Community. Pharmacy News. Medicines support from pharmacists improves quality of care and saves money p2



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Community Pharmacy News JULY 2010 Medicines support from pharmacists improves quality of care and saves money p2 Inside this issue Making a difference with asthma MURs Servier distribution change Branded medicines supply update

General News www.psnc.org.uk July 2010 Community Pharmacy News Delivering more for less by improving medicines adherence Think tank 2020health recently released a report called Cutting the costs without cancelling the services: How to save the NHS 12bn in one year. One of the report s central themes was the need to get more out of the NHS s medicines budget by reducing the waste and inappropriate use of expensive drugs. It proposed redirecting more patients to pharmacies for medicines guidance, and called for the NHS to set ambitious targets for the reduction of medicines waste. These recommendations are to be welcomed. If the NHs is to meet the profound financial challenges it faces in the coming years, improved medicines adherence will be crucial. It is projected that the Health service currently spends hundreds of millions a year on medicines that go on to be wasted. The untold costs of sub-optimal use are no doubt significantly higher. Recent research from Asthma is a very common condition 5.4 million people in the UK are receiving treatment for it, that s 1 in 11 children and 1 in 12 adults which is one of the highest rates anywhere in the world. As many GPs and their teams have for a long time provided asthma clinics within their practices which help to manage the treatment of people with asthma, many pharmacists could be forgiven for thinking that asthma is a disease that we treat effectively in the UK; unfortunately this is not always the case. There were 1,204 deaths from asthma in the UK in 2008 that s one death every 8 hours. An estimated 75% of hospital admissions from asthma and 90% of deaths are thought to be preventable with good management of the condition. Community pharmacists can make a difference to these startling statistics by helping people with asthma understand more about their medicines and how to use them. Targeting people with asthma for MURs is a good way to play your part the MUR is the ideal vehicle to improve a person s knowledge of their condition and the medicines used to treat it. In order to help community pharmacists the United states suggests that between 11% and 20% of all hospital admissions, A&e visits and repeat doctor visits are a direct result of non-adherence. Ineffective use of medicines places an enormous and unnecessary burden upon finite health resources. No-one is better placed to reduce this burden than community pharmacists. The national MUR service has served as an important first step toward improving medicines adherence. MURs have a track record of success, demonstrating the clear benefits of patient involvement in improving outcomes. They have also received impressively high patient satisfaction levels, and have led to substantial improvements in patients opinion of their care. They demonstrate how patients benefit from personally tailored information and support, when that support is easily accessible and provided by their pharmacist. Making a difference with Asthma MURs! to carry out asthma MURs, Asthma UK the charity dedicated to improving the health and well-being of people in the UK who have asthma has worked with PSNC to develop a leaflet for people with asthma Asthma advice from your pharmacist. This leaflet is designed to be given to a person with asthma before they have an MUR. To order free copies of the leaflet or for more information on asthma visit the health professionals section of the Asthma UK website (www.asthma.org.uk/ health_professionals). What is asthma? Asthma is a condition that affects the airways the small tubes that carry air in and out of the lungs. People with asthma have airways that are almost always red and sensitive (inflamed). These airways can react badly when you have a cold, or other viral infection, or when you come into contact with an asthma trigger. The usual symptoms of asthma are: coughing wheezing tightness in the chest shortness of breath Not everybody will get all these symptoms. Some people experience them from time to time; a few people may experience these symptoms all the time. Asthma medicines There are two main kinds of asthma medicine: relievers and preventers. Relievers are medicines that you take immediately to relieve asthma symptoms. They quickly relax the muscles surrounding the narrowed airways and help the airways open wider, making it easier to breathe again. Everyone with asthma should have a reliever inhaler. Relievers are usually blue. Preventers are medicines that control swelling and inflammation in the airways. They also stop the airways from being so sensitive to asthma triggers. The protective effect of preventer treatments builds up over time so it is important to take them every day, even if you are feeling well. Not everyone with asthma will need preventer medicine. Preventer inhalers are usually brown, red or orange. They are also available in tablet form. Take Control of Your Asthma includes more information about triggers, treatments, personal asthma action plans and controlling your symptoms. For your free copy contact Asthma UK s Supporter & Information Team 08456 03 81 43 info@asthma.org.uk Take control of your asthma You can take control of your asthma by knowing what medicines to take and when to take them, avoiding things that trigger your asthma and knowing what to do if your symptoms get worse. Personal asthma action plans You should be offered a written personal asthma action plan by your doctor or nurse, who should complete it in discussion with you at your asthma review. The plan will contain the information you need to keep control of your asthma, including details about your asthma medicines, how to tell when your asthma symptoms are getting worse and what you should do about it, and what to do if you have an asthma attack. How do I know if my asthma is getting worse? If your symptoms are getting worse you may recognise some or all of the following: needing more and more reliever medicine waking at night with coughing, wheezing, shortness of breath or a tight chest having to take time off work because of your asthma feeling that you cannot keep up with your normal level of activity or exercise noticing a drop in your peak flow meter readings. If you notice any of these signs or symptoms, make an appointment with your doctor or nurse to help you to get back in control of your asthma. An emergency is when any of the following happen: 1 Your reliever (blue) inhaler What you must do during does not help an attack: 2 Your symptoms get worse 1 Take your reliever (blue) inhaler (cough, breathless, 2 Sit up and loosen tight clothing wheeze, tight chest) 3 If no immediate improvement 3 You are too breathless during an attack, continue to take to speak, eat or sleep one puff of reliever inhaler every minute for five minutes or until symptoms improve 4 If your symptoms do not improve in five minutes or if you are in doubt call 999 or a doctor urgently 5 Continue to take one puff of your reliever inhaler every minute until help arrives. Asthma UK The NHs can extend the benefits it already receives from this service by using pharmacies to offer personalised support to patients as soon as they embark on a new medicines regimen. This will empower patients to better understand their therapy and help them to manage their care more effectively. By facilitating greater patient understanding of their medicines, pharmacists can improve patients adherence and increase their involvement in their healthcare; boosting the quality of care delivered and reducing the amount the NHs spends on unused or ineffectively used medicines. Pharmacists are ideally placed to improve medicines adherence across the board. However, they must be empowered to do so. we look forward to working with the Government to ensure pharmacy s potential to reduce medicines waste and sub-optimal use is fully harnessed. Asthma pharmacist Asthma UK is dedicated to improving the health and well-being of over five million people in the UK with asthma. Asthma UK Adviceline Ask an asthma nurse specialist 08457 01 02 03 asthma.org.uk/adviceline Asthma UK website Read the latest independent advice and news on asthma asthma.org.uk Asthma UK publications Request booklets, factfiles and other materials with independent, specialist information on every aspect of asthma 08456 03 81 43 info@asthma.org.uk advice from your Talk to your pharmacist about the best ways to control your asthma Asthma UK membership Become a member of Asthma UK and receive Asthma Magazine four times a year 08456 03 81 43 membership@asthma.org.uk Asthma UK, Summit House, 70 Wilson Street, London EC2A 2DB T 020 7786 4900 F 020 7256 6075 2006 Asthma UK Registered charity number 802364 HA0030708

Community Pharmacy News July 2010 www.psnc.org.uk Drug Tariff News Community Pharmacy News Drug Tariff News at a glance This month includes: News on: servier Labs. Distribution Change Licensed simvastatin oral suspension products Do you know: How NHs Prescription services apply price changes FAQs on: Otrivine Child Nasal Drops Faxing Anonymised Prescriptions Named Patient supply products Servier Laboratories Ltd announce new Distribution Arrangements servier Laboratories Ltd is to distribute their branded medicines under a reduced wholesaler model, with Alliance Healthcare (Distribution) Limited, Phoenix Healthcare Distribution Limited and AAH Pharmaceuticals Limited from 1st August 2010. A chart with a summary of key manufacturers distribution arrangements can be downloaded from the PsNC website (www.psnc.org.uk/ distribution). Licensed Simvastatin oral suspension launched Rosemont Pharmaceuticals have launched two licensed simvastatin oral suspension products: Simvastatin 20mg/5ml oral suspension sugar free 150ml Simvastatin 40mg/5ml oral suspension sugar free 150ml It is a professional requirement that where a product is ordered on a prescription, a pharmacist must supply a product with a marketing authorisation, where such a product exists and is available, in preference to an unlicensed medicine. Product Pack Status Changes NHs Prescription services have confirmed the following item has changed pack status: Item Pack Size Old Pack Status New Pack Status Fluvastatin sodium 28 (4 x 7 standard Pack Calendar Pack 80mg m/r tablets sub-packs) General information on special containers and calendar packs along with an online searchable database of products granted this status can be found in the online Drug Tariff Resource Centre (www.psnc.org.uk/specialcontainer). Levest 150/30 tablets added to Free of Charge Contraceptives List The Department of Health has advised that Levest 150/30 tablets has been added to the List of Contraceptive Drugs to be Dispensed Free of Charge in Part XVI of the Drug Tariff. Prescriptions for contraceptive devices listed in Part IXA of the Drug Tariff, spermicidal gels, creams, films and aerosols are automatically exempt from the prescription charge. As are systemic drugs which are promoted as contraceptives and which are listed in Part XVI of the Drug Tariff. In addition to this, no prescription charge should be levied if the prescriber has marked the prescription to make it clear that the prescription is for contraceptive use. Sativex granted licence Bayer schering Pharma UK have announced that sativex Oromucosal spray has been granted a licence. This is the first cannabinoid medicine derived from whole plant extracts from the cannabis sativa plant containing both delta-9- tetrahydrocannabinol (THC) and cannabidiol (CBD). The product was previously available on an unlicensed basis. sativex is indicated as add-on treatment for symptom improvement in patients with moderate to severe spasticity due to Ms who have not responded adequately to other anti-spasticity medication and who demonstrate clinically significant improvement in spasticity related symptoms during an initial trial of therapy. Pharmacies can obtain the product via Movianto (email: orders.uk@movianto.com Tel No: 01234 248632). Ongoing problems due to manufacturer quota schemes At present, the supply arrangements for some products are having an adverse impact on workload in pharmacies and can lead to delays in patient care. PsNC is working constructively with manufacturers, wholesalers, the Department of Health and regulators to find solutions to the current problems that could be introduced to help meet the needs of UK patients more efficiently. In March, at a Ministerial summit on the current problems, a range of actions were agreed that are now being taken forward. These include a proactive, targeted programme of inspections by the MHRA, exploring the possibility of contingency stocks being held by wholesalers and the establishment of a supply chain group to examine problems affecting individual products with a view to finding possible means of mitigation and resolution.

List of Medicines Impacted by Branded Medicine Supply Problems www.psnc.org.uk July 2010 Community Pharmacy News Pharmacies have reported problems obtaining the following medicines through wholesalers. This list is not exhaustive. If a product cannot be obtained through the normal channels, emergency stock can be obtained direct from the manufacturer: Actonel 35mg tablets (Procter & Gamble Aprovel tablets (sanofi-aventis) Arava 20mg tablets (sanofi-aventis) Arimidex 1mg tablets (AstraZeneca Asasantin Retard capsules (Boehringer Ingelheim Ltd) Azilect 1mg tablets (Lundbeck Ltd) Azopt 10mg/ml eye drops (Alcon Laboratories (UK) Ltd) Bonviva 150mg tablets (Roche Products Ltd) CellCept capsules/tablets (Roche Products Ltd) Cipralex tablets (Lundbeck Ltd) CoAprovel tablets (sanofi-aventis) Crestor tablets (AstraZeneca Cymbalta gastro-resistant capsules (Eli Lilly and Company Ltd) Elidel 1% cream (Novartis Pharmaceuticals Emselex modified-release tablets (Novartis Estradot /24hours patches (Novartis Eucreas tablets (Novartis Pharmaceuticals Exforge tablets (Novartis Pharmaceuticals Ezetrol 10mg tablets (MSD-SP Ltd) Femara 2.5mg tablets (Novartis Pharmaceuticals Glivec tablets (Novartis Inegy tablets (MSD-SP Ltd) Inspra tablets (Pfizer Ltd) Januvia 100mg tablets (Merck Sharp & Dohme Ltd) Keppra tablets (UCB Pharma Ltd) Micardis/MicardisPlus tablets (Boehringer Ingelheim Ltd) Myfortic gastro-resistant tablets (Novartis Neoral capsules (Novartis Pharmaceuticals Persantin Retard 200mg capsules (Boehringer Ingelheim Ltd) Rilutek 50mg tablets (sanofi-aventis) Sandostatin LAR powder and solvent for suspension for injection vials (Novartis Singulair tablets (Merck Sharp & Dohme Ltd) Spiriva 18microgram inhalation powder capsules (Combopack and Refill Pack) (Boehringer Ingelheim) Spiriva Respimat 2.5micrograms/dose solution for inhalation cartridge with device (Boehringer Ingelheim Ltd) Symbicort Turbohaler (AstraZeneca Zyprexa tablets/velotabs (Eli Lilly and Company Ltd) Please note: If a wholesaler chose to trade medicines for export and as a consequence the needs of patients in the UK were not met, the holder of the wholesale dealer s licence could be in breach of the Regulations, and could face regulatory action against his licence, and/or criminal prosecution. This also applies to products that have not been reported as having supply problems and are therefore not listed above. There is no obstacle to exporting medicines in a way that does not impact on availability of the product to UK patients. Feedback to PSNC: Contractors who have experienced problems in obtaining medicines because of quota arrangements are encouraged to feed this into the PSNC Information Team to support PSNC s ongoing monitoring of the situation. PSNC will work to ensure this information is fed into the Department of Health as evidence of the problems that are arising. An online feedback form for this purpose can be found online at www.psnc.org.uk/brandedshortages. For support on this issue, please contact the PSNC Information Team (01296 432823). Manufacturer s Contingency Arrangements The table below summarises the contingency arrangements for the manufacturers and products that PsNC is currently most frequently receiving calls about: Manufacturer Affected Products include Summary of Contingency Ordering Procedure ALK-Abello EpiPen If a pharmacy has difficulties in obtaining stocks of these medicines from the wholesaler they should EpiPen Jr contact the ALK Customer Services Team on 01488 686 016, emergency supplies can then be located and Grazax dispatched. The Customer Services Team are available 8.30am to 5.00pm, Monday-Thursday and 8.30am to 4.30pm, Friday. Astrazeneca Any If any pharmacy has problems with obtaining stock of any AZ medicine from AAH or Unichem they should contact the Supply Chain Team on 0800 032 0501. Boehringer Ingelheim Micardis If any pharmacy has problems with obtaining stock of Boehringer Ingelheim medicines they should Micardis Plus contact Boehringer Ingelheim customer services on 01344 741101. Alternatively complete the emergency Persantin Retard supply form (available on the PSNC website) and fax it to: 01344 741177. Genzyme Renagel If any pharmacy has problems obtaining Renagel from their wholesaler they should complete the exceptional supply form (available from the PSNC website), and fax it to Genzyme customer service fax number: 01865 774254 Janssen-Cilag Cilest If any pharmacy has problems obtaining Janssen-Cilag products from their wholesaler they should Concerta complete the emergency supply form (copy available on the PSNC website), and fax it to the emergency Evra supply fax number: 01494 567401. Invega Risperdal Topamax For any pharmacist involved in Community Pharmacy, understanding aspects of the Pharmacy Contract will be relevant CPD. Why not make a record in your RPSgB CPD Plan & Record file or on-line at www.uptodate.org.uk

Community Pharmacy News July 2010 www.psnc.org.uk Lilly UK Cialis If wholesaler can t supply the product, contact Lilly s emergency Direct 2 Pharmacy customer service desk Cymbalta which is open Monday-Friday, 8.30am-5pm 0800 0121178 Zyprexa Lundbeck Azilect If wholesaler can t supply the product, contact Lundbeck customer service department on 01908 638935 Cipralex who will be able to assist you in obtaining emergency supplies, or fax a request to 01908 638959 with the following details: Name and Address of Pharmacy Alliance Healthcare account number Order requirement Product and qty. MSD Januvia If wholesaler can t supply this product, then please contact MSD customer services on 01992 452094 or Singulair FAX MSD customer services on 01992 467270 with the following details: The name and address of the pharmacy The wholesaler name, branch and account number Order requirement product, strength, pack size, number of packs Delivery will normally be made within 48 hours. Novartis Femara Products only available via Unichem and AAH. Myfortic Novartis is also able to deliver directly to pharmacies with a direct account if there are any supply Neoral difficulties with the wholesalers. To order directly call Novartis Customer Care on 08457 419 442, or fax the Novartis emergency order form (downloadable from the PSNC website) to 0845 741 9443, or email it to novartis.customercare@novartis.com. Deliveries will normally be made within 48 hours of order, depending on location. Novo Nordisk Any If sufficient supplies of product are not available from a pharmacy s wholesaler for any reason, Novo Nordisk can ship direct to a pharmacy if they have a patient prescription to fulfil. Urgent orders can be placed by phoning Novo Nordisk Customer Care on 0845 600 5055. Roche Bonviva If wholesaler can t supply the product, contact Roche Customer Care 0800 731 5711. Delivery will normally Cellcept be made next working day for orders received up until 16.00, dependent upon location. Xenical Sanofi-aventis Aprovel These products are available via three national wholesalers; AAH, Phoenix and Unichem. However if Co-Aprovel problems are experienced in obtaining these products then the pharmacy should contact Sanofi-aventis Rilutek customer services directly on 0800 854 430 who will in turn facilitate an emergency direct to pharmacy Lantus Optiset order. Schering Plough Ltd Cerazette If wholesaler can t supply the product contact Schering Plough s customer service team on 01707 363785. Shire Fosrenol If any pharmacy has problems obtaining Fosrenol they should contact Movianto on 01234 248653. Movianto can arrange a next day direct delivery. UCB Keppra If wholesaler can t supply the product, then fax UCB s national distributor UDG, on 01773 810 644 with the Budenofalk caps 3mg following details: The name and address of the pharmacy Their wholesaler name, address (town) and account number Their order requirements i.e. what formulation and strength of Keppra, how many packs The urgency of the situation (deliveries are usually made within 3 working days but can in exceptional circumstances be made in 2 or 1 working days) A template fax back form and a link to UDG s electronic ordering system can be found on the PSNC website. UDG Customer Services can be contacted on 01773 510123 or 01773 515170. Warner Chilcott Ltd Actonel Once Weekly Warner Chilcott Ltd have provided the following statement regarding emergency supplies of Actonel: (previously Warner Chilcott (formerly Procter & Gamble Pharmaceuticals) does not have a direct ordering system. Procter & Gamble We make Actonel available through three wholesalers in the UK AAH, Alliance & Phoenix and in N. Ireland Pharmaceuticals) AAH, Sangers & Alliance. If you experience problems sourcing Actonel from any of these wholesalers you can contact us at 0800 0328701 (UK) and 1800 882937 (ROI). You will be asked to try with the wholesalers for three (3) working days from the first call. If you are still unable to get the product from either of the wholesalers we will be able to source an emergency supply. Address change? Please let us know if your mailing address used for CPN is incorrect either return the envelope with any amendments made to the address to: Database Changes, PSNC, 59 Buckingham Street, Aylesbury HP20 2PJ or email changes to cpn@psnc.org.uk or fax changes to 01296 438427. All details correct at time of printing. No part of this publication may be reproduced without the written permission of the PSNC. Produced for the PSNC by Communications International Group.. PSNC. Colour repro by TSS Digital, Margate. Printed by Truprint, Margate. The publishers accept no responsibility for any statement made in signed contributions or in those reproduced from any other source. Distributed for PSNC by: Communications International Group Linen Hall, 162-168 Regent Street, London W1B 5TB Tel: 020 7434 1530 Fax: 020 7437 0915

Frequently asked questions www.psnc.org.uk July 2010 Community Pharmacy News The PSNC Information Team receives many phone calls each day from community pharmacies across England and Wales. Queries range from whether an item is allowed on an NHS prescription to how much contractors will be paid for supplying certain items. 1. 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. 2. I have received an FP10 prescription for an unlicensed named patient supply product. Does this mean that I need to provide the manufacturer with the name of the patient? The commonly used term named patient supply is incorrect in that the term used in the legislation is individual patients and although there must be an audit trail which ultimately leads to an individual PSNC E-NEWS To receive a weekly summary of the latest news and guidance featured on the PSNC website including pharmacy contract news, Drug Tariff News, NCSO updates, events information and much more, sign up to receive PSNC s weekly e-newsletter. Visit www.psnc.org.uk/enews to register patient, there is no need for those involved in the supply chain to know the name of that patient. Patient identifiable information should not be shared without patient consent. 3. I can t obtain a common branded product from my wholesaler. The manufacturer is requesting that I share the prescription form serial number. Does the prescription form identifier link to the patient? A number of manufacturers are requesting that contractors fax anonymised copies of prescriptions before stock is released. PsNC does not believe that this is appropriate as an ongoing measure in managing supply. It is exceptionally burdensome for pharmacies and there is a risk that patient identifiable information will be inadvertently disclosed. The NHs (Pharmaceutical services) Regulations 2005 require that contractors have appropriate arrangements in respect of compliance with Confidentiality: the NHs Code of Practice. This requires that patient identifiable information is not shared without patient consent. There are similar requirements on the sharing of personal health information under the Data Protection Act 1995 and the common law duty of confidentiality. Therefore, before faxing a prescription to a manufacturer, any information that could be used to identify the patient must be obscured unless the patient has consented to their information being shared. A detailed briefing on the legal and ethical provisions that limit or prohibit the use of personal information can be found in the NHs Information Governance: Pharmacy Contractor workbook (www.psnc.org.uk/ig). Although the pre-printed serial number on prescription forms is a unique identifier, this identifies the paper form, not an individual patient. For security reasons, PCTs record details of which forms were issued to which prescribers. This information should not normally be in the public domain. Look out for more frequently asked questions next month If you would like more information on whether a particular product is allowed on an NHS prescription, the PSNC Information Team will be happy to help (01296 432823 or e-mail info@psnc.org.uk). ENHANCED SERVICES The most popular services searched for during the month of June were: Anticoagulation monitoring / dispensing COPD Cardiovascular screening / VRA H. pylori eradication and dyspepsia management Asthma review and management Enhanced services are negotiated locally and commissioned mainly by PCTs. PSNC has collated details of over 350 Enhanced Services on the Community Pharmacy Services database which is available on the PSNC website at: www.psnc.org.uk/database Want to find information on a particular service? On the services database page of the PSNC website click on the search button to find details of local services across the country. Want to share details of a service? If you have developed or implemented a service in your area and would like to share the details including any documentation with PSNC and LPCs then you can upload the information to the online services database by clicking submit information on a Local Service. Paper used in this newsletter is produced from fully sustainable, well-managed forests

Community Pharmacy News July 2010 www.psnc.org.uk Do you know... How NHS Prescription Services apply medicine price changes to payments? As prices in the market are constantly changing, there is an agreed mechanism in place to increase and decrease the reimbursement prices for medicines. For proprietary preparations and Part VIII products where the price is based on a proprietary product (e.g. most Part VIII Category C products), a price change up to and including the 8th of the month takes effect for prescriptions dispensed in the following month. A price change after the 8th of the month will be applied for reimbursement purposes to prescriptions dispensed one month later. For example, if the manufacturer s list price for a proprietary product changed on the 6th of July, the new reimbursement price would apply to prescriptions dispensed in August. If a manufacturer s list price changed on the 15th July, the new reimbursement price would apply to prescriptions dispensed in september. For non-proprietary or generic drugs (excluding products in Part VIII, Category M) the reimbursement price change takes place one month earlier that proprietary medicines. For example, if the manufacturer s list price changed on the 6th of July, the new reimbursement price would apply to prescriptions dispensed in July. If a manufacturer s list price for a generic drug changed on the 15th July, the new reimbursement price would apply to prescriptions dispensed in August. The reimbursement prices of category M medicines are changed quarterly. where a product has been granted the NCsO Concession, contractors are able to endorse NCsO and the details of the product dispensed (manufacturer or brand name, pack size etc) and be paid based on the list price of the endorsed product rather than on the Drug Tariff price. If a price change occurs during a month that NCsO is granted and NCsO is claimed, the price change mechanism, generic or proprietary as appropriate, continues to apply when the reimbursement price of the endorsed product is calculated. Is it allowed? Subject to the prescriber having the appropriate prescribing rights, any food, drug, toiletry or cosmetic may be prescribed on an NHS prescription unless the product is listed in Part XVIIIA of the Drug Tariff (the blacklist ) or the criteria set out in the Tariff for prescribing products listed in Part XVIIIB of the Drug Tariff (the selected list ) is not met. As an exception to this rule, blacklisted products can be dispensed where a product is prescribed generically and the generic product is not blacklisted and the name of the product has a recognised official title. If a product has been registered as a medical device, it can only be prescribed on an NHS prescription if it is listed in Part IX of the Drug Tariff. Registered medical devices can be identified by a CE mark on the product s packaging. Product Allowed on Product Comment an FP10 Type Prescription Fertility (ovulation) no device This product is a medical device which is not listed in Part IX of the Drug Tariff, and therefore thermometer is not allowed to be prescribed on an NHs prescription. Lofric Female no device Astra Tech have recently made changes to the base material and pack sizes of several LoFric catheter lines. 20cm /CH 08/ These modified products are still marketed with the same name but the product codes have been Code 940800 changed and in some cases the pack size has been changed. whilst this particular Lofric product is no longer listed in the Drug Tariff, the equivalent product from the new range (code 4030825) is listed. The prescription would need to be amended by the prescriber. A table summarising the Lofric product range changes can be downloaded from the PsNC website. Medi-test combi no device This product is a medical device which is not listed in Part IX of the Drug Tariff, and therefore is not test strips allowed to be prescribed on an NHs prescription. spirigel alcohol yes cosmetic This product is a cosmetic which is not listed in Part XVIIIA of the Drug Tariff (the blacklist) and is therefore handgel allowed to be prescribed on an NHs prescription. stellisept yes cosmetic This product is a cosmetic which is not listed in Part XVIIIA of the Drug Tariff (the blacklist) and is therefore antimicrobial body allowed to be prescribed on an NHs prescription. cleansing foam

www.psnc.org.uk July 2010 Community Pharmacy News For the latest PSNC news and information visit www.psnc.org.uk Partners in the PSNC Community Pharmacy Development Programme PSNC website For up to date information and news on Commumity pharmacy issues, visit the PSNC website at www.psnc.org.uk PSNC Community Pharmacy News is published by: The Pharmaceutical Services Negotiating Committee, 59 Buckingham Street, Aylesbury, Bucks HP20 2PJ Community Pharmacy News is edited by: Mike King LLB BSc MRPharmS who can be contacted at the above address or by email at: mike.king@psnc.org.uk PSNC