Midazolam Endorsing Guidance

Midazolam payment terms

Advice on endorsing for containers; Getting it wrong could be very expensive

By Ailsa Colquhoun

From 1 December, 2011, where the contractor has provided the prescribed quantity of Midazolam 10mg/ml oral solution in containers with an integral means of administration, these prescriptions will be reimbursed as multiples of the 5ml basic price listed in Part VIIIB of the Drug Tariff.

To ensure accurate payment, contractors must clearly endorse where they have supplied containers with an integral means of administration e.g. the quantity dispensed over pack size (20ml/5ml) or as 4x5ml.

Where the prescription is not endorsed to indicate that the contractor has supplied a container with an integral means of administration, payment will be based on the existing arrangements laid out in Part VIIIB - the minimum volume (5ml) plus the price/ml for any volume dispensed thereafter.

Dr Philip Koopowitz points out the pitfalls of getting the endorsing wrong:

1. The minimum volume for Midazolam is 5ml, reimbursed at £97.51. (£19.50 per 1 ml)
2. The price per ml thereafter is 87p

So if you supply 10ml of Midazolam solution, you will be re-imbursed for 5ml + 5 x 1ml extra ie. £97.51 + 5 x 0.87 = £101.86, if it is not endorsed correctly.

But if you had been supplied 2 x 5ml by the supplier, you could potentially be charged 2 x £97.51 =£195.02.

So endorse in multiples of 5ml.