Any revised system of pharmaceutical pricing must not generate "unintended consequences" which place further stress on the medicines supply chain, UK pharmacy representatives have warned.
As the government moves forward with its plans to introduce a value-based pricing (VBP) system for branded medicines, community pharmacy group Pharmacy Voice has emphasised that the emerging system needs to take note of international pricing and also be sensitive to the reimbursement mechanisms for pharmacies.
"When a product is priced much lower in one European Union [EU] country than another, legitimate cross-border trade occurs and this can result in shortages in the lower-priced country," said the group's chief executive, Rob Darracott.
"Shortages create administrative problems for those further down the supply chain, and cause inconvenience and potentially interrupt the treatment of patients," he added.
"A change to the pricing system of medicines could lead to serious unintended consequences, and further stakeholder involvement is required to identify risks as the policy is developed," Mr Darracott emphasised.
The Pharmaceutical Services Negotiating Committee (PSNC) has also stressed that any new arrangements must be considered carefully "if mistakes of the past are not to be repeated or exacerbated."
Changes in the distribution of branded medicines have cost the NHS at least £400 million in lost savings through reduced competition in the wholesaling market and increased pharmacy procurement costs, according to Committee estimates.
"There are risks in the supply chain that must be addressed if we are to avoid compromising the safe supply of medicines to patients," PSNC chief executive Sue Sharpe stresses. "Reductions in list prices could put security of supply under strain, which is why we support the concept of manufacturers paying 'value-based rebates' to the NHS," she added.
"Changes in the medicines supply chain have led to unacceptable waste and inefficiency. To avoid this in future, pricing arrangements for branded medicines must take supply chain costs into account, and incentivise the efficient supply of medicines to pharmacies," said Ms Sharpe.