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Pharmaceutical Services Negotiating Committee

Appliances

This section of the site contains guidance linked to particular appliances.

Related resources include the PSNC Disallowed Appliances List which provides guidance on popular appliances which may not be prescribed on an NHS prescription.

For support, please contact the PSNC Information Team

Bandages, Dressings and Dressing Kits

Aquacel and Aquacel Ag are listed in the Drug Tariff under ‘Protease Modulating Matrix - sterile' in Part IXA so can therefore be prescribed on an FP10 prescription.

Aquacel Ribbon and Aquacel Ag Ribbon are listed under 'Wound management dressing - Cavity dressing' in Part IXA so can therefore be prescribed on an FP10 prescription.

The ‘Ametop dressing pack' contains 12 tubes of 1.5g Ametop gel and 24 Opsite Flexigrid dressings 6cm x 7cm. As Opsite Flexigrid 6cm x 7cm dressing is listed in Part IXA of the Drug Tariff, and Ametop gel is allowed on an FP10 prescription as a medicinal product, the Ametop dressing pack would be passed for payment by NHSBSA Prescription Services.

The requirements for prescriptions ordering the packs of Emla 5% cream with occlusive dressings have changed recently. The term 'pre-medication pack' is no longer recognised by NHS Prescription Services. To keep in line with dm+d descriptions (which prescribers should be doing) prescriptions should be written as either: Emla 5% cream 25g + 12 dressings or Emla 5% cream 5g + 2 dressings. The NHS Prescription Services will consider this to be a "drug packed with a non tariff appliance" (see Drug Tariff Part XVI 12.11) and pass the prescription for payment. If a prescription is received written as either "Emla 5% cream" or "Emla 5% cream pre-medication pack", as long as the pharmacy endorses that they gave the dressing pack (using the descriptions above), they will be reimbursed for dispensing that pack.

FAQ. I have a prescription for Emla 5% cream. There is a pack that comes with occlusive dressings, if I dispense this what will I be reimbursed?

The requirements for prescriptions ordering the packs of Emla 5% cream with occlusive dressings have changed.

There used to be a pack known as a ‘pre-medication pack’, but this is no longer recognised by NHS Prescription Services. To keep in line with dm+d descriptions (which prescribers should be doing) prescriptions should be written as either:

Emla 5% cream 25g + 12 dressings

OR

Emla 5% cream 5g + 2 dressings

However, if a prescription is written simply as "Emla 5% cream", pharmacy contractors can still be reimbursed for dispensing any of the available pack sizes (including the dressings packs), as long as they endorse the prescription accordingly (using the descriptions given above).

Please note that the patient would pay only 1 prescription charge (and the pharmacist would receive only one fee) because the dressings are ‘Non Drug-Tariff Appliances' which are only permitted because they are packed with a prescribable drug and are required as part of the drug’s use. More information is available in Part XVI of the Drug Tariff (10.11 Drugs Packed with Non Drug Tariff Appliances.)


 4Ulcercare is a magnet-containing device designed to be wrapped around the leg to prevent the recurrence of leg ulcers. A variety of sizes of this product were added to Part IXA of the Drug Tariff in March 2006 under the heading ‘leg ulcer wrap'.

We are frequently asked what can be dispensed against a prescription for ‘Knitted Viscose Primary Dressing Type 1'. N-A Ultra is a type 1 knitted viscose dressing. Two sizes of dressing are listed in the Tariff, 9.5cm x 9.5cm and 19cm x 9.5cm. If the prescriber has not indicated a particular size, payment will be based on the contractor's endorsement. If there is no endorsement, payment will be based on the smallest size listed in the Drug Tariff. 

Soffban Natural 10cm x 3.5m pack was re-branded ‘Profore #1'. The Drug Tariff listed both the old and new names for 12 months but the listing for Soffban has now been removed. If prescriptions are received for ‘Soffban 10cm x 3.5m', they should be returned to the prescriber to be amended to read ‘Profore #1'. Soffban continues to be available from BSN Medical in a number of pack sizes. No Soffban Bandage is currently listed in Part IXA of the Tariff therefore no Soffban bandage can be prescribed on an NHS Prescription.

Litepress & Co-Plus have been re-branded as Profore #3 and Profore #4. Only appliances listed in Part IX of the Drug Tariff can be prescribed on an FP10 prescription. As both Litepress & Co-Plus Bandages are no longer listed in Part IXA of the Drug Tariff, they should not be prescribed on an FP10 prescription. If you receive a prescription for these products, the prescription should be returned to the prescriber to be amended to read Profore #3 or Profore #4. Litepress & Co-Plus Bandages continue to be available from BSN Medical in a number of pack sizes. No Litepress or Co-Plus Bandage is currently listed in Part IXA of the Tariff.

Steripaste (15%) 7.5cm x 6m, Zincaband (15%) 7.5cm x 6m, Ichthaband (15/2%) 7.5cm x 6m, Quinaband 7.5cmx6m and Calaband 7.5cm x 6m are all considered medicinal products. They are not listed in the blacklist so can be prescribed on an NHS prescription.

The following Mepilex products have been deleted from the  Drug Tariff and are no longer be reimbursable on an NHS prescription.

Mepilex
10cmx10cm
10cmx20cm
15cmx15cm
20cmx20cm

Mepilex Border
7.5cmx7.5cm
10cmx10cm
15cmx15cm
15cmx20cm

Only these sizes have been deleted, all the other Drug Tariff listed sizes remain reimbursable.

Catheters

Q. How will I be reimbursed for a prescription for a catheter which is only written generically?

A. Many appliances listed in Part IX of the Drug Tariff are listed by specific brand name, and it is recommended that they should be prescribed by the brand or manufacturer name listed in Part IX of the Drug Tariff to be allowed on an NHS prescription. However, for some items there are default prices in place which are designed to cover situations in which a prescriber has only written a generic prescription.

The generic defaults in place for catheters can be found in Part IXA of the Drug Tariff at the beginning of the "Catheters, Urinary, Urethral" section. The first part of the clause in question reads: "Where the brand is notstated by the prescriber, the basic price of each listed catheter supplied must not exceed..."

Therefore, in order to be reimbursed by NHS Prescription services for a catheter priced higher than the relevant default price, the pharmacy would need to return the prescription to the prescriber for amendment. The prescription must be amended to include a specific brand name as listed in Part IX of the Drug Tariff. Pharmacy staff cannot make this amendment themselves.

Other medical devices which have generic defaults are: elasticated tubular bandages, absorbent perforated plastic film faced dressings, permeable non-woven synthetic adhesive tape BP 1988, and peak flow meters. All default prices can be found in Part IX of the Drug Tariff, in the same sections as you would find the reimbursement prices for the branded versions of these products 

Catheter Maintenance Solutions

Some Uro-Tainer products are classed as medicinal products and some as medical devices. The table below provides guidance on the commonly prescribed Uro-Tainer products:

 Uro-Tainer Type Pack Size  Classification  Allowed on FP10 Prescription 
Chlorhexidine
1:5000
100ml Medicinal
Product
Yes
NaCl 0.9% 50ml Drug Tariff
Appliance
Yes
NaCl 0.9% 100ml Drug Tariff
Appliance
Yes
NaCl 'M' 0.9% 50ml Non Drug
Tariff
Appliance
No
NaCl 'M' 0.9% 100ml Non Drug
Tariff
Appliance
No
Twin
Solutio R
6%
2x30 ml Drug Tariff
Appliance
Yes
Solutio R
6%
50ml Non Drug
Tariff
Appliance
No
Solutio R
6%
100ml Non Drug
Tariff
Appliance
No
Twin Suby G
3.23%
2x30ml Drug Tariff
Appliance
Yes
Suby G 3.23% 50ml Non Drug
Tariff
Appliance
No
Suby G 3.23% 100ml Non Drug
Tariff
Appliance
No

 

Cervical Collars

There are a number of Cerivical Collars now listed in Part IXA of the Drug Tariff.

Elastic Hosiery

As a general rule, all prescriptions for hosiery should indicate the quantity being dispensed; include a description of the article (eg. knit, style) and an indication of the Compression Class. The Drug Tariff listings are generic and the NHSBSA Prescription Services does not receive or maintain specific information relating to Drug Tariff specification brands. To price your prescription, NHSBSA Prescription Services processing staff need sufficient information about the product being dispensed. If this is not available, the prescription will be returned to the pharmacy for more information to be added.

For below knee and thigh length standard stock sized garments (where there is no indication that 'made to measure' has been supplied) the only knit available is circular knit. The NHSBSA Prescription Services has confirmed that in this case, if the contractor hasn't endorsed the knit, 'circular knit' will be the default for payment. The style (eg. below knee or thigh length) and the compression class must still be clearly marked on the prescription for the NHSBSA Prescription Services to make the correct payment. If this is not included on the prescription, the prescription will be returned.

For anklets, kneecaps and made to measure stockings where there is a choice of knit, the type of knit dispensed along with the style (e.g. below knee, thigh length, anklets or kneecap) and the compression class must be clearly marked on the prescription for the NHSBSA Prescription Services to make the correct payment. If this is not available, the prescription will be returned to the pharmacy for more information to be added.

'Scholl Ultima Thigh Length Hold-up Stockings' are allowed on an FP10 Prescription. Scholl Ultima Hold-ups are the same length as ordinary thigh length stockings and conform to Drug Tariff Specification 40 so are allowed. Reimbursement would be at the set Drug Tariff price for Class 1, circular knit, thigh length stockings.

FAQ. If a patient requires made-to-measure compression hosiery, does the prescription need to specify “Made-to-Measure”?

If the prescriber has requested a standard stock size of elastic hosiery but after measuring the patient, it is identified by the pharmacist that the patient requires a made-to-measure product, as long as the prescription is very clearly endorsed to indicate that a made-to-measure product was provided, a contractor will be reimbursed on this basis.

Where measuring and fitting has occurred, pharmacies should also clearly endorse prescriptions with the letters ‘MF’ to claim the measured and fitted additional fee (Part IIIA 2. B(a) of the Drug Tariff ).

Gengigel Gel and Mouthrinse

Both Gengigel Gel and Mouthrinse are registered as medical devices and are listed in Part IXA of the Drug Tariff under Oral Film Forming Agents. Neither product appears in the Dental Formulary so therefore cannot be prescribed on an FP10(D) prescription by dentists. These products may however be prescribed by Doctors and Nurses.

Head Lice Devices

The only 'Steel Nit Comb' allowed on prescription is the ‘Nitty Gritty NitFree Comb.'

Hypodermic Equipment

The 200 lancet pack size of Freestyle Lancets is listed in Part IXA of the Drug Tariff so this pack is prescribable on an FP10 Prescription. Previously there was also a 100 lancet pack size listed in the Drug Tariff but this was removed from the Drug Tariff in September 2005 and is no longer prescribable. As there is now only one pack size listed in Part IXA of the Drug Tariff, payment will be based on this pack size so there is no need to endorse the prescription. Contractors should take care not to endorse the prescription with the 100 pack size. As this pack size is no longer available on an FP10 Prescription, the NHSBSA Prescription Services would disallow the prescription.
 

Lancet Types (Sterile, Single Use)

Since August 2005, information regarding the Type of Lancet has not appeared in the Drug Tariff. Below is a table listing the Lancets prescribable with their type details.

Type A - Mount Fluted Longitudinally
Type B - Mount with Concentric Rings
Type C - Device Specific Type
X - Single Use Disposal Device  (never listed as a type in the Drug Tariff
* - Type Unconfirmed 

 

Type  Name & Manufacturer Size (mm/guage) 
A BD Micro-fine + (Becton Dickinson)  0.2/33
0.3/30
* Bionime Rightest GL 300 (Response Medical Equipment Ltd)   0.31/30
A Cleanlet Fine (Gainor Medical) 0.36/28 
A FreeStyle (Abbot Labs Ltd)  0.5/25 
A Glucoject No-dol Lancets (A. Menarini Diagnostics) 0.315/30
A GlucoMen Fine (A. Menarini Diagnostics) 0.45/26 
A Microlet Lancets (Bayer Diagnostics)  0.5/28
A Milward Steri-Let (Entaco) 0.66/23
0.36/28
A MPD Ultra Thin (Medical Plastic Devices) 0.46/26
* Multiclix (Roche Diagnostics) 0.3/30
A OneTouch Finepoint (Lifescan UK) 0.5/25
A OneTouch Ultrasoft (Lifescan UK) 0.4/28
* Safe-T-Pro Uno (Roche Diagnostics) 0.63/23
C  Softclix (Roche Diagnostics Ltd)  0.4/28
C Softclix XL (Roche Diagnostics Ltd) 0.8/21
A Thin Lancets (Abbot Labs Ltd)  0.36/28
B Unilet ComforTouch (Owen Mumford Ltd)  0.375/28
A Unilet General Purpose Superlite (Owen Mumford Ltd) 0.66/23
X Unistik 3 Comfort  (Owen Mumford Ltd) 1.8/28
X Unistik 3 Normal (Owen Mumford Ltd) 1.8/23
X Unistik 3 Extra (Owen Mumford Ltd) 0.2/21
* Universal Lancets (VitalCare UK) 0.36/38
A Vitrex Gentle (Vitrex Medical Ltd) 0.36/28
A  Vitrex Soft (Vitrex Medical Ltd)  0.65/23 
* WaveSense Ultra-Thin (WaveSense Europe Ltd) 0.35/28
0.2/33

 

Lymphoedema Garments

FAQ. I have a prescription for the Jobst Elvarex Custom Fit Class 1 Thigh High stocking (L1-01-06) and the patient says they need the silicone band (LA004) to go with it – will I be paid correctly if I endorse the silicone band as it is recognised as an additional option?

A. Any additional options must be specifically ordered by the prescriber, otherwise they will not be reimbursed by NHS Prescription Services. The pharmacy cannot endorse the additional options themselves so the prescription would have to be returned to the prescriber to be amended.

There is a note in Part IXA, lymphoedema garments, underneath the Jobst Elvarex Custom Fit items, which reads: "Where Jobst Elvarex garments are prescribed including specifically prescribed additional options, the dispenser must ensure that full details including order codes are clearly endorsed on the FP10." Therefore, the pharmacy can only endorse details of additional items which have been specifically prescribed. 

Normal Saline (NaCl) Nasal Drops

Normal Saline Nasal Drops/Sodium Chloride Nose Drops are listed in Part IX of the Drug Tariff so contractors can only provide one of the products listed in this section. The nasal drops that can be dispensed can be found in Part IXA of the Drug Tariff under the heading ‘Nasal Drops - Sodium Chloride 0.9%'

Contractors should endorse the name of the manufacturer (not the supplier) on the prescription. If the prescription is endorsed with the manufacturer of a normal saline nasal drops 0.9% product not listed in the Drug Tariff, a copy of the prescription will be returned to the contractor marked disallowed.

Protectives

The ‘Limbo Waterproof Protector - Adult ½ leg' is listed under the heading of ‘Protectives' in the Appliances section (Part IXA) of the Drug Tariff and will therefore be passed for payment by the NHS Business Services Authority Prescription Pricing Division.

Roche Diagnostics Manufacturers Rebate Scheme (MRS)

In October 2006, the Department of Health decreased the Drug Tariff prices for a range of blood glucose test strips. Although Roche Diagnostics reduced the prices of their affected blood glucose test strips – Active, Advantage Plus, Aviva, BM-Accutest and Compact, they did not reduce them in line with the decreases to the reimbursement prices for these products. To ensure that pharmacy contractors are not financially disadvantaged by this change, Roche Diagnostics have put in place a Manufacturer’s Discount Scheme under which monthly rebates are made to pharmacy contractors. This scheme is available through all pharmaceutical wholesalers and has been in place since 1st October 2006.

The scheme is administered differently by different wholesalers according to their own internal policies. In some cases, pharmacies receive a cheque from their supplier in respect of purchases during a particular month. In other cases, to minimise workload on pharmacies in reconciling additonal paperwork, wholesalers provide discounts on the invoice rather than a payment at a later date. We would recommend checking to ensure that your wholesaler has implemented this Scheme and that you are receiving rebates or additonal discount for these lines. More information is available from wholesalers or the Accu-Chek Pharmacy Careline on 0800 195 1440.

Sharps Disposal Bins (Sharpsguard/Sharpsafe)

The disposal of sharps contaminated with medicines, even small quantities, normally involves incineration. The disposal of sharps disposal bins containing cytotoxic medicines requires special high temperature incineration. To support the identification of risks when sharps disposal bins are removed by a waste company, sharps disposal bins are now available with different coloured lids, it is therefore important that when supplying to a patient, a bin with an appropriate lid colour is supplied.

Yellow lidded bins are suitable for sharps that are contaminated with medicinal products, other than cytotoxic drugs. Purple lidded bins are suitable for sharps which are contaminated with cytotoxic drugs and as orange lidded bins may not be disposed of by incineration, they are only suitable for sharps which are not contaminated with medicines.

If there is a possibility of sharps being contaminated with medicines, for example if broken vials or incompletely discharged syringes are possibly going to be present, the safest option is to supply the patient with a yellow lidded bin. If there is a possibility that the patient will need to dispose of sharps contaminated with cytotoxic medicines, the purple lidded bin should be supplied to the patient. General Information about Sharps can be found in the Waste Section of this site.   

Sharpsbin Name Change

The name of the product, ‘Sharpsbin' (Daniel’s Healthcare) was changed to ‘Sharpsguard'. During the period of transition, Sharpsbin had a dual listing in the Drug Tariff. This listing has now been removed and prescriptions for the Daniel’s Healthcare product should now only be written using the new name, ‘Sharpsguard’.

From February 2009, prescriptions written as ‘Sharpsbin’ will not be passed for payment and will be returned as disallowed. Prescriptions received for ‘Sharpsbin’ should be returned to the prescriber for amendment to either the new name for the Daniel’s Healthcare product, ‘Sharpsguard' or there is an alternative disposal unit listed in the Drug Tariff, Sharpsafe (Frontier Medical Products).

She-wee

The Shewee Ltd incontinence device “Shewee” is included in Part IXB of the Drug Tariff and as such would be allowed to be prescribed on an NHS prescription.

Sodium Hyaluronate Cream

Xclair Cream (Sodium Hyaluronate) has been registered as a medical device. This product is listed in Part IXA of the Drug Tariff so would therefore be passed for payment by the NHSBSA Prescription Services.

Spacers

The listing for ‘Spacer/Holding Chamber Devices’ was changed in the September 2005 issue of the Drug Tariff. Each device will be listed by brand name rather than generic name and manufacturer. The NHSBSA Prescription Services has confirmed that prescriptions for spacers must be written using the listed brand names in the Drug Tariff. Prescriptions which have been written using the generic descriptions will not be passed for payment. If you need to get a prescription changed from a generic description to an equivalent brand, the table below illustrates the generic descriptions and equivalent brand names of the Spacer Devices listed in Part IXA of the Drug Tariff under the heading (Atomizers, Hand Operated):

 Generic Type  Brand Name

Type 1:
One piece to take aerosol canister without actuator 

Nebuhaler:
(Astra Zeneca) (Plastic cone-shaped 750ml capacity)
Type 1:
One piece to take aerosol canister without actuator
Nebuhaler with paediatric mask:
(Astra Zeneca) (Plastic cone-shaped 750ml capacity)
Type 2:
In two detachable parts to take aerosol with actuator
Volumatic (Allen & Hanburys) (Plastic cone-shaped 750ml capacity)
Type 2:
In two detachable parts to take aerosol with actuator - With paediatric face mask
Volumatic paediatric with mask (Allen & Hanburys) (Plastic cone-shaped 750ml capacity)
Type 3:
One piece for use with all types of pressurised MDI aerosols

Aerochamber Plus (GSK) (Plastic cylindrical body and mouthpiece; rubber MDI adaptor 145ml capacity)

Able Spacer (Clement Clarke) (Plastic cone-shaped body and mouthpiece; rubber MDI adaptor 135ml capacity)

Type 3:
One piece for use with all types of pressurised MDI aerosols with adult, child or infant mask
Aerochamber Plus with Adult, child or infant face mask (GSK) (Plastic cylindrical body and mouthpiece; rubber MDI adaptor 145ml capacity)
Type 3:
One piece for use with all types of pressurised MDI aerosols with small (infant), medium (child) or large (adult) mask
Able Spacer with either small (infant), medium (child) or large (adult) mask (Clement Clarke) (Plastic cone-shaped body and mouthpiece; rubber MDI adaptor 135ml capacity)
Type 3:
One piece for use with all types of pressurised MDI aerosols
Pocket Chamber (Ferraris Medical) (Plastic cylindrical body, mouthpiece and MDI adaptor. 100ml capacity)
Type 3:
as above with neonatal, child, teenager or adult mask
Pocket Chamber with neonatal, child, teenager or adult mask (Ferraris Medical) (Plastic cylindrical body, mouthpiece and MDI adaptor. 100ml capacity)

Type 3:
One piece for use with all types of pressurised MDI aerosols

 Optichamber (Respironics) (Plastic cylindrical body, mouthpiece and MDI 218ml capacity)

Swabs

Sterile Non-Woven Fabric Swabs 4ply 7.5cm x 7.5cm (Drug Tariff Specification 28)' are listed in Part IXA of the Drug Tariff so can be prescribed on an NHS prescription. In October 2006, the Department of Health decreased the reimbursement price for this product. For a number of months there was difficulty obtaining this product at the Drug Tariff price with one key manufacturer, Johnson & Johnson, discontinuing their brand of swabs on the basis that supply became uneconomic.

The Department of Health have since increased the price of this product again and Johnson & Johnson have confirmed that they have resumed manufacture of their Topper 8 brand of swabs.

Ideally prescriptions for appliances should be issued using the Drug Tariff description for the product. If an item listed in Part IXA of the Drug Tariff by generic name with no brands listed is prescribed by a brand name, it can be dispensed, however contractors should clearly endorse the generic description on the prescription to ensure that the product can be identified by prescription pricing staff.  

Vaginal Moisturisers

Replens MD is a registered medical device. It is listed in Part IXA of the Drug Tariff so is therefore allowed on an NHS prescription.

This product should not be confused with the product, Replens which is listed in Part XVIIIA of the Drug Tariff (the Blacklist). If you receive a prescription for Replens, the prescription should be returned to the prescriber for the letters ‘MD' to be added to the product name on the prescription or for an alternative product to be prescribed.


Foods, Drugs, Toiletries and Cosmetics

Could the product you are looking for be regulated as a food, medicine, toiletry or cosmetic? Click on the links below for additional support:

Product Related Guidance: Medicines

What can be Prescribed on the NHS? (Guidance)

 

 

 

 


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