DHSC adjusts reimbursement rates following pricing error

The Community Pharmacy England has announced that DHSC has made retrospective reimbursement price adjustments for Aptamil products

The Department of Health and Social Care (DHSC) has announced adjustments to the reimbursement rates for several Aptamil products dispensed earlier this year, following a pricing error that left pharmacies out of pocket.

The changes, which apply to products dispensed between January and April 2024, come after Community Pharmacy England (CPE) raised concerns about discrepancies in the pricing data used by the NHS.

The issue stemmed from recent price increases by Nutricia Ltd, the manufacturer of Aptamil, which were not reflected in the NHS Dictionary of Medicines and Devices (dm+d).

To address the shortfall, the DHSC has retrospectively increased the reimbursement prices for the following Aptamil products:

- Aptamil Anti-Reflux powder (800g): From £14.29 to £16.08

- Aptamil Comfort milk (800g): From £14.29 to £16.08

- Aptamil First milk powder (200ml): From £0.92 to £1.06

- Aptamil Follow On milk (200ml): From £0.92 to £1.06

- Aptamil Lactose Free powder (400g): From £7.70 to £8.39

These changes, effective from January 2024, are intended to ensure that pharmacies are appropriately reimbursed for the cost of these products.

The CPE also shared that they have raised concerns to the DHSC regarding "the accuracy of certain product and pricing information held on dm+d".

"Community Pharmacy England is in discussion with DHSC regarding improvements to the data quality and checking processes for dm+d database, managed by NHS Business Services Authority (NHSBSA)", the statement read.

Discussions between CPE and the DHSC are ongoing to improve data quality and avoid similar issues in the future.

This adjustment comes amid wider tensions between the DHSC and the pharmacy sector.

Category M Reimbursement 

In a separate move, the DHSC has decided to reduce Category M reimbursement prices from August 2024, following an error that led to overpayments in July.

The decision has been met with strong opposition from CPE and other industry leaders, who argue that the current funding model is inadequate.

Janet Morrison, CEO of CPE, warned that the funding cuts could lead to more pharmacy closures, putting patient access to services at risk.