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	The Pharmaceutical Journal Vol 269 No 7225 p743 23 November 2002	This page Reprint Photocopy
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Drug tariff

Need for rational and realistic fees

From Mrs T. C. Jenns, MRPharmS

While browsing through my Drug Tariff recently, I had a look at the section that deals with the extra fee of 40p that is paid when a threshold quantity is exceeded.

The quantities and entries appear to be entirely random, for example:

• Aprinox 2.5mg 53; Aprinox 5mg 56; bendroflumethiazide 2.5mg 63; bendroflumethiazide 5mg 62

• Lipostat 10mg 60; no other strengths listed

• Zocor 10mg 61; Zocor 20mg 67; simvastatin 20mg 67; no other strengths listed

• Lipitor not listed

• Losec capsules 20mg 70; no other strengths or tablets or generics listed

• Zoton not listed

• Zirtek tablets 45; generic not listed

• Thyroxine 25痢 95; thyroxine 50痢 115; thyroxine 100痢 85; Eltroxin 50痢 107; Eltroxin 100痢 80

Who is responsible for updating this list and how are the quantities decided? Should it be based on an excess of two months supply, eg, 57 for a once daily dose? If so why are all the quantities different? The list needs a radical overhaul to reflect modem prescribing and all drugs (and dressings and appliance) should have a threshold quantity set. This could be put next to the relevant entry in parts VIII and IX. If a proprietary product, eg, Zantac was prescribed, the same level as the generic entry for ranitidine could apply. Drugs not appearing in the tariff, eg, propranolol SR 80mg, would have to be listed elsewhere.

It is in our interest to get this looked into so that we receive rational and realistic fees.

Tessa Jenns
Wimbourne, Dorset

Dr GORDON GEDDES, head of information and technical services, Pharmaceutical Services Negotiating Committee, replies:

Fees related to threshold quantities were introduced with effect from 1 September 1987 to offset the discontinuation of differential on-cost. At that time, the PSNC became increasingly aware of the tendency of medical practices in some areas to issue repeat prescriptions for longer treatment periods up to six months in some cases. This practice was not uniform throughout England and Wales. Before the introduction of a flat on-cost rate (and its eventual disappearance) a switch to longer term prescribing had been partially offset by a higher on-cost rate. Thus a fee related to the treatment period became a PSNC objective.

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