Drug Tariff News

1st November 2021 - Source: Amanda Chell

October quarter 3 Category M pricing adjustment has been published.

  • In summary, 576 of the 660 lines are down in price. The average price reduction is just under 11 per cent.
  • Some 81 prices are increased, by an average of just over 24 per cent.
  • In this adjustment here are no additions or deletions.

This reflects the greater negative effects of margin adjustment and underlying price changes, despite the earlier agreement to add £12.2 million to reimbursement over two quarters.

Reference DDA website

October 2021 Dispensing Fee Scale 

Every April and October the dispensing fee scale is re-calculated. Currently there is no information available for the new dispensing fee as off 1st October 2021. DDS will advise in due course when the information becomes available.

Additions to Part 2

Only 6 items have been added to Part 2 of the October Drug Tariff and these are listed below:

  • Dovato 50mg/300mg tablets
  • Ethosuximide 250mg/5ml oral solution sugar free
  • Fortijuce liquid
  • Levothyroxine sodium 125micrograms/5ml oral solution sugar free
  • Promazine 25mg/5ml oral solution
  • Voriconazole 200mg tablets

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 October Drug Tariff. Ones that I think you may find of interest are:

Carbocisteine 250mg/5ml oral solution sugar free, 300ml has gone into the Drug Tariff as a Category C item with the reimbursement of £8.39 based on Brown and Burk UK Ltd.

Glycopyrronium 7.2micrograms/ dose / Formoterol 5micrograms/dose inhaler CFC free has gone into the October Drug Tariff again as a Category C with the reimbursement price based on Bevespi Aerosphere. This is an Astra Zeneca product so only available from AAH with a 5% discount.

Leuprorelin 10.72mg implant prefilled syringes has gone into the Drug Tariff as a category C with the reimbursement price based on Staladex. Staladex is an Accord product and PSUK are currently offering 35% Manufacturer Discount Scheme.

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

Only 1 item has been deleted from the October Drug Tariff and that is Meprobamate 400mg tablets. This was discontinued in September 2020.

If you do still have stock of Meprobamate, please be aware that it is a schedule 3 (exempt safe custody) item.

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

Only 1 item is listed in ‘Other Changes’ and that is Co-amilofruse 5mg/40mg tablets, pack size 28. This was listed as a Category C item based on Frumil, but is now a Category A item. The reimbursement price has gone from £5.28 up to £6.49, and  this can be purchased generically for as little as £4.95.

Part VIIIC Additions

No further additions have been added to part VIIIC for October 2021. As a reminder regarding Part VIIIC, please see the notes below:

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:

  • Inclisiran 284mg/1.5ml solution for injection pre-filled syringes (1) – Leqvio – DND

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.