Drug Tariff Update – December 2020
Dispensing doctors need to be aware that from April 2021 the Drug Tariff will no longer be printed and distributed in hard copy form. March 2021 will be the final month in which a printed Drug Tariff will be circulated. The Drug Tariff will continue to be published on a monthly basis and accessible at the following website link: https://www.nhsbsa.nhs.uk/pharmacies-gp-practices-and-appliance-contractors/drug-tariff.
Please take some time to digest the changes and if you don’t understand anything, then please email@example.com Profitability and efficiency have been severely tested over the last year, and we must guard against losing money unnecessarily. If your dispensary needs further assistance, then get in touch.
Remember the Electronic Version of the Drug Tariff is available 3 working days before the start of the next month
Make time to have a read of the Preface
Current Issues for December 2020:
Amlodipine 2.5mg tablets (New strength) – entering as a Cat A generic at £5.30
IMPORTANT – make sure you are purchasing for LESS THAN this Drug Tariff price or you will need to ensure that you write the prescription accordingly by manufacturer, supplier or brand name or you will lose money on each generic prescription dispensed!
Salbutamol 100mcg/dose dry powder inh cartridge – 200 dose – Cat C based on Salbulin Novolizer at £2.75
Sumatriptan 3mg/0.5ml prefilled injections – Cat C based on Sun Pharmaceuticals price – in replacement of Imigran but at a lower dose of 3mg. Reimbursement Price is now £39.50.
IMPORTANT if you are dispensing a brand with a higher cost price that £39.50 against a generic prescription for this item you must make sure the supplier or brand name is listed on the right hand side of the prescription.
Generic descriptions for the following items have been removed from the Drug Tariff since they have been discontinued, but if you have stock still it is likely to be very nearly out of date! It can still be used and dispensed, but full details of manufacturer, price and pack size need to be endorsed:
Amoxil 125mg/1.25ml 20ml paediatric – long gone are the days for using loads of this each week!
Synalar N ointment
Locoid cream and ointment – 30g pack size only – Therefore if no stock of 30g left, an order for “Hydrocortisone butyrate 0.1% 30g” cream or ointment must be endorsed as giving 100g – if that is available!
Manevac granules 400g
Paracetamol 500mg / Metoclopramide 10mg Tabs x 42 – Paramax tablets
Only 3 other price changes are listed for very low usage items:
Haloperidol 5mg/1ml soln for inj ampoules x 10 – was Cat C at £35.00 but now Cat A at £38.50
Paracetamol 1g suppositories x 10 – Another price increase from Cat C £59.50 to Cat A £59.75
Quetiapine 20mg/ml oral susp SF x 150ml – was Rosemount price of £132.00 – now Cat A at £115.64
IMPORTANT – check your purchase price of this product and ensure that if you are buying for above the new Drug tariff price you are correctly making sure the prescription states which brand or supplier you are dispensing. If your purchase price is above Drug Tariff price you will lose money if these prescriptions are not correctly written.
Profitable Dispensing Tips – Modified Release Brands
The clinical decision must always come first, the patient must receive treatment according to their clinical need and prescribing decisions always need to be based on clinical need. In my experience of working with dispensing doctors for over twenty five years, it is generally accepted that for patients on a modified release medicine, continuity of a specific manufacturer “brand” of the medicine should be dispensed to the patient each time.
In a dispensing practice this can lead to opportunities to benefit the patient by giving them a continuous supply of medicine, which is the same brand each month, and ensure an income supply for the dispensary.
For example, where the Drug Tariff reimbursement price is based on the original brand, there may be newer manufacturers who have come into the market with a lower NHS list price and may even offer a discount to dispensing doctors.
This is how it works, lets use some round numbers to make it as simple as possible.
The Drug Tariff price for modified release product A is £20.00 per pack.
The NHS List price for a branded version of modified release product A is £15.00 per pack.
The actual purchase price of branded version of modified release product A is £10.00 per pack.
So where the prescription is written generically for modified release product A the default reimbursement price is the Drug Tariff price of £20, but where the branded version has been dispensed, at a purchase price of £10, then the margin on dispensing is £10 less clawback.
The patient gets continuity of supply and the dispensary assures its income stream which in turn funds rural healthcare provision.
Tip of the week – look at your modified release dispensing and prescribing, especially where the purchase price and Drug Tariff prices are high. Check your high volume modified release dispensing as well, target your top five modified release “generics” and work out if there are alternatives to the original brand or the “generic” as supplied by your wholesaler.
For a couple of examples of modified release brands which are priced at well below the Drug Tariff price email me firstname.lastname@example.org and I will send you the details free of charge
For an informal FREE chat about your dispensary profitability just contact me by the above email – always happy to help.
How Many Items per Hour are you dispensing?
So many phone calls I have taken over the years begin something like, “Greg, we’ve had the annual accounts back and the dispensary is showing a loss for the year…” to which my initial response [in my head] is surprise to put it mildly. A dispensary which is losing money is almost unheard of and usually it turns out that the reality is there has been a drop in the profit generated rather than a dispensary losing money.
It is at this point that the Dispensary Manager and I both let out a sigh of relief, I mean, showing a loss in profit is bad, but at least it isn’t an actual loss to the surgery.
So we talk through the problems that might have led to a drop in income, for example, if the dispensing fee has dropped by 5% in a year, then a drop of income of 5% in that year wouldn’t be unexpected, or at least with further investigation of the figures we could find where the drop in income was coming from.
It might be that the margin on generics had dropped for the year across the board for all practices or it could the figures show a rise in the cost of running the dispensary? Or is the dispensing speed being severely affected by poor dispensary layout and design? What are the dispensary running costs year on year, month on month?
Far too often the management accounts for the dispensary are held in secret by the GP partners and the Dispensary Manager is left in the dark. I would advise that all Dispensary Managers have full access to the management accounts for the dispensary and that these are produced monthly for large dispensaries, quarterly reports would suffice for most dispensaries. This is the only way you can manage a business and if you compare year on year accounts, like with like, you can spot trends or signs of a problem.
The question is are you the Dispensary Manager? If you are expected to manage the dispensary as a business you need all the tools to do so, you are the manager of a business.
Two questions for every dispensary manager:
What percentage of your time do you devote to managing the dispensary and what percentage of your time do you spend dispensing?
Secondly do you know how many items per hour your dispensers are currently dispensing [handing over not bagging up] to your patients?
Email me your answers to email@example.com and I will give you my opinion on what you should be doing/what your dispensing speed should be.
And for November we are giving free initial distance support via Microsoft teams, Zoom or the good old phone – get in touch now as we are introducing a NEW distance mentoring and support service for dispensary managers. Not just a one-off visit with a report you cant implement, we want to give Dispensary Managers professional and impartial help and support at a fair cost to the practice.
Its all about the patient – if your dispensary closes, where will the patient get their medicine from?