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Pharmaceutical Services Negotiating Committee

Food, Drugs, Toiletries and Cosmetics

This section of the site contains guidance linked to particular foods, medicines, toiletries and cosmetics.

For support, please contact the PSNC Information Team: 0844 381 4180 or 0203 1220 810

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z 

Aciclovir

The PSNC Information Team are frequently asked whether dispersible tablets can be dispensed against a prescription for ‘Aciclovir Tablets 800mg'. Contractors will be paid based on the Drug Tariff price for the prescribed item, Aciclovir Tablets 800mg. Therefore in order to ensure correct payment, pharmacists need to get the prescription amended to say Aciclovir Dispersible Tablets 800mg.

Amlodipine Tablets

Prescriptions for any amlodipine salt will  be reimbursed based on the Drug Tariff price for amlodipine. The Category M price for amlodipine has been set based on pricing information submitted by manufacturers for all amlodipine salts including amlodipine besilate. Before the generic product became available there was a concession in place for this product linked to dispensing the Istin brand. This concession ceased with effect 1st July 2007.

In some areas, prescribing systems continue to default to a specific amlodipine salt. The different amlodipine salts are all pharmacologically equivalent and can be exchanged in clinical practice. However, the Code of Ethics requires that ‘except in an emergency, pharmacists must not substitute any other product for a specifically named product without the approval of the patient or carer and the prescriber’. Therefore, if a prescription specifies a particular amlodipine salt, a pharmacist would be expected either to dispense that salt or to consult both the prescriber and patient regarding any substitution. In such circumstances, pharmacists may wish to develop locally agreed protocols with prescribers for substitution with an alternative salt.

Click on the link below to download a template letter that can be used to request that a GP issues non-salt specific prescriptions for amlodipine:

Template Letter to Prescribers (MS Word Format)

Products prescribed via the Electronic Prescription Service require a DM&D code. The NHS Dictionary of Medicines and Devices (DM&D) lists this product without a salt identifier so this is only a problem where GP systems are using drug databases other than DM&D. PSNC has written to all pharmacy and GP system suppliers on this issue.

Anti-Malarials

Mefloquine, Malarone and the Paludrine / Avloclor Travel Pack are allowed on an FP10 Prescription. Doctors are encouraged to write private prescriptions for anti-malarials, but as these items are not blacklisted, contractors will be paid for supplying them.

Atimos Modulite

Atimos Modulite 12mcg Pressurised Inhalation Solution (Formoterol Fumarate Dihydrate) was launched in 2005. This product must be stored in the fridge before dispensing to the patient. As this item requires cold chain storage, it is included with the "Cold Chain Storage" group listing in the 'List of Drugs for which Discount is not Deducted'.

After dispensing, the product does not need to be stored in a fridge but will expire after 3 months at room temperature.

Beclometasone

There are currently two Beclometasone Dipropionate CFC-free inhalers available on the UK market, Clenil Modulite and Qvar. However it should be noted that these inhalers have been designed differently and provide different quantities of the active drug to the lungs. Qvar is approximately twice as potent as Clenil Modulite. It is important that this is taken into account, and doses adjusted accordingly, to ensure that patients receive an appropriately effective dose and to prevent potential safety concerns arising if patients are switched from one CFC-free inhaler to the other CFC-free inhaler. The MHRA are advising prescribers to issue prescriptions for this item using the brand name of the product to ensure that the intended inhaler is dispensed.

Both Beclometasone 50mcg/actuation inhaler CFC-free and Beclometasone 100mcg/actuation inhaler CFC-free were removed from Part VIII of the Drug Tariff in 2006. If a prescription for the generic product is received, pharmacy contractors should endorse the prescription with the brand name of the product supplied to ensure correct payment. If no endorsement is made on the prescription, the NHSBSA Prescription Pricing Division will return the prescription to the contractor for this information to be added.

The PSNC Information Team is frequently asked what should be dispensed against prescriptions for ‘Beclometasone 100mcg/actuation inhaler CFC-Free Extra Fine Particle, 200 Dose'. The product being referred to is the Qvar® aerosol inhalation. The aerosol droplets delivered by this inhaler are on average much smaller than the Beclometasone diproprionate particles delivered by CFC-suspension formulations or dry powder formulations of Beclometasone diproprionate, hence why the product is often referred to as having ‘extra fine particles' (ref: Product Data sheet)

Beclometasone Breath Actuated Inhalers

All strengths of Beclometasone breath actuated inhaler have been removed from Part VIII of the Drug Tariff with effect from 1st October 2009. Therefore contractors must endorse the brand name of the product dispensed, or where no brand exists, then an endorsement of manufacturer/ supplier.

Betahistine

Prescriptions for Betahistine hydrochloride or Betahistine dihydrochloride will be reimbursed based on the Drug Tariff Part VIII Price for Betahistine. The Martindale (35th edition p2056) indicates Betahistine hydrochloride is the same product as Betahistine dihydrochloride. The former is the recommended International non-proprietary name (modified) for the product and the latter is the British Approved Name (modified).

The manufacturer of Serc has confirmed this and that their product is equivalent to both titles.

Caverject Dual Chamber

This product is supplied in a pack containing 2 pre-filled syringes and the manufacturer has confirmed that each pre-filled syringe is a dual chamber item . If a prescription was received for 8 Caverject Dual Chamber items, you would be reimbursed for 8 pre-filled syringes (4 packs).

Champix

Champix is classed as a medicinal product and is used for smoking cessation. Champix is available in quantities of 0.5mg or 1mg and a titration pack is available which contains both strengths. This product does not appear in Part XVIIIA of the Drug Tariff (the ‘blacklist') and therefore can be prescribed on an FP10 prescription.

Cetaphil Moisturising Lotion

This cosmetic is not listed in Part XVIIIA of the Drug Tariff (the blacklist) and would therefore be allowed on an NHS prescription. 

Clozapine

In response to queries from contractors, the following article summarises the arrangements for ordering the drug, Clozapine and provides the contact details for the three Clozapine Monitoring Services.

Clozapine is indicated in Schizophrenia in patients unresponsive to or intolerant of conventional antipsychotic drugs. As neutropenia and potentially fatal Agranulocytosis are side effects of treatment with Clozapine, regular blood tests are essential and patients are only allowed to continue with treatment if the results are satisfactory. Blood tests are usually taken two weeks prior to the next dispensing day:

A green result allows the patient to continue with treatment.

An amber result means that the patient continues with treatment but must have another blood test within a day or two and have at least twice weekly blood tests until the blood result improves.

A red result means that the patient must stop taking Clozapine immediately. All UK patients who have a red alert are recorded on a database known as the Central Non-Rechallenge Database (CNRD). Patients who develop confirmed neutropenia on Clozapine are registered on the database and should never be rechallenged with Clozapine again unless there are good clinical grounds to do so.

There are currently three suppliers of Clozapine, Novartis (Clozaril), Genus (Denzapine) and Teva (Zaponex). Each supplier closely monitors patients receiving their product, with the aim of ensuring that only patients with satisfactory blood test results are given Clozapine. The patient, prescriber and supplying pharmacist must all be registered with the appropriate supplier's patient monitoring service.

Clozapine can only be prescribed and dispensed in primary care to patients who have been receiving Clozapine for at least a year. Shared Care allows patients better intergration in to their local community and reduces the number of times each patient must travel to their hospital. To arrange for the product to be collected by a patient at a community pharmacy, the patient's consultant should contact the patient's preferred pharmacy to confirm that they are prepared to offer this service and then nominate them on the shared care protocol form provided by the relevant supplier. Patients must always use the pharmacy registered with the service. In the unlikely event of a patient presenting a prescription for Clozapine without being registered at any community pharmacy or if the patient expresses an interest in collecting the product from another pharmacy, they must be advised to return to the prescriber or the community psychiatric team.

Occasionally pharmacies may receive prescriptions for this product from the patient's GP. GPs are not allowed to initiate the prescribing of Clozapine but consultants may request that a GP prescribes Clozapine as part of a shared care protocol

More Information

Clozaril Patient Monitoring Service
0845 769 8269
To order Clozaril ring CPMS and supply is made as requested by the pharmacy subject to recent satisfactory blood result.

Denzapine Patient Monitoring Service
020 8236 0000
To order Denzapine, pharmacists must first call the DMS. For subsequent orders, a copy of the prescription form should be faxed to the company and supply will be made subject to a recent satisfactory blood result.

Zaponex Patient Monitoring Service
tel 0207 365 58 42
fax 0207 365 58 43
To order Zaponex contact the ZPMS. Pharmacies will be given a PIN no to enable access to the blood result on the website.
Zaponex will be sent out to the pharmacy but the pharmacy must ensure that the patient has a satisfactory blood test prior to issuing the medication to the patient
www.ztas.co.uk.

Cod Liver Oil

Blacklisted brands of Cod Liver Oil (including Seven Seas Cod Liver Oil) can be dispensed against a prescription for 'Cod Liver Oil'. This is because the prescription has been written generically and ‘Cod Liver Oil' appears at the head of a monograph in the British Pharmacopoeia. If the doctor had specifically ordered a blacklisted brand, for example, ‘Seven Seas Cod Liver Oil', the prescription would have been disallowed if dispensed.

The same applies to other forms of Cod Liver Oil (including capsules) provided that the individual form does not have a generic entry in the blacklist.

Complan Shake

I have received an FP10 prescription for ‘Complan Shake'. Can I dispense this item?

‘Complan Shake' is a powder based product which provides a nutritionally balanced supplement feed when reconstituted with water or milk. As ‘Complan Shake' is not listed in Part XVIIIA of the Drug Tariff (‘the blacklist'), it can be prescribed on an FP10 prescription. However, a prescription ordering just ‘Complan' should not be dispensed as the original ‘Complan' is blacklisted and therefore cannot be prescribed on an FP10 prescription.

Co-Proxamol Tablets

The MHRA cancelled licenses for all Co-proxamol products at the end of 2007.

Meda, the manufacturer of a popular brand of co-proxamol, is continuing to supply Co-Proxamol as an unlicensed medicine. Their product is available through the supplier, Creo (0844 879 3188).

Co-proxamol tablets can currently be found in Part VIII of the Drug Tariff with a fixed NHS reimbursement price. Where a product is listed in Part VIII of the Drug Tariff and is prescribed generically, pharmacy contractors can choose to dispense any product that meets the generic description and will be reimbursed based on the set Drug Tariff price.

Dermablend

The American Dermablend range has been discontinued in the UK and replaced by a new camouflage range produced by Vichy, which uses the same formulation as the original Dermablend.

The original product (Brodie & Stone) was available in 15 shades of the 10.7g pack size and 11 shades of the 28.4g pack size. The Vichy Dermablend range contains an initial eight shades (6g).

As Dermablend is not listed in Part XVIIIA of the Drug Tariff (the black list), it can be prescribed on an NHS Prescription. But L'Oreal/Vichy have confrmed that they are only supplying this product to pharmacies that are Vichy stockists. The product is not available through the normal wholesaler network and will not be supplied directly to pharmacies that are not vichy stockists.

Pharmacies that receive prescriptions for Dermablend must refer the patient back to the prescriber so that an alternative camouflage product can be prescribed. Alternatively, patients can contact the Vichy Consumer Advisory Department (0800 169 6193) for details of their nearest Vichy stockist. Vichy will send consumers a starter kit with samples of the new range to help them find a match for their skin, along with a list of stockists.

This product was removed from Part XV of the Drug Tariff (the borderline substances list) in December 2005.

PSNC has written to Vichy to raise concerns about their decision not to supply non-Vichy stockists.

Diazepam Syrup 5mg/5ml

Diazepam syrup 5mg/ 5ml is a synonym for diazepam oral solution 5mg/ 5ml. Diazepam oral solution 5mg/ 5ml is listed in Part XVIIIA of the Drug Tariff (the black list), so Diazepam syrup 5mg/ 5ml cannot be prescribed on an NHS Prescription.

If a product is listed generically in Part XVIIIA of the Drug Tariff, all available brands of that product cannot be prescribed or dispensed on an NHS Prescription.

If a prescription is received for Diazepam syrup 5mg/ 5ml, Diazepam oral solution 5mg/ 5ml or proprietary equivalents of this product, the prescription should be returned to the prescriber so that an alternative product can be prescribed.

Dianette

Supplier Must be Endorsed

There are a number of cases where products with the same marketing authorisation number and brand name are marketed by a number of different suppliers, for example Dianette Tablets are manufactured by Bayer Schering Pharma and is supplied to Generics UK under third party livery. A prescriber may issue a branded prescription for Dianette Tablets and a pharmacist will have the flexibility to dispense either supplier's product. As the reimbursement price of a branded drug is based on the manufacturer's list price, reimbursement prices for these brands may differ depending on the manufacturer supplied.

Under the PPD's legacy processing procedures, if a prescription was not endorsed to indicate supplier, the PPD would default to the reimbursement price for the originator supplier's product. The CIP system no longer defaults to a particular supplier's product so the name of the supplier must be endorsed to ensure that copies of prescriptions aren't returned for clarification.

Products know to be affected include:

Dianette (marketed by Bayer Schering Pharma and Generics UK)
Dicloflex Retard 100 Tablets (marketed by Dexcel- Pharma, Almus, Kent and Teva)
Dicloflex 25mg gastro-resistant tablets (marketed by Dexcel-Pharma, Almus and Teva)
Dicloflex 50mg gastro-resistant tablets (marketed by Dexcel-Pharma and Almus) Dicloflex SR 75 tablets (marketed by Dexcel-Pharma, Almus, Kent and Teva) Monosorb XL 60mg (marketed by Dexcel-Pharma, Kent and Teva) Nifedipress 10mg MR tablets (marketed by Dexcel-Pharma and Teva) Nifedipress 20mg MR tablets(marketed by Dexcel-Pharma and Teva) Verapress MR 240mg Tablets (marketed by Dexcel-Pharma, Alpharma (Actavis) and Teva)

Where different suppliers have the same list price, the PPD will not return the form.

The Generic UK List Price of Dianette has recently changed and is now different to the list price of Bayer Schering Pharma. Therefore if prescriptions for Dianette dispensed in the month of July are submitted to the PPD without either ‘Bayer Schering Pharma' or Generics UK' endorsed on them, they will be returned for clarification.

The Department of Health have recently confirmed that in this scenario, if after being returned to the contractor, the script is re-submitted without the required endorsement, reimbursement will be made based on Part II clause 7C of the Drug Tariff, where the Secretary of State for Health will determine the price paid. This will be the lowest price that can be paid for that particular brand.

Emla 5% cream dressings packs

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.)

Fenofibrate

There are currently two formulations of Fenofibrate 200mg capsules, a non-micronised and micronised form. However it should be noted that these formulations are not bio-equivalent.

The micronised formualtion of Fenofibrate has improved bioavailability; 67mg of micronised Fenofibrate is therapeutically equivalent to about 100mg of non-micronised Fenofibrate. The branded product ‘Fenogal' contains 200mg non-micronised Fenofibrate and was previously the only non-micronised product available in the market. This product could be dispensed against a prescription calling for ‘Fenofibrate 200mg Capsules'. The manufacturer ‘Genus Pharmaceuticals' have confirmed that Fenogal capsules have now been discontinued, and stocks at wholesalers have been exhausted.

It is important that the correct product is supplied in accordance with a prescription for Fenofibrate 200mg capsules. If a prescription for ‘Fenofibrate 200mg micronised capsules' is received, then a micronised formulation should be dispensed. Fenofibrate 200mg micronised capsules are listed in Part VIII of the Drug Tariff, and the fixed price based on the Category C product ‘Lipantil Micro 200' will be reimbursed for these prescriptions. However if a prescription is received for ‘Fenofibrate 200mg capsules' the pharmacist should contact the prescriber to make them aware that the non-micronised formulation is unavailable. The pharmacist will be reimbursed based on the Part VIII price for Fenofibrate 200mg micronised capsules against this prescription.

 

Floxapen

Floxapen which was the only available 125mg/5ml Flucloxacillin oral suspension product has been discontinued. As oral suspensions and oral solutions are considered as two different formulations, you would not be reimbursed for supplying one against a prescription for the other. If you receive a prescription for the oral suspension, whilst there is no available product, to ensure correct payment, the prescription should be sent back to the prescriber for an alternative formulation to be prescribed (e.g. the oral solution).

Formoterol

I have received an FP10 Prescription for ‘Formoterol 12micrograms/dose Dry Powder Inhaler'. What product should I dispense?

There are currently two products that meet this generic description, Oxis 12 Turbohaler and Easyhaler (Formoterol) 12micrograms/dose. However, these products have been designed differently and deliver a different quantity of active drug to the lungs. The Easyhaler device delivers 12mcg, the same quantity of substance as the metered dose. Each 12mcg metered dose of Oxis Turbohaler 12mcg, delivers a dose of 9mcg to the patient.

There are also differences in the therapeutic indications for these products and the posology and method of administration. The resistances of the devices are different and the manipulation required to actuate the Easyhaler (shake, press and inhale) is different from the Oxis (twist in both directions and inhale).

It is important that care is taken to ensure that patients are not switched between these two products without appropriate counselling.

Gaviscon

The 500ml pack size of Gaviscon Liquid was discontinued in 2005 but the 150ml, 300ml and 600ml packs remain available. These packs are not classed as special containers so the quantity dispensed should be as prescribed. Contractors will be reimbursed based on the endorsed pack size. If there is no pack size endorsed, the PPD will pay based on the pack size listed in the Common Pack List (Part VII of the Tariff) which is currently the 600ml pack .

Contractors would not be reimbursed for dispensing ‘Gaviscon Advance' against a prescription for ‘Gaviscon'. If in the interests of the patient, a pharmacist believes that Gaviscon Advance is required where standard Gaviscon has been prescribed, they should contact the prescriber and arrange for the prescription to be amended accordingly.

Gaviscon Infant Sachets are packaged as ‘dual sachets.' Pharmacists will be paid based on their endorsement for this item, so against a prescription for 30 sachets, pharmacists are able to supply either one pack (15 dual sachets) or two packs (30 dual sachets). If there is no endorsement, the NHSBSA will assume that the prescribed number of dual sachets have been dispensed (ie. in this case 2 complete packs).

Glucosamine

As glucosamine and glucosamine sulphate are recommended International Non-proprietary Names (rINNs) and are not blacklisted by generic name, any brand of glucosamine including blacklisted items in Part XVIIIA of the Drug Tariff may be dispensed against a generic prescription for this product. Contractors will be reimbursed based on the endorsed product.

Haelan Tape

Haelan Tape has been reclassified as a drug rather than an appliance. It is not blacklisted so is therefore allowed on an FP10 Prescription.

Healthy Start Vitamins

Healthy Start Vitamin Drops are only obtainable via NHS Supply Chain, which does not have the capacity to supply community pharmacies (as stated on the NHS Healthy Start website).

In most circumstances the drops are ordered by Primary Care Trusts and then distributed by health visitors direct to patients/ parents. Health Start Vitamin Drops are a licensed medicine and the Department of Health have not blacklisted the product as it was hoped that community pharmacies would be able to obtain them via a normal supply method. Unfortunately due to the stability/ short expiry of the product it is not being distributed to wholesalers and thus community pharmacies will be unable to obtain the product via these means.

Community pharmacists will experience difficultly in obtaining the product due to the lack of availability in the normal pharmaceutical wholesale supply chain. If community pharmacists cannot obtain Healthy Start Vitamin Drops, the prescription should be returned to prescriber.

Hedrin Lotion

Hedrin lotion is used to treat head lice and has been registered as a medicinal product. It is not listed in Part XVIIIA of the Drug Tariff (‘the blacklist'), therefore can be prescribed on an FP10 prescription.

Helicobacter Tests

There are a number of helicobacter tests available on prescription including Diabact UBT, Helicobacter Test Hp-Plus, Helicobacter Test INFAI and Pylobactell. These tests are registered as medicinal products, they are not blacklisted so are therefore allowed on prescription.

i-caps

i-caps, the ocular vitamin from Alcon is not ‘blacklisted' so would be prescribable on an FP10 Prescription.

Japanese Encephalitis Vaccine

Japanese Encephalitis Vaccine is available as an unlicensed medicinal product. This product is not listed in Part XVIIIA of the Drug Tariff (the ‘Black List') therefore can be prescribed on an NHS prescription.

Under the Pharmacists Terms of Service, a pharmacy contractor is required to supply drugs ordered with reasonable promptness therefore this product should be dispensed and the pharmacy contractor will be reimbursed accordingly.

Under the GPs Terms of Service, GPs are able to make a charge for ‘treatment consisting of an immunization for which no remuneration is payable by the PCT and which is requested in connection with travel abroad'. So although a pharmacy contractor will be reimbursed for dispensing this product, the GP may be questioned about the appropriateness of prescribing this product on the NHS rather than the charging the patient directly for the vaccine.

Ketoconazole Cream

Prescriptions specifically asking for Nizoral Cream require an ‘SLS' endorsement. A prescription for ‘Ketoconazole Cream' which has not been marked ‘SLS' by the prescriber would be passed for payment by the PPD.

L-Carnitine / Levocarnitine 

L-Carnitine tablets are available from Lamberts Healthcare. The Lamberts Healthcare L-Carnitine tablets appear in part XVIIIA of the Drug Tariff (the blacklist) and cannot be given against a prescription written for L-Carnitine. However, the product has an official recognised title under the name of Levocarnitine and so for prescriptions received written for Levocarnitine tablets the blacklisted Lamberts brand could be dispensed.

Lamotrigine

Generic Lamotrigine was launched in May 2005 following the expiry of the patent on Lamictal.

The Department of Health has stated that there is no compelling evidence to suggest that switching from the originating brand to a generic alternative will have an adverse clinical outcome. However, in a note published on the Department of Health website, prescribers have been reminded that they can modify their usual generic prescribing practice if, in their clinical judgement, the circumstances of individual patients warrant such action.

If Lamotrigine is prescribed generically, pharmacies will be reimbursed based on the Drug Tariff Price for the Product. If Lamotrigine is prescribed by brand name (e.g. Lamictal), pharmacies will be reimbursed based on the List Price for the Branded Product.

Lidcare Wipes

This product is not listed in Part XVIIIA of the Drug Tariff (the blacklist) so can therefore be prescribed on an NH.

Medical Gases

Entonox is classed as a medicinal product. It is not listed in Part XVIIIA of the Drug Tariff (the black list) so can therefore be prescribed on an NHS prescription.

Melatonin Capsules

Melatonin capsules and tablets are both classed as medicinal products. As there are no listings for melatonin in Part XVIIIA of the Drug Tariff (Black List), the product can be prescribed on an FP10 Prescription.

The MHRA has imposed restrictions on the import of unlicensed Melatonin products following the introduction of a newly Licensed product Circadin 2 mg Prolonged Release Tablets.

Further information can be found on the MHRA website.

Menthol in Aqueous Cream (0.5% 1.0% 2.0%)

Menthol in Aqueous Cream (0.5% 1.0% 2.0%) is listed in Part VIII Category C of the Drug Tariff with the reimbursement price set based on the list price of Arjun Cream.

If this product is prescribed generically as either 'Menthol Cream' or 'Menthol in Aqueous Cream', contractors will only be reimbursed based on the fixed Drug Tariff price for this item. This product is available from a number of suppliers.

Movelat Cream

Movelat gel 100g and Movelat cream 100g have recently been discontinued by the manufacturer Genus Pharmaceuticals, and replaced with new 125g pack sizes. NHS Prescription Services have confirmed that if a pharmacy has residual stock of the 100g pack size remaining, they are able to dispense and endorse that the 100g pack size was dispensed, in which case the prescription would be reimbursed based on the 100g pack size.

Once all remaining 100g stock has been dispensed, further prescriptions for 100g can be met with 125g packs and will reimbursed in line with Drug Tariff Part II Clause 10.  

Neotigason

Neotigason was previously subject to distribution restrictions, so that this product could only be dispensed by hospital pharmacies or in the community by a pharmacy which had been specifically nominated by a consultant dermatologist. This product was originally ‘hospital only' as a condition of its product licence. Roche has removed the distribution restrictions for Neotigason. This means that this product, in common with other pharmaceutical products, is now available to community pharmacies for ordering via their wholesaler

Niquitin

I have received an FP10 prescription for ‘Niquitin CQ 7mg patches and Niquitin CQ Clear 7mg patches'. How many prescription charges should the patient pay?

The NHSBSA Prescription  Services have confirmed that when different colours of the same preparation are prescribed on the same prescription form, only one prescription charge should be levied. The Pharmacy contractor will receive one dispensing fee for each prescribed colour of the preparation supplied to the patient.

Nurofen Caplets

Nurofen Tablets can be found in Part XVIIIA of the Drug Tariff (‘the blacklist’). Volume III of the British Pharmacopoeia 2007 provides authoritative monographs for different dosage forms. There is no monograph that defines caplets, caplets are considered tablets (i.e. capsule-shaped tablets). Therefore ‘Nurofen Caplets’ are encompassed by the Blacklist entry for ‘Nurofen tablets’ and can not be prescribed on an NHS prescription.

Occuvite Preser Vision

Bausch & Lomb Pharmaceuticals' Ocuvite Preser Vision is a vitamin and mineral supplement which has been specifically formulated to promote the chances of preserving eye health and maintaining vision. This product is not listed in Part XVIIIA of the Drug Tariff (the blacklist) so can therefore be prescribed on an FP10 Prescription.

Octenisan

I have received an FP10 prescription for ‘Octenisan'. Is this allowed on an FP10 prescription?

Yes. Octenisan is an antimicrobial wash lotion. This product is a cosmetic; it does not appear in Part XVIIIA of the Drug Tariff (‘the Blacklist') therefore would be passed for payment by the NHSBSA Prescription Services.

Otrivine Child nasal drops

I have received an FP10 prescription for Otrivine Child nasal drops. Can I dispense this product?

Yes. NHs Prescription services have confirmed that the entry in Part XVIIIA of the Drug Tariff (‘the blacklist’) for ‘Otrivine nasal drops 0.05%’ does not encompass the Novartis Consumer Care product, ‘Otrivine child nasal drops 0.05%’. Therefore whilst a prescription for ‘Otrivine Nasal drops 0.05%’would not be passed for payment, a prescription for ‘Otrivine Child nasal drops 0.05%’would be passed for payment.

There is a similar scenario with the 0.1% strength of this product. A prescription for ‘Otrivine Nasal drops 0.1%’would not be passed for payment; a prescription for ‘Otrivine adult nasal drops 0.1%’would be passed for payment.

The generic description for this product is ‘Xylometazoline 0.05% nasal drops’. As the generic name is not blacklisted and the generic name is a recognised official title, Otrivine can also be dispensed against a generic prescription for this product.

Peppermint Oil Capsules

‘Peppermint Oil 0.2ml Capsules e/c' are listed in the Drug Tariff Part VIII Category C item with the reimbursement price based on the manufacturer's list price for the brand, Mintec. There is a separate listing in the Drug Tariff for ‘Peppermint Oil 0.2ml Capsules MR e/c'. The reimbursement price for this item is based on the list price of the brand, Colpermin. If ‘Peppermint Oil 0.2ml Capsules e/c' was prescribed but the patient was expecting the modified release capsules, the prescription would have to be changed to read ‘Peppermint Oil 0.2ml Capsules MR e/c'.

Perindopil Tablets

Generic Perindopril Erbumine (= tert-butylamine) 2mg, 4mg and 8mg tablets are widely available from a number of generic manufacturers and wholesalers.

The originator brand was Coversyl. Servier Laboratories Ltd discontinued their branded products, Coversyl and Coversyl Plus and replaced them with two alternative products, Coversyl Arginine and Coversyl Arginine Plus. The erbumine (= tert-butylamine) and arginine salts of perindopril are bioequivalent. However because of the greater molecular weight of the arginine salt compared with the erbumine (= tert-butylamine) salt the dose of the active substance is increased in order to deliver the same quantity of perindopril.

Discontinued Servier Product 

 

Replacement Servier Product

 Coversyl 2 mg Tablets (perindopril erbumine (tert-butylamine) 2mg

Bio-equivalent to

 Coversyl arginine 2.5mg Tablets (perindopril arginine 2.5mg)

 Coversyl 4mg Tablets (perindopril erbumine (tert-butylamine) 4mg)

 Bio-equivalent to

 Coversyl arginine 5mg Tablets (perindopril arginine 5mg)

 Coversyl 8mg Tablets (perindopril erbumine (tert-butylamine) 8mg)

 Bio-equivalent to

 Coversyl arginine 10mg Tablets (perindopril arginine 10mg)

 Coversyl Plus (perindopril erbumine (tert-butylamine) 4mg/ indapamide 1.25mg)

 Bio-equivalent to

 Coversyl arginine Plus (perindopril arginine 5mg/indapamide 1.25mg)

Frequently Asked Questions

I have received a prescription for Perindopril Erbumine Tablets 2mg. What should I dispense?

Perindopril erbumine and Perindopril tert-butylamine are synonyms and are to be regarded as the same thing. This product is available generically from a number of manufacturers. Reimbursement will be based on the Drug Tariff Part VIII price for this product.

I have received a prescription for Perindopril tert-butylamine Tablets 2mg. What should I dispense?

Perindopril erbumine and Perindopril tert-butylamine are synonyms and are to be regarded as the same thing. This product is available generically from a number of manufacturers. Reimbursement will be based on the Drug Tariff Part VIII price for this product (listed in the Drug Tariff as Perindopril erbumine).

I have received a prescription for Coversyl Plus. I can no longer obtain this product, could I dispense Coversyl Arginine Plus instead?

No, these are different products. The Code of Ethics requires that ‘except in an emergency, pharmacists must not substitute any other product for a specifically named product without the approval of the patient or carer and the prescriber’. Reimbursement would be based on the list price of the discontinued Coveryl Plus.

I have received a prescription for perindopril arginine 2.5mg Tablets. What will I be reimbursed based on?

As Perindopril Arginine 2.5mg tablets are not listed in Part VIII of the Drug Tariff, reimbursement will be based on the contractor's endorsement (i.e. if the brand 'Coversyl arginine' is endorsed, reimbursement will be based on the manufacturer's list price for this product).

I have received a prescription for perindopril 2.5mg Tablets. What will I be reimbursed based on?

As Perindopril 2.5mg tablets are not listed in Part VIII of the Drug Tariff, reimbursement will be based on the contractor's endorsement. The only 2.5mg Perindopril product available is the Perindopril arginine salt (i.e. if the brand 'Coversyl arginine').

Qlaira

Qlaira is a combination product which contains 5 different types of tablet; as such a pharmacy contractor would receive 5 professional fees for dispensing this item against an NHS prescription. As Qlaira is recognised as a contraceptive drug an NHS prescription for this item would not incur a prescription charge.

Regaine

Regaine is listed in the blacklist under both brand and generic name (Minoxidil) therefore cannot be prescribed on an NHS prescription.

Roaccutane

Roaccutane was previously subject to distribution restrictions, so that this product could only be dispensed by hospital pharmacies or in the community by a pharmacy which had been specifically nominated by a consultant dermatologist. This product was originally ‘hospital only' as a condition of its product licence. Roche has removed the distribution restrictions for Roaccutane. This means that this product, in common with other pharmaceutical products, is now available to community pharmacies for ordering via their wholesaler

Sativex

Sativex (Cannabis Sativa L.Extract) is a licensed medicine in the UK and a controlled drug under the Misuse of Drugs Act in Schedule 1 of the Misuse of Drugs Regulations 2001.

Normally Schedule 1 medicines could only be stocked and supplied by pharmacy contractors if they had the appropriate licence. In this case, the Home Office have confirmed that they have issued an open general licence for the product which allows pharmacists to dispense the product as an unlicensed medicine under certain conditions. There is no longer the requirement for a prescribing doctor or dispensing pharmacist to contact the Home Office in relation to obtaining a licence to prescribe or supply Sativex.

The Home Office have lifted the record-keeping requirements and therefore pharmacists do not need to record Sativex in their Controlled drug registers.

The Home Office have advised that, where a lockable refrigerator is available, Sativex should be stored in it prior to dispensing. Otherwise it should be kept in a fridge not visible to the general public.

Prescription requirements still apply - prescriptions must be written in the same way as they are for Schedule 2 drugs with prescriptions including the dose, form, strength and total quantity of the preparation in both words and figures.

Private prescriptions for Sativex should be on the private form FP10PCD.

Sativex remains a Controlled Drug in Schedule 1 of the Misuse of Drugs Regulations 2001 and will do so until such time as it has been approved by the MHRA, at which point the Home Office anticipate that Sativex (but not cannabis) will be rescheduled as a Schedule 4 controlled drug.

Ordering Sativex

Sativex can only be ordered through Movianto:

Customer care Tel: 01234 248632
Fax. No: 01234 248705  
Email: orders.uk@movianto.com 

Orders must include the following information to comply with regulatory requirements:

 - initials of first and last name only, DOB and gender of patient
- medical condition for which Sativex is being prescribed (if not known please consult the prescriber)
- name and address of the prescribing doctor (including practice name and postcode)
- delivery details for the pharmacy; name, address and telephone no.

Movianto will advise of the delivery date. Medicines Information queries should be directed to Bayer on 01635 563116.

SMA Staydown

Any food, drug, toiletry or cosmetic can be prescribed on an FP10 Prescription Form unless the product is listed in Part XVIIIA of the Drug Tariff (the blacklist). SMA Staydown is not blacklisted so it can be prescribed on an FP10 Prescription.

Solpadeine Plus

Solpadeine tablets can be found listed in Part XVIIIA of the Drug Tariff (the blacklist), however, this entry does not encompass Solpadeine Plus tablets. Therefore a prescription for Solpadeine Plus tablets would be passed for payment by the NHS Business Services Authority Prescription Pricing Division.

Suboxone Tablets

The NHSBSA Prescription Pricing Division have confirmed that contractors in England will be reimbursed for dispensing Suboxone in instalments against Form FP10MDA. Suboxone contains buprenorphine and naloxone. The intention of the naloxone component is to deter intravenous misuse.

Sunscreen Lip Balm

The generic description, ‘sunscreen lip balm’ is not listed in Part VIII of the Drug Tariff therefore a prescription for this product would be reimbursed based on the contractor’s endorsement.

Before dispensing a product that matches this description, it is worth checking that the product is eligible to be prescribed on an NHs prescription. If the actual product is considered a food, drug, toiletry or cosmetic product and is not listed by brand/supplier name in Part XVIIIA of the Drug Tariff (the ‘blacklist’), it could be dispensed. If the product has been registered as a medical device (i.e. if the packaging includes a CE mark), as there are no sunscreen products in Part IX of the Drug Tariff (Appliance section), the product could not be dispensed.

Vernagel

Vernagel (a super absorbent powder which traps body fluids and is used by colostomy/ileostomy patients) is classed as a drug. It is not blacklisted so would be passed for payment.

Viteyes

‘Viteyes Original Formula Plus Lutein' capsules are classed as a medicinal product and are used to support good ocular health. This product does not appear in Part XVIIIA of the Drug Tariff (the ‘blacklist') so can therefore be prescribed on an FP10 prescription.

Voltarol Gel

The Voltarol Gel Patch has been registered as a medicinal product and has prescription only medicine (POM) status. It is not listed in Part XVIIIA of the Drug Tariff (the blacklist) so would be passed for payment by the NHS Business Services Authority Prescription Pricing Division.

The product is available in a pack of 10 with 2 subpacks of 5 patches. The subpack of 5 patches has been granted special container status.

Zipzoc Stockings

Zipzoc Stockings is classed as a medicinal product. It is not listed in Part XVIIIA of the Drug Tariff (blacklist) so can therefore be prescribed on an FP10 prescription.

Appliances

Could the product you are looking for be registered as an appliance?

Click on the links below for additional support:

Product Related Guidance: Appliances

PSNC Disallowed Appliances List

What can be Prescribed on the NHS? (Guidance)


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