The health committee takes evidence on how the NHS purchases medicines
Topical questions sees queries about the Police Scotland budget and HIAL air traffic control
A statement on the veterans strategy
MSPs debate the Scottish National Investment Bank Bill for the final time
An SNP MSP leads a debate on Robert Burns
Martin Sawer from the Healthcare Distribution Association is "very concerned" about friction in the system.
Mr Sawer points out any more barriers will cause concern and his organisation are working very closely with the UK department of health.
There will be preparation necessary for December 31st, he adds.
Labour MSP David Stewart asks about confidence in supply post-Brexit.
Warwick Smith says Brexit is concerned because a different regulatory process for the UK will make life "more difficult and more expensive".
Any deviation from the EU at all will add cost he warns, and calls for the UK to stick "as closely as possible" to the EU regulatory framework.
It will be necessary for manufacturers to understand the new customs arrangements between the UK and EU and there is still work to be done on this, he adds.
Martin Sawer from the Healthcare Distribution Association says he is not convinced a more interventionist management of supply will work.
He warns it is expensive for the public purse.
He adds there are only five direct-to-pharmacy schemes, with wholesaling more common.
There are too many wholesale dealers licences out there which means we sometimes do not know where a product is, he warns.
That does however provide competition, Mr Sawer says, and he calls for more transparency around this.
Brexit may provide greater flexibility in this area he suggests.
SNP MSP Emma Harper asks about shortage in HRT and wonders whether it is possible to predict shortages.
It is difficult for us to understand route causes but we believe HRT is due to two suppliers of estrogen being closed down in China, Mr Smith replies.
There have been a series of issues causing supply chains to get long and thinner, and therefore less resilient than in the past he says.
At the moment there are 78 products on the UK's shortage list but our competitive price is keeping that lower than other European companies Mr Smith explains.
Martin Sawer from the Healthcare Distribution Association
Martin Sawer from the Healthcare Distribution Association says any patient having to wait for a medicine is one too many, but we are in a better place than ten years ago.
Ironically Brexit planning has helped identify a list of products that will be in short supply, Mr Sawer adds.
He says every pharmacy now has an infographic to explain why shortages have happened.
We need the government to prioritise data collection, Alison Culpan says.
Data can "save time, money and lives" she adds.
From the industry perspective the means anonymised, aggregated data but the NHS also needs to know about effectiveness she explains.
There is a bit of a wait and see culture in Scotland but this will not result of fast enough progress, Ms Culpan warns.
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Tory MSP Miles Briggs asks about outcomes and payments for results.
We desperately need data, replies Ms Culpan and she does get worried when people get hung up on price rather than value.
"We need to be able to collect the data so we know the outcomes."
Martin Sawar from the Healthcare Distribution Association
Martin Sawar from the Healthcare Distribution Association agrees the flexibility around pricing regulation has provided resilience in the supply chain.
Elsewhere in Europe, where tendering and other mechanisms are in place, are actually suffering worse shortages than the UK he adds.
Tory MSP Brian Whittle again asks about price differences for the same drugs within the UK.
Ms Culpan says ABPI encourages all its members to give all four nations the same arrangement.
However she points to differences between the nations on data collection and uptake of the voluntary scheme around innovative medicines.
Image source, bBCPrescription costs have risen by a quarter in the past decade
In 2018 we reported the cost of providing prescriptions had gone up by 25% in the preceding decade, with an ageing population and new drugs part of the reason.
NHS figures show the total bill for 2017-18 was £1.3bn, external, which is 25.7% more expensive than 10 years ago.
Paracetamol and aspirin are among the most commonly-prescribed drugs.
Prescriptions have been free in Scotland since April 2011, a policy introduced by the SNP government.
Warwick Smith from the British Generic Manufacturers Association
Warwick Smith from the British Generic Manufacturers Association points out volume is a key factor for generics, as the bigger the market the lower prices can be kept.
Mr Smith says the UK is the lowest priced of comparable countries in Europe and the US.
It can be up to 700% higher in some of these countries, he says, insisting competition is better than government intervention.
Mr Warwick explains the UK market remains attractive due to the low level of government intervention and we are attractive because we are a member of the EU.
"The system we have for unbranded generics works very well indeed."
Ms Culpan says there is good stewardship from Scottish government officials working with the industry, which is playing its part.
The Association of the British Pharmaceutical Industry's Scottish director tells the committee she does not see this partnership stopping and patients will still be able to access innovative medicines.
Alison Culpan from ABPI
Convener Lewis Macdonald again asks about price regulation schemes and Alison Culpan from ABPI says it works very well in Scotland.
In 2019/20, Scotland will get £70m back for the new medicines fund due to the 2% cap on branded products she highlights.
What we spend on medicine now is only 1% more than in 1948 she says.
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Image source, bbcMSPs will now quiz:
Mr Stewart pivots to the US-UK trade negotiations and points out drugs prices are five times higher on average in the US.
Ms Woodeson accepts there is a risk drug prices could rise with a trade deal between the US and the UK.
She points out UK government ministers have made strong statements that the NHS will not be on the table, the price the NHS pays for drugs will not be on the table and the services will not be on the table.
The first session for today's committee draws to a close.
Mr Stewart asks if there is any prospect of delay to approval for new drugs due to Brexit.
Mr Mogford replies: "There is no reason at all for there to be delay in the regulation of new products."
We will need to consider what is decided in the longer term for what Brexit means for the agency, he adds.
Labour MSP David Stewart turns discussion to the post-Brexit strategy, asking specifically about the future relationship with the regulatory European Medicines Agency (EMA).
The EMA moved to Amsterdam in March 2019, leaving its London base.
Jonathon Mogford from the MHRA explains almost all regulation evaluation is done at European level at the moment.
From 1 February current systems remain in operation, but ith the big difference will be the UK will not lead scientific work Mr Mogford says.
Products will be licensed therefore to the EU27 plus the UK, he adds.
There is still work going on around longer term arrangements with both sides agreeing to consider cooperation, such as mutual recognition arrangements or information sharing, he states.
Scotland's chief pharmaceutical officer Rose Marie Parr explains legislation would be required to allow care homes to hold the licence for controlled drugs.
Ms White asks if it would be the UK government would need to be approached to achieve this.
Prof Parr agrees that controlled drugs licensing is a reserved matter and a matter for the Home Office.
Ms Woodeson is unaware if there is a blanket ban on care homes having a licence as it would be determined by the staff there.
Mr Briggs asks why our IT systems are so far behind other European systems.
Prof Parr says HEPMA is being rolled out but accepts there is some impatience as to why we are not further ahead.
SNP MSP Sandra White asks why Home Office licenses for controlled drugs are not given to care homes in the same way they are to hospices.
Prof Parr accepts that many care homes are providing palliative care and there is ongoing work looking into this issue to ensure providers of palliative care can run efficiently.
She adds more in-roads need to be made on paediatric palliative care.