar and Crown Dependencies Policy, Department of Health and Social Care
  • Maria Jones: Policy Lead on Medicines Regulatory Policy Northern Ireland – Windsor Framework, Department of Health and Social Care

Aim

To enable pharmacists and pharmacy technicians to understand the implications the Windsor Framework Agreement will have on medicines and the pharmacy sector from 1 January 2025.

Learning Outcomes

Having attended this workshop, you will be able to understand:

  • The new packaging and licensing arrangements for medicines placed on the Northern Ireland market from 1 January 2025
  • The implication of the Windsor Framework Agreement on the EU Falsified Medicines Directive
  • The supply of medicines using prescriptions from EEA prescribers from NI pharmacies
  • Changes to the supply of medicines to and from NI from 1 January 2025
  • How to raise potential concerns about any future EU legislation that may have an impact on pharmacy and medicine supplies in NI.

Summary

It is important that contractors and their teams are prepared for the implementation of the Windsor Framework on 1 January 2025, and contractors are asked to:

  • Note the workshops being offered
  • Try to ensure that appropriate member(s) from their dispensary teams attend one of these sessions.

CPNI colleagues are available to discuss any aspects of the new arrangements. Any questions relating to the venues should be directed to the NICPLD team.

Kind regards

Mike

SENT ON BEHALF OF
PROF MIKE MAWHINNEY
Head of Regulatory Affairs

LIVING WELL PHARMACIES ONLY: SURVEY LAUNCH DATE
**FAO LIVING WELL PHARMACIES ONLY**
Dear Contractor
Correspondence has been issued by SPPG on 1st October 2024 regarding the Living Well Campaign.

SUMMARY

  • The survey for the campaign ‘Live longer and stronger’ has opened on 30th September 2024 and can be accessed here.
  • The survey will remain open until 6pm on 28th October 2024.
  • The current campaign ‘Sexual Health’ began on 1st October 2024 and online resources for this campaign can be found on the BSO website.

ACTION

  • Contractors are asked to review the correspondence issued by SPPG on 1st October 2024 regarding the Living Well Service and share with relevant team members.
  • The survey for the campaign ‘Sexual Health’ is now available and must be completed before 6pm on Monday 28th October 2024.

For any further information please contact CPNI offices.

Kind regards

SENT ON BEHALF OF
GERARD GREENE
Chief Executive
Drug Tariff Update
Dear Colleague
CPNI has been liaising with BSO and DOH(NI) colleagues in relation to various issues that have been reported to us by contractors, and we can provide the following update:

Forxiga 5mg and 10mg Tablets
Following significant reports and provision of evidence from contractors highlighting that there is no discount available for the purchase of Forxiga tablets, CPNI made representation to BSO colleagues. CPNI can confirm that Forxiga 5mg and 10mg tablets have been moved to zero discount. This change is effective from August 2024 prescriptions, and a retrospective adjustment should have been made in the September 2024 payment for any prescriptions dispensed from May 2024.  It is estimated that this change will result in approximately £500k clawback not being deducted per annum from the Forxiga reimbursement payments to contractors.

Lyclear Cream
Lyclear Cream has been out of stock since early June 2024 to date. BSO have agreed that any Lyclear Cream dispensed under the Pharmacy First: Everyday Health Conditions will be reimbursed as the Drug Tariff price for the generic permethrin cream. This payment will have been made for prescriptions dispensed from July 2024 to date, and an adjustment should have been received for any June 2024 prescriptions dispensed. The price will be reviewed on a monthly basis. Please continue to inform CPNI colleagues of any further stock issues in this regard.

Juvela Product Price Changes
A report was received regarding Juvela products, whereby the manufacturer has increased numerous prices across the range. This was reported to BSO colleagues by CPNI, and we can confirm that the increased prices have been applied to August 2024 prescriptions onwards. A retrospective adjustment for the increased list price has been made for prescriptions dispensed from May to July 2024, and should have been paid with the BSO payment made at the end of September.

Secure Transfer of Prescriptions
After representation from CPNI regarding the remuneration for the transfer of prescriptions to BSO, it can be confirmed that the amount paid to contractors has been increased from £14.10 to £25.00 per month.

Chloraprep 3ml Applicator
In January 2024, reports had been received from contractors that the price to purchase Chloraprep 3ml applicator (25 pack) had increased from £23.00 to £32.73. CPNI raised this issue with BSO, and it has been agreed to increase the reimbursement price to £32.73 for prescriptions dispensed from June 2024. A retrospective adjustment from January to May 2024 will also have been made with the August 2024 payment for any prescriptions dispensed during that period. The supply of chloraprep 3ml applicators is continuously being reviewed by BSO.

Knee Pressure Offloading Devices
After representation by CPNI, knee pressure offloading devices have been added to the zero discount list from July 2024.

Drug Reimbursement Price Changes
Following representation, CPNI can confirm that the reimbursement prices for the following products have been re-determined. A retrospective adjustment has/will be made by BSO in the coming months.

DrugOld List PriceNew List Price
Lurasidone 18.5mg tablets pack size 28
(From April 2024)
£37.60£80.00
Lurasidone 37mg tablets pack size 28
(From April 2024)
£37.60£80.00
Lurasidone 74mg tablets pack size 28
(From April 2024)
£37.60£80.00
Adrenaline (base) 150micrograms/0.15ml
(1 in 1,000) solution for injection
pre-filled disposable devices pack size 1
(From July 2024)
£53.80£60.69
Adrenaline (base) 150micrograms/0.3ml
(1 in 2,000) solution for injection
pre-filled disposable devices pack size 1
(From July 2024)
£53.80£60.69
Adrenaline (base) 150micrograms/0.3ml
(1 in 2,000) solution for injection
pre-filled disposable devices pack size 2
(From July 2024)
£107.60£121.38
Adrenaline (base) 300micrograms/0.3ml
(1 in 1,000) solution for injection
pre-filled disposable devices pack size 1
(From July 2024)
£53.80£60.69
Testosterone 16.2mg/g transdermal gel
(20.25mg per actuation) pack Size 88g
(From August 2024)
£31.11£39.94
Testosterone 40.5mg/2.5g transdermal gel
unit dose sachets pack size 30
(From August 2024)
£31.11£39.94
Estradiol 0.06% transdermal gel
(750microgram per actuation) pack size 80g
(From August 2024)
£6.17£9.15

A change to the reimbursement price will also be applied to the following branded prescription items, in the months detailed below:

DrugOld List PriceNew List Price
Aptamil comfort milk powder 800g
(January-April 2024)
£14.29£16.08
Aptamil anti-reflux powder 800g
(January-April 2024)
£14.29£16.08
Aptamil lactose-free powder 400g
(January-April 2024)
£7.70£8.39
Aptamil follow on milk 200ml
(January-April 2024)
£0.92£1.06
Aptamil first milk liquid 200ml
(January-April 2024)
£0.92£1.06
Latuda 18.5mg tablets pack size 28
(From April 2024)
£37.60£80.00
Latuda 37mg tablets pack size 28
(From April 2024)
£37.60£80.00
Latuda 74mg tablets pack size 28
(From April 2024)
£37.60£80.00
EpiPen 300micrograms/0.3ml
(1 in 1,000) solution for injection
auto-injectors pack size 1
(From July 2024)
£53.80£60.69
EpiPen 300micrograms/0.3ml
(1 in 1,000) solution for injection
auto-injectors pack size 2
(From July 2024)
£107.60£121.68
EpiPen Jr.150micrograms/0.3ml
(1 in 2,000) solution for injection 
auto-injectors pack size 1
(From July 2024)
£53.80£60.69
EpiPen Jr.150micrograms/0.3ml (1 in 2,000)
solution for injection
auto-injectors pack size 2
(From July 2024)
£107.60£121.68
Jext 150micrograms/0.15ml (1 in 1,000)
solution for injection
auto-injectors pack size 1
(From July 2024)
£53.80£60.69
Jext 300micrograms/0.3ml (1 in 1,000)
solution for injection
auto-injectors pack size 1
(From July 2024)
£53.80£60.69
Testogel 16.2mg/g gel
Pack size 88g
(From August 2024)
£31.11£39.94
Testogel 40.5mg/2.5g transdermal
gel sachets pack size 30
(From August 2024)
£31.11£39.94
Oestrogel Pump-Pack 0.06% gel
Pack size 80
(From August 2024)
£6.17£9.15
Nutrison water for gastroenteral feeds
Pack size 1litre
(From January to July 2024)
£2.16£2.43

Please continue to notify CPNI of any pricing issues you are experiencing via our Medicine Shortage Reporter.

Kind regards

SENT ON BEHALF OF
GERARD GREENE
Chief Executive
Dear Colleague
The final update of concessionary prices were granted today for September 2024:
DrugPack SizeConcessionary Price
Amantadine 100mg capsules56£18.06
Apixaban 2.5mg tablets60£14.99
Apixaban 5mg tablets56£13.78
Brimonidine 0.2% eye drops5£2.26
Calcipotriol 0.005% / Betamethasone dipropionate 0.05% gel60£24.83
Captopril 12.5mg tablets56£22.97
Captopril 25mg tablets56£21.73
Captopril 50mg tablets56£24.29
Carbimazole 5mg tablets100£1.98
Chloramphenicol 0.5% eye drops10£5.25
Citalopram 10mg tablets28£0.85
Citalopram 20mg tablets28£0.85
Clarithromycin 125mg/5ml oral suspension70£3.59
Clarithromycin 250mg/5ml oral suspension70£7.92
Clonidine 25microgram tablets112£13.39
Clotrimazole 500mg pessary and Clotrimazole 2% cream1£6.04
Co-amoxiclav 125mg/31mg/5ml oral suspension sugar free100£3.05
Co-amoxiclav 250mg/62mg/5ml oral suspension sugar free100£3.10
Co-amoxiclav 500mg/125mg tablets21£3.21
Colecalciferol 1,000unit tablets28£3.23
Dorzolamide 20mg/ml / Timolol 5mg/ml eye drops5£6.34
Dorzolamide 20mg/ml / Timolol 5mg/ml eye drops 0.2ml unit dose preservative free60£21.51
Erythromycin 250mg gastro-resistant tablets28£12.47
Escitalopram 20mg tablets28£1.54
Escitalopram 5mg tablets28£1.72
Etoricoxib 60mg tablets28£6.75
Etoricoxib 90mg tablets28£6.85
Fenofibrate micronised 200mg capsules28£3.32
Flucloxacillin 250mg/5ml oral solution sugar free100£5.63
Fusidic acid 2% cream15£2.46
Haloperidol 1.5mg tablets28£14.25
Haloperidol 5mg tablets28£9.32
Haloperidol 5mg/5ml oral solution sugar free100£8.18
Hydrocortisone 10mg tablets30£1.92
Hydroxocobalamin 1mg/1ml solution for injection ampoules5£11.75
Itraconazole 100mg capsules15£7.57
Lacosamide 200mg tablets56£10.63
Levetiracetam 250mg tablets60£2.11
Levetiracetam 500mg tablets60£6.50
Lisinopril 20mg / Hydrochlorothiazide 12.5mg tablets28£7.50
Lofepramine 70mg tablets56£23.12
Lorazepam 1mg tablets28£3.16
Mebeverine 200mg modified-release capsules60£7.63
Memantine 10mg/ml oral solution sugar free50£26.29
Metformin 500mg modified-release tablets56£2.00
Methylphenidate 54mg modified-release tablets30£73.62
Midazolam 10mg/2ml solution for injection ampoules10£5.58
Naftidrofuryl 100mg capsules84£9.25
Naproxen 250mg gastro-resistant tablets56£4.68
Olanzapine 10mg tablets28£4.44
Olanzapine 20mg tablets28£4.41
Oxycodone 10mg/1ml solution for injection ampoules5£8.00
Oxycodone 5mg/5ml oral solution sugar free250£8.48
Oxytetracycline 250mg tablets28£17.85
Pregabalin 300mg capsules56£2.80
Pregabalin 75mg capsules56£1.69
Propantheline bromide 15mg tablets112£103.50
Quetiapine 300mg tablets60£13.79
Quinine sulfate 200mg tablets28£6.32
Quinine sulfate 300mg tablets28£2.85
Ramipril 2.5mg tablets28£1.20
Ropinirole 2mg tablets28£26.24
Sodium chloride 0.9% nebuliser liquid 2.5ml unit dose ampoules20£9.50
Sulpiride 200mg/5ml oral solution sugar free150£99.45
Terbinafine 250mg tablets14£7.79
Trandolapril 4mg capsules28£9.13
Travoprost 40micrograms/ml / timolol 5mg/ml eye drops2.5£8.13
Venlafaxine 225mg modified-release capsules28£18.00
CPNI has been concerned about concessionary price insufficiency for some time and has made representations to DoH(NI) on this matter and will continue to do so particularly in light of the concessionary price associated with both strengths of Apixaban for September 2024.

Concessionary prices will be paid against the usual code, no additional endorsements are needed.

Please continue to notify CPNI of any pricing issues you are experiencing via our Medicine Shortage Reporter.

Concessionary prices are also published on the CPNI website.

Kind regards

SENT ON BEHALF OF
GERARD GREENE
Chief Executive
Dear Contractor
The Department of Health NI has issued correspondence dated 27 September 2024 extending the expiry date of serious shortage protocol SSP073 Chemydur® 60XL tablets.

The new expiry date is 11 October 2024.

BACKGROUND

  • SSPs made under the Human Medicines Regulations 2012 are an additional tool to manage and mitigate medicines shortages.
  • SSPs enable community pharmacists to supply specified medicines in accordance with a protocol rather than a prescription, without needing to seek authorisation from the prescriber – saving time for patients, pharmacists and prescribers.
  • Pharmacists should refer to the latest versions of the existing SSPs which are now available on the Business Services Organisation dedicated page on its website.
  • Operational guidance on the implementation of SSPs in Northern Ireland can be found on the BSO website.

ACTION

Contractors should:

  • Note that the expiry date for serious shortage protocol SSP073 for Chemydur® 60XL tablets has been extended.  The new expiry date is 11 October 2024.
  • Note that the letter giving the key points, and the full SSP are both available on the Business Services Organisation dedicated page on its website.
  • Note the guidance relating to the decision pathways for SSPs; notification of GPs; the need for patient/carer agreement, and action to take when this is not given; professional judgement; and actions regarding unclear quantities.
  • Ensure that their dispensary teams are aware of this update.

Contractors should contact their local SPPG office in the first instance should further information be required. CPNI colleagues are also available for assistance.

Kind regards

Mike

SENT ON BEHALF OF
PROF MIKE MAWHINNEY
Head of Regulatory Affairs

For the attention of Community Pharmacies providing the Autumn 2024 COVID-19 and Seasonal Influenza Community Pharmacy Vaccination Service
Dear Colleague
SPPG have issued a reminder to community pharmacies providing the Autumn 2024 COVID-19 and Seasonal Influenza vaccination programme.

SUMMARY

ACTION

Contractors providing the service should:

Please do not hesitate to contact the CPNI office should you require any further information.

Kind regards

SENT ON BEHALF OF
GERARD GREENE
Chief Executive