How can Migraleve tabs. be prescribed on NHS?

[philly]

Hi,
I have a tricky question, difficult to answer even for experienced pharmacists.

On what grounds can Migraleve tabs. be prescribed on NHS? It is not listed in Part VIII of Drug Tariff. On the other hand, it is not listed in Part XVIIIA ('Black List') of Drug Tariff.
Is it allowed to prescribe on NHS any medicinal product provided that it has been granted a marketing authorisation in the UK and it is not blacklisted?
What price will be reimbursed for a prescription for Migraleve tabs.?

Thank you for reading

[Pharmanaut]

Hi,
I have a tricky question, difficult to answer even for experienced pharmacists.

On what grounds can Migraleve tabs. be prescribed on NHS? It is not listed in Part VIII of Drug Tariff. On the other hand, it is not listed in Part XVIIIA ('Black List') of Drug Tariff.
Is it allowed to prescribe on NHS any medicinal product provided that it has been granted a marketing authorisation in the UK and it is not blacklisted?
What price will be reimbursed for a prescription for Migraleve tabs.?

Thank you for reading

Part VIII is just a list of standard prices; if it is in part VIII that is what you will be paid regardless of endorsement. (Unless announced NCSO)
If not in Part XVIIIA then can be prescribed on NHS, provided they are in the prescribers formulary. (See Nurse and Dentist Sections).

You are reimbursed the standard C&D priced depending on your pack endorsement. Note: endorse the pack that you use, not the one that gives you most reimbursement. (Counter-fraud could pick this up).
Migraleve Duo - double prescription charge; based on two tablets with different formulations.

None of this compels any prescriber to prescribe it for any patient - entirely up to the prescriber.

For more on the DT visit the relevant organisation.
PSNC for Eng/Wales
Community Pharmacy Scotland, for ...Scotland.

[philly]

Did you know that:
"WHISKY is not on the blacklist, so a prescription for this item would be passed for payment by the NHSBSA Prescription Pricing Division. The prescriber may however be questioned by their Primary Care Trust (PCT) about the appropriateness of prescribing this item at NHS expense?"
That's funny. What price would be reimbursed for 'whisky'? It's not in the C+D, I suppose.

Also, I have become confused about SLS and ACBS. The PSNC site states:

"If the ‘SLS’ endorsement is missing, the prescription should not be dispensed and will not be passed for payment by the NHSBSA Prescription Pricing Division" and

"If the ACBS endorsement is missing for a product on the borderline substances list, pharmacy contractors CAN STILL DISPENSE the prescription and it WILL BE PASSED FOR PAYMENT by the NHSBSA Prescription Pricing Division. However the prescriber may be asked by their PCT to justify why the product has been dispensed at NHS expense."

In that case, what is the 'ACBS' endorsement requirement for?

[bobbin]

Did you know that:
"WHISKY is not on the blacklist, so a prescription for this item would be passed for payment by the NHSBSA Prescription Pricing Division. The prescriber may however be questioned by their Primary Care Trust (PCT) about the appropriateness of prescribing this item at NHS expense?"
That's funny. What price would be reimbursed for 'whisky'? It's not in the C+D, I suppose.

Also, I have become confused about SLS and ACBS. The PSNC site states:

"If the ‘SLS’ endorsement is missing, the prescription should not be dispensed and will not be passed for payment by the NHSBSA Prescription Pricing Division" and

"If the ACBS endorsement is missing for a product on the borderline substances list, pharmacy contractors CAN STILL DISPENSE the prescription and it WILL BE PASSED FOR PAYMENT by the NHSBSA Prescription Pricing Division. However the prescriber may be asked by their PCT to justify why the product has been dispensed at NHS expense."

In that case, what is the 'ACBS' endorsement requirement for?

Whisky would be reimbursed based on your endorsement. You would need to endorse the brand name or supplier, pack size and price (excluding VAT).

The purpose of the ACBS endorsement is to draw attention to the fact the the product is being prescribed for an ACBS-approved indication. Given that GP's prescribing systems probably just endorse it automatically, it's really quite pointless IMO.

[bobbin]

It's not in the C+D, I suppose.

The C&D lists the prices of branded medicines....but the PPA do not actually use the C&D for pricing prescriptions. They use their own database which is based on the NHS Dictionary of Medicines and Devices. It contains the Drug Tariff prices for generics and the NHS dm+d prices for branded products.

[bobbin]

Is it allowed to prescribe on NHS any medicinal product provided that it has been granted a marketing authorisation in the UK and it is not blacklisted?

It is perfectly legal for doctors to prescribe unlicensed medicines if they wish to do so.

[Defblade]

There was a case in the trade press once of a script that the pharmacy couldn't read.

The story went the doctor had gone on a housecall, decided no treatment was necessaryat the time. Patient showed the doctor to the door, and had a chat admiring the doctor's new 4x4. The doctor did then decide to write a script.

Patient took (illegible) script to pharmacy, pharmacy eventually rang doctor. Doctor said he'd written a joke script - "one new range rover like mine" - to cheer the patient up a bit.

PPA said it would have to have been passed for payment if supplied

[johnep]

WE kept Brandy and Gin in the dispensary, used to make up 'Brompton Mixture' This contained cocaine, diamorphine and sometimes morphine as well. Largactil used to potentiate effect. I feel a google coming on.
johnep

[philly]

Another question arouse in my mind associated with this thread: what are the regulations that forbid prescribing drugs for malaria prophylaxis on the NHS? Does Drug Tariff say anything about it?

[johnep]

None and no. Have had a script for year's supply of Lariam for a back packer. However, the PCT may well add antimalarials to 'the red book'.
My own (biased) opinion is, that if someone can afford to go abroad and risk infection, then they should not expect to get prophylaxis on the NHS.
When I went on export trips, I got a private script.
johnep