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Part IX of Drug Tariff
New arrangements
Dr Allan Tennant reports
4th of January 2010
The DH has published an overview of the new arrangements under Part IX of the Drug Tariff for the provision of stoma and urology appliances, and related services, in primary care.
A uniform reduction of 2% will be made on the reimbursement prices of all items listed as of 31 March 2010 in the following sections of Part IX of the Drug Tariff:
- Part IXA catheters: urinary; urethral
- All items listed in Part IXB, which lists incontinence appliances; and
- All items listed in Part IXC, which lists stoma appliances.
The new reimbursement prices come into effect on 1st of April 2010
An annual reimbursement price increase mechanism will be introduced six months after the price reduction has been implemented.
Dispensing appliance contractors (DACs) and pharmacy contractors will be required to provide a number of related essential services. They may also choose to provide some related advanced services.
New regulations will be put before pharmacy 6 months before 1st of April 2010 and will come into effect in October 2010.
Essential services will include:
A repeat dispensing service
A dispensing referral: if the DAC or pharmacy contractor cannot dispense the item prescribed or cannot provide the required stoma appliance customisation, he or she must - with the patient's consent - refer the prescription form or repeatable prescription to another DAC or pharmacy contractor. If the patient does not consent to this, then the DAC or pharmacy contractor must provide contact details for at least two other contractors - if he or she has the details. - who may be able to dispense the required item or service. DACs and pharmacy contractors shall not accept or receive any gift or reward for making such referrals.
- Urgent supply without a prescription
A home delivery service and supply of wipes and disposal bags:
Provide appropriate advice:
Remuneration for essential services
- Professional dispensing fee of 90p for each Part IX prescription item dispensed.
- Additional dispensing fee: other than for catheter kits and intermittent self-catheters (ISCs), a fee of £3.40 for each of the qualifying items, which are dispensed. The fee will rise to £9.30 for each catheter kits and ISC dispensed. These fees do not have to be claimed; they will be paid automatically for each qualifying item. In each case, the level of the fee reflects an understanding that not all of the qualifying appliances are delivered to a user's home.
Expensive prescription fee: as with pharmacy contractors, DACs will receive an expensive prescription fee. A fee will be paid that is equivalent to 2% of the net ingredient cost on all prescriptions over £100.
Dispensing of appliances measured and fitted will be raised to £2.60 per prescription item. In order to claim this fee, DACs and pharmacist will need to endorse the prescription to indicate that the item has been measured and fitted.
Infrastructure Payment for DACs
Advanced services remuneration
Stoma Appliance Customisation: a fee of £4.32 will be paid for every Part IXC prescription item that can be customised.
Appliance Use Reviews (AURs): remuneration for AURs conducted at premises managed by the DAC or pharmacist will be at £27.00 per review. For reviews carried out at the user's home, the fee will be £54.00. If, within a 24-hour period, reviews are conducted for several users living at the same location, the DAC or pharmacy contractor may claim £54 for the first review and £27 for each subsequent review.
Also DACS will be paid for using ETP
We will have to wait to see how these new arrangements affect our patients and DACs, however dispensing doctors should be able to continue their relationship with their appliance contractors, continuing to provide the added value service for our patients.
The DDA spent a considerable period of time over this very long consultation process discussing with and informing the civil servants about the services we provided patients via DACs.
We do not know if these new arrangements see a change in global remuneration, obviously remuneration will fall, however this maybe overcome by growth in items.
We will bring you more information and reaction as it becomes available.