Nearly every week we hear about the stresses and strains on the NHS and often the “c” word is the issue. In this case “c” stands for cost.

The NHS has been with us for decades now, and at its inception there were much fewer medicines available to prescribe than today, and it is the growth in the number of medicines available to prescribers within the NHS which has led to a growth in the cost of those prescribed medicines.

Most practice managers in the UK work in prescribing only practice, where drug cost and spend is of course an issue, and cost-effective prescribing is a must, but those practice managers probably have less idea of how that drug cost is controlled or monitored than those who work in a dispensing practice.

This article is intended as a brief overview of a monthly publication, still sent out to all GPs, called the Drug Tariff.

What is the Drug Tariff?

In simple terms, the Drug Tariff tells you exactly what it says on the tin – it is a tariff of drug prices, by that I mean that it lists the reimbursement price paid to a dispensing contractor [retail pharmacy, dispensing doctor or appliance contractor] for dispensing a drug to a patient via an NHS prescription. This is not a professional [dispensing] fee, but a price paid to the dispensing contractor to reimburse them for the cost to purchase the dispensed medicine which was ordered for the patient by the prescriber.

The paper prescription, once the medicine has been dispensed to the patient, effectively becomes an invoice for payment and is sent away to NHS prescription services for payment.

The role and purpose of the Drug Tariff [this list is not exhaustive]

• To define the NHS terms of reimbursement for pharmacy and appliance contractors. [The situation for dispensing doctor contractors is primarily set out in the Statement of Financial Entitlement and overrides the Drug Tariff.]
• To determine the basic reimbursement price of drugs and other devices, oxygen, dressings, appliances and reagents.
• To determine what medical devices and items are allowable for reimbursement against NHS prescriptions. [A CE marked device MUST be listed in Part IX, yes it uses Latin numerals for chapter definition, in order to be prescribed and dispensed to a patient on an NHS prescription]

The Drug Tariff defines a limited list of allowable items which may be prescribed by dentists and nurses using NHS prescriptions.

The Drug Tariff lists the criteria for prescription charges, people entitled to exemption from such charges and which items incur multiple charges.

The Drug Tariff defines the list of items only to be prescribed under certain conditions, items NOT to be prescribed on an NHS prescription and also the national Out of Hours [OOH] Formulary.

The Drug Tariff is published and distributed monthly on behalf of NHS prescription services; the contents and policy are determined by the Department of Health for England and the Welsh Government. There are separate Drug Tariffs for Scotland and Northern Ireland published on behalf of the Scottish and Northern Ireland Offices of State.

Author: Greg Bull – Dispex