Clawback Explained


Dispensing Doctor reimbursement has, for at least the past 25 years, included an element known as “Clawback”. The technical name for this is “Discount Recovery”. For the purposes of this article we will refer to it as Clawback.

For Dispensing Doctors the reimbursement of every item they dispense has the Clawback applied because The Department of Health assumes that dispensing doctors receive discounts on their purchases of medicines and devices which they dispense.

I believe that the current rate of Clawback [see Table 1 below] actually dates back to last century, December 1999 if my memory serves me correctly.

Generally speaking we work on a Clawback of 11.18% for most of our calculations, which means that 11.18% of the NHS list price or Drug Tariff price is withheld to the Dispensing Doctor for each item dispensed, regardless of whether that item was actually purchased at a discount.

This obviously means that on an item which was purchased without any discount, the Dispensing Doctor will lose 11.18% of the NHS List Price or Drug Tariff price. It follows that the higher the NHS price or Drug Tariff price, the higher the loss in dispensing will be.

There is an argument that Dispensing Doctors receive a dispensing fee, which could cover these losses. However, the dispensing fee is a professional fee to cover the dispensing activity, and where the NHS cost or Drug Tariff price is greater than about £20, the dispensing fee will not cover the loss.

To make it simple where the Drug Tariff/NHS List price of an item is £10 the reimbursement would be calculated as follows:

£10.00 minus 11.18%

Which is £10.00 minus £1.12 [as it is rounded up] = £8.88

[This does not take into account if the medicine has been personally administered or any VAT treatment]

NHS Cost of Medicines Dispensed by the Practice per Month% of NHS Cost of Medicines Dispensed Not Reimbursed
£1 to £20003.17%
£2001 – £40005.93%
£4001 – £60007.21%
£6001 – £80008.06%
£8001 – £100008.68%
£10001 – £120009.19%
£12001 – £140009.60%
£14001 – £160009.97%
£16001 – £1800010.29%
£18001 – £2000010.57%
£20001 – £2200010.82%
£22001 – £2400011.03%