14th June 2021 - Source: Amanda Chell

• Hi Amanda, we have recently started prescribing Cyanocobalamin 50mcg tabs which has a reimbursement price of £16.44 for 50 tablets. I have spotted something called Cyanocominn which is also a 50mcg cyanocobalamin tablet but is £3.57 for 50 tablets. Are we ok to dispense this brand against the generic prescription?
• Yes, if the prescription is written generically – it is what is regarded as an ‘open prescription’. Dispensing the cheaper brand will give you a very healthy profit margin.
• I have a question regarding Paliperidone 350mg/1.75ml prolonged-release suspension for injection pre-filled syringes. It is in the drug tariff as a category C based on Trevicat. Should we be dispensing it or should we let the patient get the item dispensed at a local pharmacy?
• If you check part 2 of the Drug Tariff, all strengths of Paliperidone are listed. This means that pharmacy can dispense the prescription and not suffer the clawback. As the item has a tariff price of £942.21, you will suffer clawback of £105.33, you will receive a dispensing fee but your total loss will still be over £100.00.
• Hi Amanda, what is the best way to prescribe Acidex? Currently we have been prescribing It generically, been paid for Gaviscon and dispensing Acidex. I can see there is a manufacturer discount scheme on Acidex so should we now be prescribing it as the brand?
• No definitely not, carry on doing exactly what you are currently doing. Acidex has a 20% discount when you purchase so if you prescribe generically, you will make margin from the Drug Tariff and also receive a good discount when procuring the Acidex.