Drug Tariff

Question 1

What is the drug tariff?

Answer 1

Produced monthly for the DoH by the NHS Business Services Authority and NHS prescription services
Sent to all community pharmacies in England free of charge
Contains details of which products and services may be provided via an NHS contract/ prescription
Provide information on what contractors will be paid for NHS services including reimbursement and remuneration

Question 2

Can it be supplied on the NHS?

Answer 2

Medicinal products and devices must be considered separately, All medicinal products can be prescribed as long as they are not blacklisted. Devices can be prescribed only if they are listed in the tariff.

Question 3

The Black List

Answer 3

Part XVIIIA = The Black List
Created in 1985 to cut costs, if a drug/ medicinal product is listed here it is not prescribable on the NHS by any prescriber
Includes drugs/ products that are of doubtful efficacy or are expensive

Question 4

What action could you take if a patient had a prescription for a black listed item?

Answer 4

Sell as P medicine
Get GP to change to generic
Supply as an emergency at the request of the doctor

Question 5

Selected List Scheme

Answer 5

Part XVIIIB
Contains a list of drugs only to be prescribed in specified circumstances, including all erectile dysfunction preparations except generic sildenafil (England)
The doctor must endorse the Rx SLS, if not on Rx will be treated as a black list item&raquo_space; no money for contractor

Question 6

Borderline substances

Answer 6

Part XV
Food and toiletries that can sometimes be prescribed, doctor should endorse ACBS however contractor will still be paid if endorsement missing
List A: alphabetical list of products, with the conditions they can be prescribed for
List B: List of products by condition

Question 7

Appliances

Answer 7

All non-medicinal products are covered by part IX
Unlike medicinal products, they are only prescribable if they are in the tariff
Part IXA = appliancea/ dressings/ catheters
Part IXB = incontinence
Part IXC = stoma
Part IXR = chemical reagents
If the details are missing from a dressing script you will automatically be paid for the smallest size listed in the DT unless amended by prescriber

Question 8

Chemical reagents

Answer 8

Split according to what is being tested (blood/ urine), what it is being tested for (glucose/ INR/ keotnes)
Covers all glucose testing strips, finger pricking devices and meters not allowed, lancets only allowed as listed in IXA

Question 9

Dental prescribing

Answer 9

On the NHS dentists may only prescribe drugs from part XVIIA
Listed generically, may also request the branded product as long as not blacklisted, may not prescribe any appliance or dressing, even for dental use

Question 10

Nurse prescriber formulary for community practitioners

Answer 10

Suitably qualified district nurses and health visitors may prescribe on FP10(P) or (PN)
Can only prescribe from part XVIIB(i), includes medicinal products, appliances and reagents

Question 11

Nurse, pharmacist and optometrist independent prescribing

Answer 11

Nurse and pharmacist IP’s can prescribe and medicines for any condition within their competence including CDs
Optometrist IP’s can prescribe any licensed medicines for ocular conditions affecting the eye and surrounding areas, cannot prescribe CDs

Question 12

Prescription pricing process

Answer 12

Basic price - discount deduction + additional fees + container charge/ consumables + professional fees (90p) = remuneration

Question 13

Basic pricing

Answer 13

Branded drugs do not appear in part VIII as they are priced by manufacturer list price
Generic drugs not in part VIII must be endorsed with pack size and manufacturer/ supplier

Question 14

Branded or generic

Answer 14

If a branded drug is prescribed that product must be supplied
If generic prescribed any brand of appropriate quality may be supplied

Question 15

Quantity to supply

Answer 15

Generally, the exact amount ordered by the prescriber should be supplied
Exceptions: special containers, or where the quantity ordered does not coincide with the original pack and the product s sterile, effervescent, hygroscopic, liquid prep for the bath etc.

Question 16

Contraceptives XVI

Answer 16

List of contraceptives and appliances which are free of charge
Part IXA also lists contraceptive devices which are free of charge
Other drugs not on the list which are to be used as contraceptive should be endorsed as such by the prescriber (OC) or feminine symbol

Question 17

Single Rx charge payable

Answer 17

Only one charge payable where:
Same drug or preparation supplied in more than one container
Different strengths of the same preparation are ordered on the same form
Several flavours of the same preparation are supplied
More than one appliance of the same type is supplied (except hosiery)
Drugs are supplied in powder form with the solvent separate for subsequent mixing

Question 18

Multiple Rx charges

Answer 18

Multiple charges payable where:
Different drugs, types of dressing or appliance are supplied (even in the same box)
Different formulations or presentations of the same drug or preparation are prescribed
More than one piece of elastic hosiery supplied