Drug Tariff

The scheme applies to all companies suppl)dng NHS medicines prescribed by medical or dental practitioners or nurses qualified to prescribe. Generic medicines, whose price is determined by the Drug Tariff, are excluded, as are the over-the-counter (OTC) medicines, and sales of medicines derived from private (non-NHS) prescriptions. 

It is inevitable that the increased cost of the NHS medicines bill will result in the introduction of measures elsewhere to curtail these rises. These measures have undoubtedly influenced the changes to the PPRS agreement of 2004, that is, enforced price reductions, and possibly changes to the operation of the Drug Tariff. 

If mefenamic acid tablets are too big for Miss SM to swallow then a branded capsule formulation (Ponstan) is available. The GP would need to be contacted to agree the change for Drug Tariff reimbursement purposes. 

To gain the most from this text, it is suggested that the reader has access to either the print version or on-line version of a recent copy of both the British National Formulary and the respective Drug Tariff for their country (England and Wales, Northern Ireland or Scotland). 

This introduces medicines supply in the community and covers the background details. National Health Service (NHS) prescription forms and the restrictions placed on different NHS prescribers in the community, including the role of the UK Drug Tariffs, are discussed. 

One of the most important non-clinical reference sources for the supply of items on an NHS prescription form is the Drug Tariff. Produced monthly, the Drug Tariff is the guide as to what can and cannot be prescribed on an NHS prescription form. In addition, it also provides information on the amount pharmacies will be reimbursed and remunerated for dispensing items on NHS prescription forms and performing other NHS services. 

It should be noted that three separate Drug Tariffs exist (one for England and Wales, one for Northern Ireland and one for Scotland) and although similar in nature, the contents and the layout of the different sections does differ between the three. 

The Drug Tariff is probably not the easiest book to use and navigate your way around however, it is vital that pharmacists and pharmacy technicians involved in the dispensing process are familiar with its layout. As discussed in Section 2.3, there are different classes of individuals who supply items against NHS prescriptions (pharmacists, dispensing doctors and appliance contractors) and so the Drug Tariff contains information for all three types of supplier (i.e. it is not solely a reference source for pharmacists and pharmacy technicians). 

It should be noted that some items will not attract a discount from the wholesaler when purchased by the pharmacy contractor. These items were known as zero discount or ZD items. The list of drugs for which discount is not deducted can be found in Part II of the Drug Tariff. 

This part contains a list of drugs where the price that will be reimbursed has been set (as detailed in Part II, Clause 8). Therefore, irrespective of what item was supplied against a prescription, the price that will be used to calculate the reimbursement cost is fixed and detailed within this part. There are five categories of items within this part, the difference being how the price of the item listed in the Drug Tariff is calculated. These categories are ... 

If an item is listed in Part VIII of the Drug Tariff for England and Wales, that is the price that the pharmacy will be reimbursed for supplying the item, irrespective of the brand supplied. 

Part VIII of the Drug Tariff is important for pharmacy contractors. If an item is listed within this part, supplying a more expensive alternative will render the pharmacy financially disadvantaged. 

The only exception to the fixed reimbursement price listed in Part VIII of the Drug Tariff is where in the opinion of the Secretary of State for Health and the National Assembly for Wales there is no product available to pharmacies at the appropriate price (for example if there were manufacturing shortages of a generic item and only a proprietary equivalent was available). In these cases, endorsements of brand name or of manufacturer or wholesaler of the product and pack size so used may be accepted. 

There are a number of situations where a single prescription item will attract more than one prescription charge. Student pharmacists and pharmacy technicians should study this part of the Drug Tariff and become familiar with the different charging models. 

Dentists may only prescribe items listed in Part XVIIA of the Drug Tariff on an NHS prescription form in England and Wales. Further details can be found in Section 3.2.2. 

Dentists may only prescribe, on an NHS prescription form, those items listed in the Dental Practitioners Formulary (DPF) in the Drug Tariff. 

The Northern Ireland Drug Tariff contains similar information to the Drug Tariff for England and Wales. It is divided into 13 parts (including the general notes) as detailed below. 

This part lists those chemical reagents which may be prescribed on an NHS prescription form and is similar in composition to Part IXR of the Drug Tariff for England and Wales (see Section 2.4.1). 

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