29th September 2020 - Source: Amanda Chell

• I have a quick question to pick your brains as usual. Vitamin B12 injection has raised its head again at the practice, as some of the Drs have been prescribing loading doses of 6 injections on one prescription. I have informed them they will potentially lose 5 PA fees if they do that? Am right in saying that a prescription for the initial 6 doses would lose 5 PA fees? Just out of curiosity, what is the PA fee we get?
• You are correct, if the G.P puts 6 hydroxocobalamin on one prescription, you will lose out on 5 extra dispensing fees. With regard to the PA fee- there is no PA fee, it is just the dispensing fee.

• Please can you advise me if we should be ordering in Degarelix 80mg (Firmagon) inj or outsourcing them to the local pharmacy, we have one patient just starting the treatment and its about £129.

• Degarelix is an expensive item and falls into part 2 of the Drug Tariff. This means that if the Pharmacy dispense it, they will not suffer clawback whereas a dispensing doctor would. Correct outsource it to a local pharmacy.

• Hi, I have been asked by the GP where we can purchase Nebido 10000mg/4ml vial from?

• Nebido is a Bayer product and so falls into the Alliance solus arrangement, so you would purchase from Alliance however, Nebido is also a part 2 product so you may decide to let a local pharmacy dispense it for you.