The Drug Tariff II Flashcards
What is the purpose of the Drug Tariff?
- Details the community pharmacy contract with the NHS (essential, advanced, enhanced services)
- A list of prices of drugs/appliances and fees for pharmacies
List the 5 ways that community pharmacies are paid
- Establishment and Practice payments
- IT and repeat dispensing prescriptions
- Fees
- Advanced services payments
- Enhanced services payments
What do Establishment and Practice payments depend on?
Number of items dispensed per month
Describe ‘Fees’ as pharmacy payment
- NHS payment to pharmacies for dispensing an item = 90p
- Plus additional payments for other services provided
What are the payments from advanced services?
- MUR = £28 each, up to 400 a year
- NMS = £20-28, depends on how may completed per month
Why are enhanced services payments not included in the Drug Tariff?
They are locally commissioned and paid for by councils, NHS England area team or CCG
What is the Black List?
Items which are:
- Unnecessary
- Expensive
- Have no medical use
- Duplication with other medicinal products
What items are allowed on an FP10 prescription?
- Any medicine, food, drink or medical cosmetic item
- As long as it is not on the black list
Where is the black list found in the drug tariff?
Part XVIIIA
How much is the patient charged for a prescription?
£8.20
One charge per item
How is elastic hosiery charged to the patient?
One charge per leg
How is the patient charged when there are different strengths/flavours of the same item on the FP10?
One charge
How is the patient charged when there are different formulations of the same item on the FP10?
One charge
How is the patient charged for combination packs?
One charge per item in the same pack
How are contraceptive items charged to the patient?
- No charge
- Except for cyprindiol if not endorsed in the body of the Rx with OC
How should a prescription be endorsed?
- Pack size
- Quantity supplied if defined by number of treatment days on prescription
- Brand name, pack size and price if not i part VIIIA
What does SP stand for in an endorsement?
Special = £20
What does ED stand for in an endorsement?
Extemporaneously dispensed = £20
What does PD(n) stand for in an endorsement?
Supervised consumption = £0.55 x n
What does MF stand for in an endorsement?
Measured and fitted = £2.60
What is a special?
- An unlicensed medicine ordered on prescription for a named patient
- Produced by a specials manufacturer who is licensed and inspected by the MHRA
- Certificate of Conformity or Certificate of Analysis must be supplied with the item
What is an unlicensed imported medicine?
- A medicine unlicensed in the UK but licensed medicine elsewhere in the world
- Acquired by an MHRA licensed and inspected importer
How should unlicensed medicines be endorsed?
- SP
- Quantity/volume supplied and pack size
If not in part VIIIB add:
- Price per pack and number of packs
- Manufacturer/importer license number (MS number)
- Batch number
Where are unlicensed specials and imported medicines found in the Drug Tariff?
Part VIIIB
What 5 records should be kept for items from part VIIIB for inspection by the Licensing Authority?
- Source of the special or imported unlicensed product
- The person to whom, and the date on which the special/imported unlicensed product was sold or supplied
- Prescriber’s details
- Quantity of each sale or supply
- Batch number of the special
What 5 things must the pharmacist endorse the COA, COC or invoice of unlicensed specials/imported medicines with?
- Pharmacy stamp
- Date
- Initials of pharmacist or dispenser
- Invoice price less discount
- Prescriber’s details
Where and when must the endorsed COA/COC/invoice be sent?
- At the end of the month
- Sent to the NHS England area team of the prescriber
List 3 items that receive payment for measuring and fitting if claimed using MF in the endorsement margin?
- Elastic/compression hosiery (part IXA)
- Trusses (part IXA)
- Para-stomal garments = belts and girdles
What are compression stockings?
Elastic leg garments which compress the limb, reducing the diameter of the distended veins and cause an increase in venous blood flow velocity/valve effectiveness
What does compression therapy prevent?
The formation of blood clots in the lower legs
What does compression therapy aid the treatment of?
Lower leg ulcers
What does compression therapy relieve?
Heavy and aching legs
When should stockings be measured?
Early morning
- Sitting = below knee
- Standing = thigh length
How should elastic/compression hosiery be endorsed?
- Quantity
- Type
- Fabric/knit
- MF if appropriate
How should the patient be charged for elastic/compression hosiery?
- Per leg
- £8.20 per number of articles
How are lymphoedema garments charged to the patient?
- Charged per type of item
- £8.20 per item
- No MF endorsement allowed
What are trusses?
A surgical appliance worn to support a hernia Typically a padded belt
What are the details needed on an FP10 for urinary catheters?
- Quantity
- Size (Ch) and balloon size
- Preferably brand
- Male/female
What is included in part XIB of the DT?
Devices to manage urinary incontinence
What is included in part XIC of the DT?
Devices used to manage colostomy, ileostomy and urostomy post-surgery
How much are patients charged for home delivery of items in XIB and XIC?
£3.40
What is in part IXR of the DT?
Chemical reagents
- Mostly strips for detection of glucose/ketones in blood for diabetics
- INR test strips for warfarin patients
