1. Homecare – a pharmaceutical companys experiences and perceptions. Paul Probert January 2009 Personal view only

2. PDIG - Homecare symposium - Copyright Paul Probert January 20092 History Prior to January 2005 BI had no experience or knowledge of homecare. January 2005 – a condition of the Pan London HIV contract was to supply named homecare companies following the award of the contract. BI was awarded HIV homecare contracts for the following periods - January 05 – March 06 - April 06 – March 07 - April 07 – March 08 - April 08 – March 09 During these 4 contract periods we have experienced one company cease trading and another enter into administration.

3. PDIG - Homecare symposium - Copyright Paul Probert January 20093 Pharmaceutical Company Challenges Security of supply chain – e.g. Cold Chain and Cytotoxics. Financial risk to pharmaceutical companies. New contractual relationships and legal costs in the event of a breakdown. - Risk to all parties. - No standard agreements. Access to Contract Prices – risk of selling on Data ownership - Rebates data. - Contract Prices. - Supply chain. Level of patient stockholding.

4. PDIG - Homecare symposium - Copyright Paul Probert January 20094 Perceived Homecare Company Challenges High capital requirement for stock holding. Contractual relationships (as for pharmaceutical companies). Access to Contract Prices – Individual pharmaceutical company choice. Data supply - Rebates data. - Contract Prices. - Supply chain. Administration challenges - Invoicing. - Patient registration. - Confidentiality. - Deliveries.

5. PDIG - Homecare symposium - Copyright Paul Probert January 20095 Contract Experiences Rebates - Payment delays from NHS to Homecare companies. - Timing of claims from Homecare companies. Credit Limits - Homecare products are often higher priced specialist medicines. - Newer Homecare companies tend not to have credit ratings sufficiently high enough to warrant larger purchase volumes. - To date, the risk has been borne by the pharmaceutical companies.

6. PDIG - Homecare symposium - Copyright Paul Probert January 20096 Ongoing Homecare Opportunities Patients - Convenience. - Confidentiality. - Medicines access for immobile patients. Hospitals – outsourced pharmacy service - Freeing up Pharmacists time (for ward rounds etc.). - Space – stockholding. - VAT savings. PCTs - outsourced pharmacy service - VAT savings. - Freeing up community pharmacists time. - Delivering DH agenda e.g. Spoonful of Sugar.