4th October 2023 - Source: Amanda Chell



Hi Amanda,

Hope you are well?

Advice please!

I have had a script for Fluorescein 1% eye drops 0.5ml unit dose.  The doctor has written “PA” the script.  Is this classed as a personally administered item?

Hi there,

I am very well thanks – hope all is good with you?

If its just Fluorescein 1% then no its not PA

However, if its Fluorescein with Lidocaine then Yes it is PA.

It’s the lidocaine that makes the difference!


Hi Amanda

I hope you are well and enjoying our wet summer!

Quick question, do you know how much we lose per patient on Abbott freestyle libre? We have an increasing number of patients now being prescribed it and I know we lose on each prescription. There was talk of us giving a script to the patient to pick up in a pharmacy. I was just trying to find out how much per month we are losing before we make a decision on what we do – Many thanks


I am very well thanks, hope all is good with you?

Depends how many libre you are putting on a prescription.

Most patients are having 2 on each script so £35 each = £70.00 (no discount given from Abbott)

Less Clawback means you only get reimbursed £62.17 – you will receive a dispensing fee, currently average is £2.30 = £64.67 means you lose £5.33.

It’s a difficult one to outsource – some practices are putting 4 on a prescription and sending out to local pharmacy so the patient is inconvenienced less.

Freestyle Libre is NOT a loss for pharmacy as it falls into Part 2 of the Drug Tariff – anything in Part 2 – Pharmacy don’t suffer the clawback – we (dispensing doctors) suffer clawback on everything!

Hope that all makes sense?

Hi Amanda,

Hope you’re well?

Just a quick question. Where possible, I’m prescribing Nitrofurantoin as 50mg tablets rather than 100mg M/R capsules… Is this still the most commercially attractive way of prescribing Nitrofurantoin? Thanks.


Best profit at the moment is the Nitro 100mg caps – the only thing to consider here is it’s a Cat A so the reimbursement can change monthly