Virtual Drug Tariff

Take a look at this section each month as it contains valuable information relevant for that edition and the next. It contains additions, deletions and any other alterations to the Drug Tariff. Take careful note of deletions to Parts IXA, IXB, IXC and IXR as if you dispense a deleted product, the prescription item will be returned as disallowed.

The Drug Tariff Preface publishes monthly lists; additions, deletions and other changes to products listed in the Drug Tariff. Each month, Community Pharmacy England compiles a summary of the changes coming into effect (the Drug Tariff Watch). To view the Drug Tariff Watch visit our page here.

Click here for Community Pharmacy England’s guide on how to make the most out of the Preface.

This section states that drugs must be of a suitable standard and appliances must be those listed in Parts IX and X. Chemical reagents should be those contained in Part IXR only and this part also refers to Part X for the Oxygen Therapy Service.

Clause 5 outlines claims for payment, including submission requirements and the payment timetable.

This section states how payments made to pharmacy owners are calculated. It includes guidance on:

• Endorsement requirements
• Quantity to be supplied
• Special Container rules
• Broken Bulk arrangements
• Out of Pocket Expenses
• Serious Shortage Protocols
• Original Pack Dispensing
• List of Drugs for Which Discount is not Deducted.

Part IIIA sets out the arrangements for the dispensing fee and additional fees that pharmacy owners can claim for, for example, the serious shortage protocol fee.

These are the current fees for Appliance Contractors. Appliance contractors are different from pharmacy contractors. They specialise in prescriptions for appliances, in particular, stoma and incontinence appliances. This section is not applicable to pharmacy contractors.

Pharmacy contractors must supply medicines in suitable containers where appropriate and are required to provide consumables when dispensing certain products. A payment for containers is made for every prescription item supplied where the quantity ordered is outside of the pack size (or a multiple of the pack size). Please note, pharmacy owners will not receive payment for containers if the product is classed as a special container or where original pack dispensing has been applied to the quantity supplied.

This is the deduction (discount) scale. Each month, pharmacy owners are reimbursed for the products they dispense, less an amount of discount deduction. The amount deducted is based on an assumed amount of discount received by pharmacy owners, which is a fixed rate set for: appliances, generics and brands.

This section of the Tariff provides information on the payments for Essential Services. This includes information on the NHS Discharge Medicine Service.

This section provides information on the payments for Essential Services that Appliance Contractors receive. This section is not applicable to pharmacy owners.

This reproduces the Secretary of State Directions (separate directions for England and Wales) for the Advanced Services for pharmacy owners.

This section outlines the arrangements and remuneration for providing national community pharmacy services for pharmacy owners in Wales.

This states that local NHS England teams in England and LHBs in Wales will be the determining authorities for commissioning and setting fees and allowances for Enhanced Services performed by pharmacy contractors.

This section outlines the gateway criterion and domain requirements for the Pharmacy Quality Scheme (PQS).

This section outlines the requirements for the Collaborative Working Scheme (Wales).

This section outlines the requirements for the Quality and Safety Scheme (Wales).

This section outlines the claim and payment information for Support for Transformation (Wales).

These are the basic prices for generic drugs. This Part is further divided into categories:

Category A includes popular generics, which are widely available. The Department of Health and Social Care calculates the reimbursement price based on information submitted by manufacturers.

Category C items are based on a particular brand or manufacturer.

Category H include drugs available from multiple suppliers (previously listed in Category C)

Category M includes drugs that are readily available, where the Department of Health and Social Care calculates the reimbursement price based on information submitted by manufacturers.

Broken Bulk may be claimed on Category C and Category H products. It can also be claimed on Category A or M products if the smallest listed pack size is equal to or greater than £50 (please note, broken bulk cannot be claimed on products classed as special containers)

Out of Pocket expenses may be claimed on Category C and Category H products only.

These are the basic prices for some unlicensed medicines. The pack size listed against a product will be used as the minimum amount for reimbursement. A prescription ordering any more will be paid on the listed pack size plus the 1ml or 1g list price for every additional 1ml or 1g prescribed. For example, a prescription for 200ml of an unlicensed medicine with a Part VIIIB listed pack of 100ml, the price will be calculated as 1x 100ml + 100 x 1ml.

Broken Bulk can only be claimed on Part VIIIB products if they have been extemporaneously dispensed by the pharmacy owner.

There is a fixed fee (currently set at £20) for dispensing any unlicensed special or import that is manufactured or supplied by a company operating under an MHRA specials license or importer’s license. This fee is to cover all costs incurred when sourcing the product. ‘SP’ must be endorsed on the prescription to claim this payment. If a product is extemporaneously dispensed by the pharmacy owner or by a 3rd party, costs incurred are covered by another fixed fee (also currently set at £20). ‘ED’ must be endorsed on the prescription to claim this payment.

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).

At present the only product listed in Part VIIIC is:

• Inclisiran (Leqvio®) 284mg/1.5ml solution for injection pre-filled syringes (Novartis Pharmaceuticals UK Ltd)

For more information see here.

Part VIIID, sets out payment arrangements for specials and imported unlicensed medicines (specials) (mainly unlicensed tablets and capsules), with reimbursement prices calculated relative to commonly identified pack sizes. The pack size listings are to support Broken Bulk claims which will be permitted for specials (except those classed as special containers) listed in Part VIIID.

Please note: Broken Bulk CANNOT be claimed for any specials listed in Part VIIIB of the Tariff or for any non-Tariff special.

There is a fixed fee (currently set at £20) for dispensing any unlicensed special or import for preparations manufactured under a Manufacturer ‘Specials’ Licence or sourced under a Wholesale Dealer Licence issued by the MHRA. This fixed fee is to cover all costs incurred when sourcing the product.

Note: Alternatively to the ‘SP’ endorsement, the ‘ED’ endorsement can be used to claim the £20 fixed fee for specials extemporaneously prepared by the contractor or a third party under the Section 10 exemption from the Medicines Act. However, it is unlikely that the ‘ED’ endorsement will apply to any specials listed in Part VIIID.

For more information see our Community Pharmacy England Briefing 005/22: Part VIIID – Specials with reimbursement prices relative to commonly identified pack sizes.

This section lists products which have been granted retrospective top-up payments for price concession lines.

These are permitted appliances and dressings. This chapter starts by listing the Technical Specifications for each section of dressings or appliances. The section is set out in alphabetical order of category. Only those items listed in this section will be allowed on NHS prescription.

Out of Pocket expenses cannot be claimed on items in this section.

More information is available by clicking on the links below:

Appliances

Dispensing an NHS prescription

This is the Incontinence Appliance section. It is divided into sections covering different components, e.g. belts, sheaths, tubes, etc. When looking for an item, first check which section it may come under, e.g. Incontinence Belts. The sub-section is then divided into alphabetical manufacturers listing their products, codes, pack sizes and prices. At the end of Part IXB is a list of manufacturers together with their addresses and telephone numbers.

Out of Pocket expenses may be claimed on items in this section.

This is the Stoma Appliance section and is similar in layout to the Incontinence section. As with Part IXB, a list of manufacturers and their contact details is included at the end of the section.

Out of Pocket expenses may be claimed on items in this section.

These are the only chemical reagents allowed on a NHS prescription. Only those pack sizes stated will be allowed.

Out of Pocket expenses cannot be claimed on items in this section.

This chapter deals with the Home Oxygen Therapy Service. The Department of Health and Social Care have indicated that following the changes to the Home Oxygen Service, this section of the Drug Tariff will be removed in the near future.

This chapter has been rescinded.

This chapter outlines the criteria and payments associated with the Pharmacy Access Scheme.

This provides information on the Essential Small Pharmacies Scheme (Wales).

This section outlines the grant payable to pharmacy owners who provide foundation trainee pharmacists with the training experience needed by pharmacy graduates.

This details the reward payments to be made where a pharmacy team member correctly identifies a fraudulent prescription and thereby prevents fraud.

This details how pharmacy contractors can request a prescription pricing recheck.

This provides information on the involvement of the global sum and the temporary safeguarding of payments.

This section outlines the dispensing compensation payment applicable to Welsh pharmacy owners.

In certain conditions, some foods and toiletry preparations have the characteristics of drugs. A board known as the Advisory Committee on Borderline Substances (ACBS) advises on the circumstances in which these products may be regarded as drugs. Part XV of the Tariff sets out the approved Borderline Substances. List A is an alphabetical index of the products (with the condition it manages underneath) and List B is an alphabetical index of conditions and those products suitable for the conditions.

This section covers prescription charges, exemptions and examples of the application of charges. It also includes the list of contraceptives to be supplied free-of-charge and medicines covered by the HRT pre-payment certificate. There are also instructions on the Prescription Charge Refund Procedure.

This is the Dental Prescribing Formulary. This list is definitive and only those substances stated will be permitted on paper FP10D prescription forms. Only items listed in the Dental Prescribing Formulary (Part XVIIA of the Drug Tariff) can be prescribed on Form FP10D. Although the Dental Formulary displays products by their generic titles and dentists are strongly encouraged to prescribe generically, a product may be ordered on Form FP10D by its brand name providing that the brand is not listed in Part XVIIIA of the Drug Tariff (drugs, medicines and other substances that may not be ordered under the NHS).

This is the Nurse Prescribers’ Formulary for Community Practitioners. Community Practitioner Nurse Prescribers are only entitled to prescribe medicines from this list or appliances from Part IX of the Drug Tariff.

This section covers guidance on non-medical prescribers such as nurse independent prescribers. These prescibers are able to prescribe any licensed medicine for any medical condition within their level of experience and competence (with some exceptions). They are able to prescribe prescription-only medicines (POMs) and any Schedule 2, 3, 4 or 5 Controlled Drug (except diamorphine, dipipanone or cocaine for the treatment of addiction). For more information, please see our Who can prescribe what? webpage.

The National Out-Of-Hours Formulary.

Drugs, medicines and other substances listed in this section are not permitted on an NHS prescription.

This is the Selected List Scheme which lists items that may be prescribed under certain conditions. Prescriptions must be marked ‘SLS’ by the prescriber. Please note that there are separate lists for English and Welsh prescribers to follow.

Pharmacy teams should note that regulations have been introduced to restrict the prescribing and supply of puberty suppressing hormones / gonadotrophin releasing hormone (GnRH) analogues to children and young people under 18 for the purposes of gender dysphoria / gender incongruence. From 26 July 2024 onwards, all GnRH NHS prescriptions are required to have the SLS endorsement. For more information see our page Gonadotrophin Releasing Hormone (GnRH) Prescription Regulations.

This small section outlines the criteria that was originally used in selecting products for inclusion in Part XVIIIA/ Selected List.

This section is the National Health Service Litigation Authority (Pharmaceutical Remuneration- Payment Disputes) (England) Direction 2022.

This chapter deals with payments to chemists suspended by direction of the NHS Tribunal.