case studies :(

[jayde-89]

hello im just running through practise case studies and im just doing this one i was wondering if some one could help me through this cuase i dont know the abbeviations on the script

picture of script

mr tim brooke
46 high street
anytown
(no date of birth)
(no age)
(no postcode)

( The T's have a dot above them )
co-amilofruse
2.5mg/20mg tablets
T om x 60
-------------------------
cabergoline 4mg tablets
T od x 60
-------------------------
nizoral cream
apply bd x op
-------------------------
two pairs class 3
stockings circular kint
below knee
-------------------------

questions

1 how many co-amilofruse could you dispense?explain all the options available to you


2)would you be paid for dispensing frumil Ls tablets against the presciption for co-amilofruse?


3)how many carbergoline tablets would you dispense and why?

4) mr brooke pays for his prescriptions , how many charges does it carry ?
A) this prescription carries 5 charges ??

5) could you dispense all the items as its written ? if not explain why ?

6) what endorsment would need to be added to allow you to dispense the items and who need to add this endorsment

7)what extra endorsment could be required fo the 4th item ?

8) what additional fee would be paid and where can you find this information

[Jeff]

Re: case studies

Answers are all here

PPA -> Drug Tariff

but it might be easier if you can get hold of the book.

Jeff

[Pharmanaut]

Re: case studies

where can you find this information

OK, based on the proverb "If you tell a student the answers, you help them pass an exam. If you tell them where to look they will find out more"

We are looking at an NHS Prescription for England/Wales?

Welcome to the wild and wacky world of the "Drug Tariff".
The website awaits you...
PPA -> Drug Tariff

Also if you can get a copy of "The NPA Guide to the drug tariff".

Clues : Calendar packs, special containers, measured & fitted (or made to measure), and SLS.
Now its over to you.... At least you can use the search facility on the tariff site.

Give it a go, post your answers and well will let you know if you can 'walk the walk'.

[Zoggite]

Re: case studies

And don't forget my personal favourite bed-time read:
http://www.psnc.org.uk/uploaded_txt/...007%20%234.pdf
Lots of useful info!

[jayde-89]

Re: case studies

Question 1.
How many co-amilofruse tablets could you dispense? Explain all the options available to you.

I would be able to dispense 56 co-amilofruse tablets as they come in a calendar pack, I could also dispense 56 and split a 28 pack to make it up 60, I would be able to claim for broken bulk

is that correct anyone ??

[jayde-89]

Re: case studies

Question 3.
How many carbergoline tablets would you dispense and why ?

I would dispense 48 as they come in packs of 16 and in a special container you cannot split special containers and have to round the quantity down to the nearest pack size.
For example 3x16=48 but 4x16=64,
64 is more than the prescriptions says so I would have to dispense 48

is that corect

[Pharmanaut]

Re: case studies

Question 1.
How many co-amilofruse tablets could you dispense? Explain all the options available to you.

I would be able to dispense 56 co-amilofruse tablets as they come in a calendar pack, I could also dispense 56 and split a 28 pack to make it up 60, I would be able to claim for broken bulk

is that correct anyone ??

Yes you are correct.
You would probably not claim broken bulk.
There is the two-thirds rule ie : if you dispense more than one prescription in the same calendar month that uses more than two-thirds of the pack your claim will be rejected.
(The above rule does not apply in Scotland)

[Pharmanaut]

Re: case studies

Question 3.
How many carbergoline tablets would you dispense and why ?

I would dispense 48 as they come in packs of 16 and in a special container you cannot split special containers and have to round the quantity down to the nearest pack size.
For example 3x16=48 but 4x16=64,
64 is more than the prescriptions says so I would have to dispense 48

is that corect

You can round up a special container if the quantity is more than half.
Watch out for products where the special container is a sub-pack eg Ikorel.
The rule is different in Scotland.

[Jeff]

Re: case studies

-------------------------
two pairs class 3
stockings circular kint
below knee
-------------------------

4) mr brooke pays for his prescriptions , how many charges does it carry ?
A) this prescription carries 5 charges ??

Are you sure?

Jeff

[jayde-89]

Re: case studies

You can round up a special container if the quantity is more than half.
Watch out for products where the special container is a sub-pack eg Ikorel.
The rule is different in Scotland.

so would i dispense the 64 ?
even thou the script says only 60 ?
im getting so confused the drug tarrif is confusing and i dunno what parts to look in

[jayde-89]

Re: case studies

2)would you be paid for dispensing frumil Ls tablets against the presciption for co-amilofruse ?

yes you would be paid fo dispensing frumil LS is you endorse it correctly

is that correct

[jayde-89]

Re: case studies

Are you sure?

Jeff

well not sure , but dont you pay one presciption charge for each pair , or is it two charges per pair ?

[Pharmanaut]

Re: case studies

well not sure , but dont you pay one presciption charge for each pair , or is it two charges per pair ?

It is one charge per stocking, 4 stockings are four charges.

[Pharmanaut]

Re: case studies

2)would you be paid for dispensing frumil Ls tablets against the presciption for co-amilofruse ?

yes you would be paid fo dispensing frumil LS is you endorse it correctly

is that correct

If you are in England or Wales have a look in part VIII of the drug tariff.
If you are in Scotland its Part 7.
If you find co-amilofruse listed there that is all you will be paid for the product even if you dispense a brand.
The only time you would be paid for a brand if there was and "NCSO" declared. This automatically expires at the end of the month.

[Pharmanaut]

Re: case studies

so would i dispense the 64 ?
even thou the script says only 60 ?
im getting so confused the drug tarrif is confusing and i dunno what parts to look in

You could supply 64 tablets on the prescription as the breakpoint is greater than half the pack. If you are in Scotland you can round up from the first tablet if you as the pharmacist decide there is a clinical need to do that, BUT YOU MUST ENDORSE that you have done so.

The drug tariff is confusing.
Bear in mind that it probably was once logical but it is now the result of lot of horse trading since the NHS started.

There are also 3 and a bit tariffs. England And Wales (E/W) (1 and a bit because some of the things are slightly different in Wales), Scotland and Northern Ireland (NI).

The best book to start with is the NPA guide to the drug tariff. The latest edition isn't as good as the previous separate books for the different tariff areas, mainly because it isn't indexed very well.

A top tip is to put some section markers in the tariff.

By all means post some more questions - always happy to help, but you have got to have a go first

For the community pharmacist good knowledge of the DT is essential as you can quite happily dispense something and end up with a disallowed item - ie no dispensing fee, no ingredient cost, and technically breaching the terms of service. The ingredient cost is the price of whatever you have supplied which can be £80 or so on a colostomy set.