Some 19 products will be added to the Discount Not Deducted list from 1 November.

The DND concession does not apply to dispensing practices. Without applied wholesaler/manufacturer discounts, all DND products will be loss-making due to the dispensing GP clawback.

The affected products  are:

• Alprostadil 10microgram powder and solvent for solution for injection cartridges with device
• Alprostadil 20microgram powder and solvent for solution for injection cartridges with device
• Alprostadil 40microgram powder and solvent for solution for injection cartridges with device
• Altrajuce Starter Pack liquid
• Anquil 250microgram tablets
• Aqumeldi 0.25mg orodispersible tablets
• Fresubin 2kcal HP tube liquid feed
• Fresubin 3.2kcal drink cappuccino
• Fresubin 3.2kcal drink hazelnut
• Fresubin 3.2kcal drink mango
• Fresubin 3.2kcal drink vanilla-caramel
• Fresubin YOcreme dessert apricot-peach
• Fresubin YOcreme dessert biscuit
• Fresubin YOcreme dessert lemon
• Fresubin YOcreme dessert raspberry
• Maxijul Super Soluble powder 132g sachets
• Peptisip Energy HP liquid
• ProSource TF ENFit liquid 60ml sachets
• ProSource TF plant liquid 45ml sachets

Community Pharmacy England maintains a list of changes to the DND list. So far this year there have been 94 products switched to the DND list, in addition to those granted automatic DND status each month.

In addition, individual items are separately listed in Part II of the Drug Tariff and group items in the Actual Medicinal Product (AMP) listing on Dictionary of Medicines and Devices (dm+d)

Also classed as DND are the following group items:

• Cold Chain Storage (ALL)
• Schedule 1, 2 or 3 Controlled Drugs: Products containing drugs listed in Schedules 1, 2 and 3 of the Misuse of Drugs Regulation 2001
• Cytotoxic or Cytostatic item (ALL):
• Immunoglobulins (ALL)
• Insulins for injection (ALL)
• Vaccines and antisera (ALL)
• Unlicensed medicines: ‘Specials’ not listed in Part VIIIB where the product has been sourced from a supplier holding a MHRA specials or importers licence (prescriptions must be endorsed with invoice price less discount/rebate)
• Hazardous chemicals

Individual items that fulfil all three of the following criteria also qualify for entry to the DND list.

• the manufacturer(s), AAH and Alliance do not offer pharmacy owners a discount
• fewer than 500,000 items per year are dispensed of the product
• average net ingredient cost (NIC) per item is more than £50.