Medicines Optimisation & Pharmacy Procurement

The MOPP work stream delivers cost-effective prices on medicines and related products, and supports the London-wide QIPP work on medicines use and procurement. Medicines cost the NHS £2.6bn a year in London alone, split almost equally between Clinical Commissioning Groups mainly GP prescriptions) and acute and mental health trusts. Hospital medicine expenditure is rising by about 12%, partly due to the introduction of new high-cost medicines. We work with commissioner and provider pharmacy teams to encourage prescribing which both is clinical, and cost-effective. We monitor expenditure, savings and lost opportunity, as well as help to establish clinical guidelines to support use of the most cost-effective products.

Key Highlights

London Regional Medicines Committee
We provided intensive specialist support to the London Regional Medicines
Committee which resulted in London being the first region in which all (32)
CCGs agreed in principle to commission the new FreeStyle Libre continuous
blood glucose monitoring device for defined patient groups, benefits of which
include better quality of care, value for money and equity of access.

Neonatal parenteral nutrition solutions
We established the first pan-London contract framework agreement ensuring
the security of supply, value for money and optimised patient care.

Biosimilar medicines
2018/19 saw the launch of biosimilar trastuzumab and rituximab and in Q4,
adalimumab. Growing uptake of biosimilar etanercept and supporting the
uptake of the new drugs helped to yield projected full-year savings of £20m

Coming up in 2019/20

Biosimilars - will continue to deliver significant savings in 2019/20 currently
expected to total £40m.

Stoma care - MOPP published resources to optimise prescribing of stoma
care products and increase value for money in 2018/19. Building on the work
completed for London, NHS LPP has reached agreement in principle with
NHS Supply Chain: Rehabilitation, Disabled Services, Women’s Health and
Associated Consumables Category Tower, to develop a national stoma care
product procurement in 2019/20.

HIV medicines - the introduction of new generic medicines is projected to
save £20m.

Medical Gases - in addition to renewal of several existing NHS LPP
frameworks and working with NW London colleagues, we are planning a
fundamental review of the current framework for medical gases with a view
to changing the procurement strategy and trying incentive trusts to implement
track-and-trace software to control cylinder stocks and generate more leverage
in a challenging market historically dominated by one supplier.

Monitoring and reporting - we have developed multiple dashboards for
our members in primary care. The MOPP team are looking at how a new
secondary care dashboard can help trusts to monitor savings in 2019/20.