September Drug Tariff News
Additions to Part 2
Only 3 items have been added to Part 2 of the September Drug Tariff and these are listed below:
Items which fall into part 2 generally have no wholesaler discount and so you would be dispensing at a loss, therefore these are items which you may consider sending the prescription to a local pharmacy.
Additions to Part 8a
6 items have been added to Part 8a of the September Drug Tariff. Ones that I think you may find of interest are:
Carbocisteine 750mg capsules, pack of 60 has gone into the Drug Tariff as a category C item with the reimbursement of £18.98 based on Brown and Burk UK Ltd. This can be purchased generically for around £17.00.
Colecalciferol 10,000-unit capsules, pack of 20 has gone into the September Drug Tariff again as a Category C with the reimbursement based on Alissa Healthcare Research LTD.
Metformin 1g tablet, pack size 28 has gone into the Drug Tariff as a Category C with the reimbursement based on RX Farma at £9.11. This can be purchased for around £8.60 but currently seems to be out of stock with most suppliers.
Previously if any of the items above had been prescribed generically, you would have had to endorse the brand, manufacturer, pack size and price paid in the left-hand column. As the items are now in the Drug Tariff, no endorsement is required.
Deletions to Part 8A
4 items have been removed from the September Drug Tariff, listed below are items which you may find of interest:
Aminophylline hydrate 350mg modified-release tablets, more commonly known as Phyllocontin Forte Continus has been removed from the September Drug Tariff. The 225mg of Aminnophylline hydrate was removed from the Drug Tariff in August 21.
Cloral betaine 707mg tablets – category A has been removed from the September Drug Tariff; this was discontinued in November 2020.
Fluticasone 125micrograms/dose / Formoterol 5micrograms/dose breath actuated inhaler CFC free more commonly known as Flutiform K-haler has been removed from the September Drug Tariff, this was discontinued April 2021.
Indometacin 75mg modified release capsules have been removed from the September Drug Tariff. These appear to have been discontinued in 2005! Other strengths of immediate release and other formulation are still available.
Items which have been removed from the Drug Tariff can still be prescribed and dispensed but you will need to endorse the prescription with manufacturer, pack size and price paid.
Other Changes to Part 8a
10 items are listed in ‘Other Changes’ – ones which I think you will find of interest are:
Beclometasone 100micrograms/ dose / Formoterol 6micrograms/dose inhaler CFC free – last month this was listed in ‘other changes’ and Fostair was removed as the brand who the reimbursement price was based on. Weirdly, Fostair has been added back in this month!!
Pregabalin 20mg/ml oral solution sugar free, pack size 473ml was sitting as a category C with the reimbursement based on Lyrica. Has now moved to a category A and the reimbursement price has dropped slightly. Purchase price ranges widely from £99.00 down to £15.00 so shopping around is advisable.
Liothyronine 5microgram tablets has moved from a Category C to a Category A but the reimbursement price has remained the same at £99.00. Purchase price is around £98.00.
Part VIIIC Additions
From September 2021, the Drug Tariff includes a new section, Part VIIIC, which sets out arrangements of payment for products with a nominal price (i.e where the purchase price of the product is significantly lower than its NHS list price). Products listed in Part VIIIC are available at nominal prices because of commercial deals in place between the manufacturer or supplier and the NHS England and NHS Improvement (NHSE&I) which allows manufacturers to supply a drug to the NHS at a reduced cost compared to its published NHS list prices as authored in the NHS Dictionary of Medicines and Devices (dm+d).
The price listed in respect of a drug specified in the following list is the basic price (see Part II, Clause 8) on which payment will be calculated pursuant to Part I Clause 5B.1 for the dispensing of that drug. The products listed in this Part are products that the Secretary of State is on notice are available from a manufacturer or supplier at a nominal price that is significantly below the NHS list price for the product because of a commercial arrangement between NHS England and NHS Improvement and the manufacturer or supplier of the product. In these circumstances, reimbursing pharmacy contractors at the NHS list price (which would ordinarily be reflected in the Category C price) would not represent value for money. Accordingly, the Secretary of State determines a basic price for products in this Part that is based on the nominal price of the listed pack size, and so takes account of the commercial arrangement between NHS England and NHS Improvement and the manufacturer or supplier, although the Secretary of State will not have been privy to the detail of the commercial arrangement. Contractors who are unable to source the products listed at or below the basic price listed in this Part, or who are subjected to additional charges when purchasing the products listed in this Part, may request a review of the basic price and repayment of any additional costs incurred. The review requires the following steps to be taken. If there are any issues with the supply, ordering and pricing of the product, contractors must first contact the suppliers of the product for notification and resolution. Should no resolution be identified by the suppliers within 5 working days of receipt, then contractors should escalate to the Pharmaceutical Services Negotiating Committee (PSNC). To support the handling of the review, contractors are required to submit evidence of any difficulties experienced including issues with pricing or supply. Any claims and supporting evidence will then be referred by the PSNC to the Department of Health and Social Care. Following a successful review, where pricing issues are identified, any adjustments will be applied by the Pricing Authority to the contractors account at the earliest possible payment date
At present the only product listed in Part VIIIC is:
Reference PSNC and Drug Tariff
So, on referencing DMD, Leqvio has a list price of £1987.36 but will only be reimbursed at £55.00 as this is the arrangement between NHS England and the manufacturer.