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Anon 13.38 - sometimes ICBs think a drug is cheaper locally, but overall the cost to the NHS is more. Local drug rebates are a classic example, because margin is paid on generics, a branded with a rebate associated might save that ICB money, but it will cost the system more as the medicine margin still needs to be paid to the pharmacy sector, and it will push reimbursement to pharmacy contractors up elsewhere.

This doesn’t worry me much, I can’t see it being locked down and clinicians having the ability to prescribe as they see fit inhibited. If this is done well it could be very good indeed.