The Drug Tarrif Flashcards
Where does the drug tariff apply?
England and Wales
Drug tariff gives details about:
Standards of products to be supplies Payment to contractors Black list Independent prescribers lists Prescription charge for patients Endorsement by pharmacists
What does the preface of the DT contain?
Additions, deletions, changes between one addition and the next.
What is the difference between renumeration and reimbursement?
Reimbursement is getting your money back for the cost of drugs you are supplying
Renumeration is getting paid for your professional time
How do we know what can be put in an FO10 (medicines and appliances)
DT specifies:
Drugs NOT allowed on FP10 (black list)
Appliances, dressing and reagents ALLOWED on FP10
Part 1 clause 1 of the drug tariff states…
Drugs must be of a suitable standard including parallel imports.
Claims for payment should be sent off no later than…
The 5th of the month following supply
Scripts should be endorsed according to
Clause 9 of part 1
Types if payments you can get? (7)
Net ingredients cost Deduction scale Consumable container allowance Professional fees Additional fees Out of pocket expenses Drugs for which discount is not deducted
How is the price of a drug determined? Eg. 5 tablets?
As a proportion of the basic price.
Price based on exact quantity supplied.
Where are basic prices listed?
Part VIII
or of not then directly from manufacturer.
What must you endorse scripts with?
Name and address of supplier (NHS and private)
Exactly what has been supplied (NHS)
Number of items on the form (NHS)
Why do we endorse? (2)
To cancel the script so that it can’t be used
To enable to PPD to pay you for what has been supplied
If the drug is in part VIIIA how do we endorse? If not?
If in part VIIIA endorsing with pack size is not necessary.
In NOT in part VIIIA endorse with pack size and if generic also manufacturer/brand name
BB stands for
Broken bulk
OOPE stands for
Out of pocket expenses
NCSO stands for
No cheaper stock obtainable
PPD assume biggest/smallest pack size used if not stated?
Biggest
Exact quantity on Rx must be dispensed except for: (4)
Sterile products
Effervescent or hygroscopic products
Tubes, aerosols etc
Products in clause 10B (usually liquid external preparations, eg coal tar)
BB applies to what type of products (3)
Drugs, incontinence and stoma appliances
When do you endorse with broken bulk?
Product is not normally used and the smallest pack size is larger than quantity on Rx.
Quantity remaining not used.
Any Rx within 6 months will be deemed to be supplied from the remainder.
When can you not use BB (2)?
Special containers
Category A&M if smallest pack size is <£50
OOPE should be used when
Expenses incurred in exceptional circumstances obtaining a drug. Eg phoning abroad, handling fee, admin dee etc.
Not frequently spied by the contractor.
Endorse OOPE with (2)
OOP or XP
Reconstituted drugs clause ensures that
Applies to antibacterial, antiviral and antifungals that require reconstitution from granules or powder
Ensures that contractor is paid for the quantity made up rather than the quantity order in the Rx
Drugs that are not usually discounted by suppliers do not require endorsement
Eg fridge lines
Definition of a special
Specials are unlicensed relevant medicinal products which have been specially prepared to meet a Rx ordered for an individual patient (named patient basis) without the need for a manufacture to hold a marketing authorisation for the medicinal product concerned.
Examples of drugs her discount is not deducted (7)
Cold chain storage CD sch 1,2&3 Cytotoxic or cytostatic items Immunoglobulins Insulin s for injection Vaccines and antisera Specials source from manufacture or made extemporaneously
Professional fees. How much at present
90p + addition fees if applicable
6 additional fees
Unlicensed meds sources from manufacturer (SP)
Extemporaneously dispensed (ED)
Appliances - measured and fitted (MF)
CDs - sch 2&3
Expensive prescription fee (to account for time waiting for reimbursement)
Oral methadone
There is a section specifying acceptable types of containers and spoons. Why? (2)
Ensure safety and accuracy
What is the deduction scale?
The higher the volume of product obtained the grater the discount give, deduction scale recovers one of this for the government.
Payment for essential services include:
Establishment payment
Practice payments
Repeat dispensing
Electronic transfer of Rx allowance
Payment for advanced services includes
MUR, NMR, stoma customisation and appliance review.
Branded or generic.
If branded on Rx must supply brand. If generic can supply any. DT lists price DoH will pay for…
Generic. Regardless of cost to the pharmacist.
Category A is
Drugs that are readily available
May use if smallest pack size is >£50
Category C is
Drugs that are priced on basis of a particular rebrand or supplier. (Not as readily available as a generic)
Endorse with a pack size if more that one is listed.
BB is allowed.
Category M is
Very common generics
Drugs which are readily available where the DoH calculates the reimbursement price from information submitted by manufacturers.
BB is allowed if smallest pack size >£50
Square symbol means
Special container
Circle symbol means
Requires reconstitution
Double SS symbol means
Selected list scheme
Formulations abbriviations STD SF CF LF PF NSF
STD standard form incl standard flavours SF sugar free CF colour free LF lactose free PF preservative free NSF non standard flavour
Can you used BB and OOPE for Appliances and dressings Incontinence supplies Stoma appliances Chemical reagents
Appliances and dressings - NO
Incontinence supplies - YES
Stoma appliances - YES
Chemical reagents. - BB for some. No OPPE
Oxygen is supplied via what form… Not an FP10
HOOF
home oxygen order form
Essential small pharmacies scheme is subsidy for
Small rural pharmacies.
What is ACBS
Advisory committee for borderline substances
What are border line substances?
How do you endorse them?
Are you a toiletry or a drug?
ACBS
Boarder line substances…
List A
List B
List C are….
List A. Products (& what condition you can use them for)
List B. Conditions (& what products you can use for them)
List C. Blank. Rejected products are now included elsewhere..
Eg. Wysol for lactose intolerant preschool kiddies.
Notes on pricing charges. DT contains list of exemptions. Multiple prescription charges and ‘no charge items’. How does this work?
If item is same form and different strengths eg. Hytrin started pack. only one charge.
If item is combination eg. HRT multiple charges.
Out of hours formulary is …
List of drugs patient should be able to access out of hours…
How to endorse no charges?
1 in the box
Under: 2n/c
For 3 items, 2 no charges
Blacklist is…
Part XVIIIA of the DT
restricts number of products available for certain minor illnesses on the NHS.
If you supply black list you what happens?
So what should you do?
You will to be paid.
Suggests alternative to prescriber
Sell an OTC if available
Get Rx changed to private
In emergency may supply as emergency supply at request of patient or doctor.
SLS means
Selected list scheme.
Certain drugs only available on FP10 under certain circumstances.
PRESCRIBER MUST MARK SLS. YOU CAN’T!
Criterion 6 of the black list says
You ant have profiled injection devices if it is more economical to have a device that is refillable.
To whom do we submit CD requisitions and Rx once supplied?
NHSBSA
What form do we have CD requisition on?
FP10CDF
What categories can we claim OOPE on?
C
