Types of fraud involving this category


Dispensing/services fraud

This relates to dispensing or other services offered at the pharmacy to patients.

Dispensing irregularities

This relates to prescriptions not dispensed as claimed. For example, the pharmacist dispenses a lower quantity or strength of medication than claimed for or added an item that was not dispensed.

Dispensing counterfeit medicines

This relates to the dispensing of counterfeit medicines; counterfeit medicines are not approved for use in the UK by the Medicines and Healthcare Products Regulatory Agency.

Dispensing reissued medicines

This relates to the improper reissue of out of date, redundant or split pack medicines by a pharmacist to another patient.

Ghost patients

This relates to false claims made by pharmacists for patients who did not attend on the day, had never attended, do not exist or were deceased at time the treatment was claimed.

Double income

This relates to false claims submitted by a pharmacy to the NHS in respect of NHS patients who have already paid the NHS charge themselves.

Patient services

This relates to false claims made by a pharmacy for payment in respect of patient services, which includes Medicines Use Reviews, Appliance Use Reviews, smoking cessation etc.

Inflated costs

This relates to the inflation of fees, allowance and reimbursements claimed under the Drug Tariff by a pharmacy. This would include claims for specials, branded substitution, out of pocket expenses and No Cheaper Stock Obtainable.

Abuse of contract

This relates to NHS paid work undertaken by a pharmacist that contravenes the terms of the contract between the pharmacy and the NHS.

Contract balancing

This relates to prescriptions dispensed at one pharmacy, submitted for payment under the details of another pharmacy in order to generate a greater net profit.

Parallel imports/exports

This relates to NHS medicines being sold abroad to generate profit, or non NHS medicines being sourced from overseas at lower cost, by pharmacies.

False claims

This relates to false claims by pharmacies for allowances, expenses, payments or grants not directly related to the care of specific patients.

Market abuse

This relates to untrue or misleading information or actions intended to artificially manipulate the market for gain.

Supply limitation

This relates to the deliberate restriction of the supply of drugs in an attempt to increase the unit price.

Price fixing

This relates to individuals involved in the NHS supply chain agreeing to fix the price that a particular drug or groups of drugs will be sold to the NHS.

Patent

This relates to pharmaceutical companies increasing patent length of a particular medicine to prevent competition from generic drug manufacturers. This creates market dominance and unfair pricing, to the detriment of the NHS.