e [email protected] f 01622 790 754 forte.ukthe final and i feel most controversial proposal was the...

www.forte.uk.com 1

January 2018

t 0370 241 8717

e [email protected]

f 01622 790 754

forte.uk.com

In July 2017, the NHS England Board approved consultation on a set of proposals to limit the primary care prescribing of 18 products - costing a total of £141 million per year. In total, over 5,500 responses were received by NHS England on the proposals to restrict prescribing of the 18 so described ‘low value medicines’. The proposals were discussed at

the NHSE board meeting on Monday 30 November 2017,,, and the board decided that a number of the 18 medicines will enter the Drug Tariff Black List - items would not be remunerated on a NHS FP10. This change will take time as the Secretary of State will need to consult on these recommendations, however, there is a risk that without comprehensive communications to patients about the change, patients take out their frustrations on staff in general practice and

pharmacies. The other medicines that are going to have strict restrictions placed upon them are dosulepin, doxazosin, oxycodone and naloxone,paracetamol and tramadol, perindopril arginine, tadalafil (5mg o n c e d a i l y ) , a n d trimepramine. These medicines CCGs will be advised to stop new presc r ip t ions being initiated in primary care, and that current patients w h o r e c e i v e t h e

medicines are reviewed and de-prescribed. The only real changes from the consultation was that liothyronine can still be prescribed but only by a NHS endocrinologist, and lidocaine patches and immediate

release fentanyl can be used in select conditions. Again these changes will require direct communication to patients as there will be a number of confused and concerned patients who would otherwise seek advice, and probably alternatives form their GPs. The final and I feel most controversial proposal was the idea to restrict prescriptions for 3,200 medicines that can be purchased ‘over the counter’. The NHS England (NHSE) board considered this proposals that would potentially save around £190 million per year , stating:“As feedback from the consultation was broadly supportive, we now believe that it is appropriate for NHS England to work with partners to develop formal and far more detailed guidance to CCGs”. Firstly, this was an interesting statement as actually only 44% of all the respondents ‘agreed’ the change, 66% responded with either ‘disagreed’, ‘neither agree nor disagree’ or were ‘unsure’, but these were conveniently omitted in the headline figure. You can understand why the NHSE board are railroading through any proposals that will save money, as the recent autumn budget yielded less than half of the required investment of £1.6 billion (Simon Stevens had asked for £4 billion additional funds). The main concern is that again without a direct to patient, fully comprehensive communications plan, general practice and pharmacies will be caught in the middle, having to spend time allaying patient concerns and recommending alternatives. So in essence there is a big risk that while NHSE saves money, we gain additional workload and costs when we are struggling with current patient demands. Message from Mark Stone, Consultant Pharmacist Partner,

I recently spent time looking at the NHSE Board meeting minutes and the consultation proposals for OTC medicines.

Alliance Healthcare (Distribution) Limited trading as Forte Pharma Ltd

A company registered in England and Wales.

Registered Office: 43 Cox Lane, Chessington, Surrey KT9 1SN

Company Registration Number: 4023414

For all your practice requirements

Proposed Black List Medicines

Co-proxamol

Glucosamine and Chondroitin

Herbal Treatments

Homeopathy

Lutein and Antioxidants

Omega-3 Fatty Acid Compounds

Rubefacients (excluding topical NSAIDS)

www.forte.uk.com 2

January 2018

t 0370 241 8717

e [email protected]

f 01622 790 754

forte.uk.com

Firstly, it is interesting to see in the paper the boards opinions on the 'success' of the consultation on OTC medications detailed in the minutes, which reads: 49. As feedback from the consultation was broadly supportive, we now believe that it is appropriate for NHS England to work with partners to develop formal and far more detailed guidance to CCGs. Now please consider the way they presented the responses! 65% of the responses agreed with the pro-posal, when really it was only 44% - less than half! There is going to be a consultation on an extended grouping of conditions that should not be treated under the NHS - I feel these will be a fait accompli with regard to the NHSE board comments on the low budget funding. Others things of note from the consultation, many medicines will join the Drug Tariff Blacklist (which will mean we can sell them! In reality most are POMs): • Co-proxamol • Glucosamine and Chondroitin • Herbal Treatments • Homeopathy • Lutein and Antioxidants • Omega-3 Fatty Acid Compounds • Rubefacients (excluding topical NSAIDS) We will need to get NHSE to recognise that the restrictions on OTC products will detriment access to care to rural patients, in the full consultation (due in early 2018). OTC Proposal: Indicative conditions or items for which prescribing could be restricted:

1. Probiotics 2. Vitamins and minerals 3. Acute Sore Throat 4. Cold Sores 5. Conjunctivitis 6. Coughs and colds and nasal congestion 7. Cradle Cap (Seborrhoeic dermatitis – infants) 8. Haemorrhoids 9. Infant Colic 10. Contact Dermatitis 11. Dandruff 12. Diarrhoea 13. Dry Eyes/Sore (tired) Eyes 14. Earwax 15. Excessive sweating (Hyperhidrosis) 16. Indigestion and Heartburn 17. Insect bites and stings 18. Malaria prevention 19. Mild Acne 20. Mild Dry Skin/Sunburn 21. Mild to Moderate Hay fever/Allergic Rhinitis 22. Mild Migraine 23. Minor burns and scalds 24. Minor conditions associated with pain, discomfort and/fever. (eg aches and sprains, headache, period pain, back pain) 25. Mouth ulcers 26. Nappy Rash 27. Oral Thrush 28. Prevention of dental caries 29. Ringworm/Athletes foot 30. Scabies/ Head Lice 31. Simple Constipation 32. Teething/Mild toothache 33. Threadworms 34. Travel Sickness 35. Vaginal Thrush 36. Warts and Verrucae






By Mark Stone

Pharmacist Partner, Tamar Valley Health, DDA Board

www.forte.uk.com 3






Pip code Product name Item size Colvan product code

406-0935 CovaWound Silicone Foam 5 x 5 cm 10 1000505





406-0869 CovaWound Silicone Foam with Border 10 x 10 cm 10 1011010



406-0554 CovaWound Silicone Foam with Border 7.5 x 7.5 cm 10 1017575

406-0836 CovaWound Silicone Foam with Border Lite 5 x 5 cm 10 1030505




406-0828 CovaWound Silicone Foam with Border Lite 7.5 x 7.5 cm 10 1037575

406-0992 CovaWound Silicone Foam Lite 10 x 10 cm 10 1041010



406-0778 CovaWound Silicone Foam Lite 7.5 x 7.5 cm 10 1047575

406-0943 CovaWound Alginate Rope 2 x 30cm 5 3000230

406-0984 CovaWound Alginate 5 x 5cm 5 3000505




406-1024 CovaWound Hydrocolloid 10 x 10cm 10 5001010



406-1057 CovaWound Hydrocolloid Thin/Transparent 10 x 10cm 10 5201010



We are pleased to announce that, as of 1 December 2017, Alliance Healthcare, including NWOS, will enter into an exclusive wholesaler distribution agreement to supply Covalon Technologies (Europe) Ltd to all pharmacies and

dispensing doctors in England, Scotland and Wales and Northern Ireland.

As part of this new agreement, the discount available for eligible products will be 10 per cent. This will be

invoiced at drug tariff price, with any applicable discounts applied on your statement at the end of the month.

www.forte.uk.com 4






We are pleased to announce that, as of 1 February 2018, Alliance Healthcare UK will become the only selected wholesaler to supply Grunenthal’s product portfolio to pharmacies, hospitals and dispensing doctors in England,

Scotland, Wales and Northern Ireland.

For your convenience, the full information of Grunenthal’s product portfolio can be found on our website at

www.alliance-healthcare.co.uk/useful-information/supply-chain-arrangements/

Purchases of Grunenthal lines will arrive as part of your usual Alliance Healthcare delivery available on a same day delivery service. If you already hold an Alliance Healthcare account, there is no need for you to take any further action. Please note that Qutenza will remain on a next day delivery service. In order to receive Grunenthal lines from 1 February 2018, you can simply order from Alliance Healthcare in your usual manner. Purchases of Grunenthal’s products will not be subject to Alliance Healthcare’s low spend surcharge, if purchased

in isolation. A discount of 5% will be available on eligible lines for downstream customers.

To set up an Alliance Healthcare account, please visit our website at www.alliance-healthcare.co.uk/contact-us

Should you have any questions in relation to Grunenthal’s product portfolio, please contact Grunenthal on:

0870 351 8960

3582707 PALEXIA 100MG PR TABLETS A 56 GBR 4032129029415




3470820 PALEXIA 50MG IR TAB FILM COATED A 28 GBR 4032129029354

3579018 PALEXIA 50MG IR TABLETS A 56 GBR 4032129024328





3830817 PALEXIA IR ORAL SOL 20MG/ML 100ML GBR 4032129047143

3830825 PALEXIA IR ORAL SOL 20MG/ML 200ML GBR 4032129045453

3527322 TRAMACET EFFERVES. TABS A 60 GBR (GRT) 4032129028593

3039021 TRAMACET TABLETS A 60 GBR 4032129026735

3248747 VERSATIS PATCH A 30 GBR 4032129038844

2087203 ZYDOL 100 AMP. A 5 GBR (GRT) 4032129003576

2087211 ZYDOL CAPSULES 50MG A 100 GBR (GRT) 4032129003552

3208634 ZYDOL CAPSULES 50MG A 30 GBR (GRT) 4032129012608

2233609 ZYDOL SR 100MG TABLETS A 60 GBR (GRT) 4032129003583



3298726 ZYDOL SR 50MG TABLETS A 60 GBR 4032129048973

2349322 ZYDOL TABS 50MG A 100 GBR (GRT) 4032129003620

2349330 ZYDOL TABS 50MG A 20 GBR (GRT) 4032129003613

2644409 ZYDOL XL 150MG A 30 GBR 4032129008403

2644417 ZYDOL XL 200MG A 30 GBR 4032129008410

2644425 ZYDOL XL 300MG A 30 GBR 4032129008427

2644441 ZYDOL XL 400MG A 30 GBR 4032129008434

4046629 RALVO 700MG MEDICATED PLASTER A 30 GBR 4032129066939

3560737 QUTENZA 179MG CUTAN. PATCH A 1 GBR/IRL 5013346098582

http://www.alliance-healthcare.co.uk/useful-information/supply-chain-arrangements/

www.forte.uk.com 5






3171253 50 ACCU-CHEK AVIVA BLD T/STRIP 15% 20%

3981214 50 ACCU-CHECK PERFORMA T/STRIPS 5% 10%

4026324 50 ACCU-CHEK MOBILE TEST CASSETTE 5% 10%

We are pleased to announce that BABY D ORAL SOLUTION VIT D3 Manufacturer Discount Scheme is back at 20%.

See below table for details.

Kora Healthcare 3779675 1 BABY D ORAL SOLUTION VIT D3 20%

We are pleased to announce that Roche has increased the discount for Accu-Chek products range. For your

convenience please refer to the table attached for details of the products.

We are pleased to announce that Scope Opthalmics has added a new product to the current MDS scheme from

1st December. For your convenience please refer to the table attached for details of the product.

Scope Ophthalmics 4039731 1 Optase Moist Heat Mask 14% (New)

Scope Opthalmics 3472925 1 HYLO-TEAR 0.1% PRESERVE FREE 14%

Scope Opthalmics 3488368 1 HYLO-FORTE 0.2% PRESERVE FREE 14%

Scope Opthalmics 3552999 1 HYLO-CARE PRESERVATIVE FREE 14%

Scope Opthalmics 3643806 1 VITA-POS (PRESERV FREE OINT) 14%

Scope Opthalmics 3692357 1 TEAR-LAC PRESERVATIVE FREE 14%

Scope Opthalmics 3866688 1 HYLO-FRESH 0.03% 14%

Scope Opthalmics 4045175 1 HYLO-DUAL 0.1% FRESH 14%

Manufacturer Discount Scheme has stopped from 1st of December.

Manufacturer Discount Scheme has stopped from 1st of December.

From 1st October, the discount on Tricare has been removed form the MDS scheme.

No other products on scheme has been affected.

www.forte.uk.com 6






From the 1st February 2018, Agamatrix will discontinue the discount for U/Thin Lancets 33G and has decided to

increase the discount for Wavesense Jazz Test Strips range, starting from 11+ packs. See below table for details.

3401619 50 WAVESENSE JAZZ TEST STRIPS 10% from pack 1 13% 11+ packs

3725553 2X25 WAVESENSE JAZZ DUO T/STRIPS 10% from pack 1 13% 11+ packs

3420601 200 AGAMATRIX U/THIN LANCETS 33G 10% from pack 1 Removed

Generating Prescription

Audit (PA)

Do you know if your GP’s and nurses are remembering to produce a prescription each

time they administer a drug?

It’s a good idea to set up a monthly audit to check a prescription has been issued,

as you may be losing hundreds of pounds!

See below a list of drugs which I would recommend

doing a search on:

Tetanus

Depo Provera

Zoladex/Prostap

Hydroxocobalamin B12

Cholera

Depo Medrone

Depo-Medrone & Lidocaine

Off patent

Crestor has come of patent as from last month, reduce

your Crestor stocks in preparation for the generic.

By Lucy Jacques

Dispensary Manager

Hastings House Surgery

We will continue to offer E-Consultancy Service to all our 8501 Forte Group Members.

Whatever your commercial or dispensary query, all you need to do is email Sally ([email protected]) with

“Forte” followed by your Alliance account number in the subject header and she will reply with an answer

within 3 working days.

www.forte.uk.com 7






Happy New Year!

Words like “extraordinary”, “shocking” and even

“bizarre” have been bandied around to describe the last

12 months, one things for sure, 2017 certainly has been

an interesting one. We’ve seen a snap General Election,

unsuccessful independence elections in Spain, La La

Land “win” the best picture Oscar, and Trump’s

inauguration… well, the less said about that, the better.

Moving swiftly on;

Teresa May triggered article 50 meaning the Brexit

discussions are moving full steam ahead, for good or for

ill. I’m sure at the moment there are more headaches

for our politicians than directly affecting us currently,

but these will come. The immediate effect on our

industry was the increase in PI line prices, which meant

that every practice wasn’t able to enjoy the luxury of

the previous year’s import prices and having to look at

more financially stable and profitable ways of

purchasing. Despite FMD (Falsified Medicines Directive)

being a European venture, this has been confirmed that

it will still be applicable to Britain post Brexit and so

processes need to be in place to ensure both your

practices and the industry are ready.

We saw a record number of PSNC price concessions

running half way through the year and into 2018. A

couple of generic manufacturers failed their MHRA

inspections meaning they had to cease production for

some time, sadly lowering supply and increasing prices

for many lines across the market.

On to better news all round;

The PSNC appointed their new CEO Simon Dukes at the

end of the year after the previous CEO, Sue Sharpe

resigned from the position she held since 2001.

Julian Mount became the Managing Director of Alliance

Healthcare at the end of March, following the

announcement of Jeremy Main’s retirement. Julian

brings with him a wealth of knowledge and

experiences a senior healthcare industry executive with

30 years’ experience in building and leading teams in

business transformation, sales, marketing and business

excellence across international markets. Julian’s

appointment saw a renewed vigour and drive towards

the key fundamentals of the business to ensure your

practices and patients receive the very best standard of

service from Alliance Healthcare.

In August, Forte was acquired by Alliance Healthcare UK

and we are now part of the wider WBA family. With this

acquisition, we continue to be able to offer our mem-

bers the same dedicated service and commitment we

always have, with the added benefit of a global power

behind us to further enhance your membership benefits

and package. Watch this space for exciting develop-

ments throughout 2018.

It was a pleasure to work with you all in 2017, and we

look forward to continuing you help you service your

communities and care for your patients in 2018 and

beyond.

At Forte, we are incredibly excited with the

announcement from Alliance Healthcare and its new

customer-centric campaign - “we’re doing things

differently”, aimed at making business with Alliance

Healthcare easier. Keep up to date with the exciting

news at: www.alliance-healthcare.co.uk/doingthings

differently

From all of us here at Forte, we would like to wish you a

very happy and prosperous new year.

It is important that we hold the most up-to-date information regarding our customers. If you have recently

changed any of your details, such as your name, address or telephone number, please let us know by emailing

[email protected] or alternatively contact us on 0370 2418717 opt#3.

mailto:[email protected]

e [email protected] f 01622 790 754 forte.ukthe final and i feel most controversial proposal was the...

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