The Drug Tariff in England and Wales [there are separate Drug Tariffs for Scotland and Northern Ireland] lists most medicines which can be prescribed and dispensed against an NHS Prescription in Primary Care.
The reimbursement price is stated next to the generic descriptor for the product in pence. This means that where the prescription has been written generically, the reimbursement price will be based on the current Drug Tariff Part VIIIA listing.
For example, in the January 2021 Drug Tariff the published reimbursement price for paracetamol 500mg tablets pack size of 100 is £3.06 which is a Category M item and so the reimbursement price is based on the amount of retained profit in pharmacy as a whole.
Every dispensary manager in the UK knows that if the item dispensed against this generic prescription is paracetamol 500mg tablets in a pack of 100 then the reimbursement price will be £3.06 regardless of the purchase price or brand dispensed.
There are also reimbursement prices in the Drug Tariff based on the original brand, manufacturer or supplier list price which are classed as Category C.
These Category C items are worth further investigation for dispensaries looking to maintain their profitability. A prescriber has full control over the way the prescription is written and can order either a specific brand to be dispensed, which may lead to cost-savings to the NHS or write the prescription generically. Where the item is written generically the choice of what to dispense is greater for the dispensary.
This can lead to some valuable extra income.
So, where the NHS list [reimbursement] price of a branded product is less than the generic [Drug Tariff Part VIIIA] price the dispensary could give the brand to the patient, which could help with patient compliance, and gain the margin between purchase price and Drug Tariff price.
Some examples include:
|Prescription is written as:||Drug Tariff Price*||Brand Below Drug Tariff||NHS List Price of Brand||Margin for Pharmacy Contractor|
|Estradiol 10microgram pessaries 24 pessary||£16.72||Vagirux 24 pack pessaries||£11.34||£5.38|
|Metronidazole 0.75% gel 40g||£22.63||Anabact gel 40g||£15.89||£6.74|
|Ropinirole 2mg modified-release tablets 28 tablet||£12.54||Ipinnia 2mg m/r tablets||£5.64||£6.90|
|Oxycodone 10mg modified-release tablets 56 tablet||£25.04||OxyPro 10mg m/r tablets||£6.26||£18.78|
*Based on England and Wales Drug tariff January 2021
Of course, the clinical decision is vital here and the patient’s needs override any commercial considerations. The GP Practice staff should ensure that the item dispensed is clinically correct for the patient and ensure all clinical factors have been considered. If the dispenser has any queries about which item to dispense, they should contact the prescriber. Where a modified release preparation is being dispensed, the dispenser should ensure it is clinically acceptable to dispense the modified release preparation of their choice and refer to data sheets and other information as required.
If the prescriber wishes the patient to receive a particular brand of medicine, the prescription should be written by brand and not generic name.