The Pharmaceutical Journal
Vol 269 No 7226 p781
30 November 2002

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  Smoking cessation
  Community pharmacy
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Letters to the Editor

Drug tariff

More information on fees

From Dr G. L. Geddes, MRPharmS

My response to the letter from Tessa Jenns (PJ, 23 November, p743) was incomplete. The complete response follows:

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 Pharmaceutical Services Negotiating Committee became increasingly aware of the tend-ency 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.

A treatment period specific to a prescription could only be determined by relating the quantity to the daily dosage when this is stated. Dosage information is not captured by the Prescription Pricing Authority but fortunately a solution in the form of a threshold quantity based on the average quantity emerged. The list in Part IIIA 2H of the Drug Tariff is derived from the 1,200 most popular solid oral dosage formulations. The threshold quantity is set at the average quantity prescribed plus 34 per cent. This formula is arbitrary but was designed to pay out a small proportion of the global sum at an initial rate of a 30p fee.

I agree with Mrs Jenns that the list is in need of revision. However, the effect of a revision results in more monies being allocated from the global sum. Recently the PSNC made a decision to leave threshold quantities untouched until more information is available regarding the quantum of the standard professional fee and the effect on average quantities following the introduction of repeat dispensing schemes.

I should be pleased to discuss the history of threshold quantity fees with Mrs Jenns outwith these columns. However, I hope that this necessarily lengthy reply will not put her off browsing through the Drug Tariff — an activity I recommend to all readers!

Gordon Geddes
Head of Information and Technical Services
Pharmaceutical Services Negotiating Committee

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