Unit 2 - Drug tariff Flashcards by Sam Robinson

How often is the Drug Tariff published for the DoH?

Monthly

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Who publishes the Drug Tariff?

NHS Business Services Authority and NHS Prescription Services

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What does the Drug Tariff contain?

Details of which products and services may be provided via an NHS contract/prescription

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What does the Drug Tariff provide information about?

What contractors will be paid for NHS services including reimbursement (cost of drugs) and remuneration (professional fees and allowances)

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Which medicinal products can be supplied on the NHS?

All medicinal products (drugs, food, cosmetics, toiletries) can be prescribed as long as they are NOT blacklisted

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Where on the Drug Tariff is the Blacklist?

Part XVIIIA

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Which devices can be supplied on the NHS?

Devices (appliances, dressings, reagents) can be prescribed ONLY if they are listed in the Tariff

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Which part of the Tariff lists the devices that can be supplied by the NHS?

Part IX

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When was the Blacklist created?

1985 to cut costs

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What does SLS stand for?

Selected List Scheme

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What is the Selected List Scheme?

Contains list of drugs only to be prescribed in specified circumstances

for a specified group of patients
for a specified conditions

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Where is the SLS list in the Drug Tariff?

Part XVIIIB

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Who must endorse a prescription with “SLS” for a Selected List Scheme drug?

Doctor

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If SLS is not written on a Selected List Scheme prescription, how will it be treated?

As a Blacklisted item - the pharmacy will not be paid for prescribing the item

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Which erectile dysfunction preparation is the only one allowed to be prescribed on the Selected List Scheme?

Sildenafil (generic)

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What is a Borderline Substance on the Drug Tariff?

“In certain conditions some foods and toilet preparations have characteristics of drugs and the Advisory Committee on Borderline Substances advises as to the circumstances in which such substances may be regarded as drugs”

Who should endorse a prescription with “ACBS” for a Borderline Substance drug?

Doctor

Which part of the Drug Tariff shows the Borderline Substances?

Part XV (15)

What does List A show on the Borderline Substances list?

Alphabetical List of Products, with the conditions they can be prescribed for

What does List B show on the Borderline Substances list?

List of products by condition

If the details (size) of a dressing prescription are missing, what will you be automatically paid for?

The smallest size listed in the Drug Tariff, unless the prescription is amended by the prescriber

How many dressings are supplied when “1 OP” is written on the prescription?

One dressing NOT one box

How are chemical reagents split up on the Drug Tariff?

According to:

what is being tested (blood/urine)
what it is testing for (glucose/INR/ketones)

Which prescription forms do dentists need to use to prescribe drugs on the NHS?

FP10 (D)

WP10 (D)

Can dentists prescribe appliances or dressings?

No - not even for dental use

What can Nurse and Pharmacist IPs prescribe?

ANY medication for ANY condition within their competence, including Controlled Drugs (except cocaine, diamorphine, dipipanone (for addiction))

What can Optometrist IPs prescribe?

Any licensed medicines for ocular conditions affecting the eye and surrounding area but NOT Controlled Drugs

How much medication should be supplied?

The exact amount ordered by a prescriber should be supplied

When should the exact amount ordered NOT be supplied?

``` When the medication is in a special container (see Part VIII) Where the quantity ordered does not coincide with the original pack and the product is: - Sterile - Effervescent - Hygroscopic - Liquid preparation for the bath - Viscous external preparation - Packed in a tube - Dropper bottle aerosol - Puffer pack - II Clause 10 ```

How do you decide how much medication to supply if you cannot split the container?

Round down - if you get a prescription for 45, give 30 | If you get a prescription for 46, give 60

What is the role of the pharmacist with regards to drug interactions?

1. Anticipate the interactions before they occur 2. Recognise them if they occur 3. Counsel patients on their therapy

Which type of drugs is it important to look out for regarding drug interactions?

Drugs with potential to cause problems with the handling of other drugs - enzyme inducers - enzyme inhibitors AND Drugs causing issues in over-dose or under-dose - drugs with narrow therapeutic index OR - where serum levels must be at or above a certain level AND Drugs with a long half life