The DDA Podcast
The DDA has created its own series of podcasts with information and analysis of dispensing doctor matters in conversation with DDA Board Members and invited guests.
The DDA Podcast
6. Best Practice with the Drug Tariff
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In this episode DDA Communications Officer Ailsa Colquhoun speaks with Philip Edwards, Head of Pharmaceutical Services and Principal Pharmacist, at NHS BSA Prescription Services on the subject of best practice with the Drug Tariff for England and Wales.
In this episode, you will find out where to find information on endorsing items and submitting payment claims, when to look out for changes to the Drug Tariff, and where to find other resources to help you to reduce reimbursement 'surprises'.
There is also information on the new Category H.
There are references in the podcast to the following resources:
The Drug Tariff for England & Wales: Drug Tariff | NHSBSA
NHS BSA newsletter: Hints & Tips
NHS dictionary of medicines and devices (dm+d)
Today I'm joined by Philip Edwards, who works at the Business Services Authority Pharmacy Service Division, where he is head of pharmaceutical services and the principal pharmacist. And our title for today is about best practice with the drug tariff for England and Wales. Before we start, I just must say that all information is correct at the time of recording, which is March 2026, and is subject to change. So please do check all information before acting on it. So good morning, Philip.
SPEAKER_00Good morning, Else, and thank you for having me.
SPEAKER_01Drug Tariff, it's an essential document for dispensing practices. I would hope it's bookmarked as it's a digital publication and is a go-to for most queries that dispensing practices will have. Please tell us what is its function, what isn't its function? The aim of today is to help practices to use it better.
SPEAKER_00Okay, I'll just start with a bit of background, if that's okay, Elsa. So the NHSBSA is an arm's length body of the Department of Health and Social Care. And as such, we are directed by the Department and indeed the Secretary of State of Health to undertake critical essential services. And one of the biggest critical essential services we do is the compilation, the updating, and the publication of the monthly NHS England and Wales Drug Tariff. And I've given it its full title there because the drug tariff covers not only England but Wales as well. And as such, there are certain sections that pertain only to England dispensing contractors and sections that pertain only to Welsh dispensing contractors. And also within the drug tariff, within English dispensing contractors, there are certain sections that again only relate to certain contractor groups. So some of the parts of the drug tariff relate to all dispensing contractors, some parts only relate to pharmacy contractors, some parts only relate to dispensing appliance contractors. And I think there's a small section called part 10 that relates to oxygen contractors. Consistent to all is that the drug tariff is a legal publication. And it outlines, I guess, two basic objectives. It provides contractors who provide NHS services details about what they'll be reimbursed and what they'll be remunerated. And for that I mean what they're reimbursed in terms of the cost of the prices for the drugs that they prescribe and dispense, and also for the medical devices and appliances. And remuneration is the associated fees and allowances for the provision of that supply. The drug tariff also details all the rules to follow when dispensing. Now, there's a lot in the drug tariff. There are actually 21 separate parts. If I can try and break down that as best I possibly can. The rules to follow when dispensing include how to submit a claim, what the submission would look like in terms of what paperwork is required, and also details things like deadlines and timescales for making claims. It also details information relating to endorsements, what's required to be endorsed on a particular item to ensure accurate and timely payments. And then we have to consider the two basic parts of the drug tariff. Part eight. I'm not sure why it's called part eight, but part eight details all the basic prices of drugs that are prescribed to primary care. And part nine details all the prices associated with medical devices and appliances. The slight difference between the two is part eight details all the basic prices of all the commonly prescribed drugs, but within the drug tariff, prescribers are still allowed to prescribe drugs outside part eight. Within part nine, the part nine list of medical devices and appliances is a finite list. So if the medical device and appliance isn't listed in part nine, we will not make payment. So it's a legal document, it has to be followed. One thing I stress when you're making claims, ensure from the start that they're accurate and correct. Because it's a legal document, once a claim is made, the NSSBSA cannot go back and make any retrospective changes. So please, dispenser contract and dispenser doctors, try and get it right first time.
SPEAKER_01And where do dispensing practices find the information on how to submit a claim, endorsing that kind of practical stuff?
SPEAKER_00The first few sections, the parts, detail how to make a claim, how to make a submission, what paperwork is required, FP34Ds, FP34PDs, and it indicates the time scales for making those claims. So that's the timely bit. Within the latter part of the drug tariff, it talks about endorsements. Certain drugs require certain endorsements to ensure accurate payments. If we don't get the full information, the drug tariff does allow us to refer back prescriptions, to ask for further information, and then we they expect the contractors to then return that information back us back to us to allow us to then process the payment accordingly. But it's all in the first few parts of the drug tariff.
SPEAKER_01And those refer back codes, you have a very helpful hints and tips newsletter that's on your website. And refer backs quite commonly feature in uh in your hints and tips. It's obviously something that practices do struggle with. They they happen, don't they?
SPEAKER_00They they do. It's best to try and get the submission and endorsement right first time, because any delay will delay payment, and obviously that affects cash flow. And there's still always the risk that if it's an incorrect endorsement, that the payment won't go through. So that's why myself and Mark, we get out to contractors and dispensary practice practices to educate and try and encourage them to get it right first time.
SPEAKER_01So what isn't the drug tariff? Because concession prices, etc., they they don't feature in the world.
SPEAKER_00So the drug tariff is not a prescribing tool, it's not a clinical decision support tool. It does contain propriety and branded products, but it's not an endorsement of those products that are listed within it. In essence, it lists all the prices of all the drugs that can be prescribed in private care and indeed medical devices and appliances. But you're right, it doesn't contain any changes in prices that don't meet the drug tariff publishing deadline. So because of, I guess, the current world market, because of shortages, we do on a monthly basis have to implement concessionary price changes. And they invariably come well after the publication date. So things like concession prices aren't published in the drug tariff, but they are published on the NHS, NHS BSA website. And we publish though, publish those prices as soon as when they are agreed with the Department of Health and Social Care. In terms of looking at prices in the round, yes, look at the drug tariff and the part eight prices and the part nine prices, but also check our website on a monthly basis to see what prices have been granted a concession. And to be clear, concession prices will only last for just one month. They're reviewed every month before the decision is made to reinstate them.
SPEAKER_01Okay, and we also do cover those in our on our website as well, as soon as we can following publication. So tell me, I mean, how long has the drug tariff been published? Just a bit of history, and what on earth did we do before it?
SPEAKER_00It's a really good question, Elsa. I I to be honest, I'm not actually sure how long it's been around. What I do know is in our archives, we have backdated copies of the drug tariff going back decades. And back in the day, the first drug tariffs were only a small little paper booklet. And the last paper drug tariff was published in March 2021. And it was, for those of you who remember, back in 2021, it was a really large paper publication. It became so large that actually we had to make a decision to stop it because we would end up having to sell out more than one copy because it became so big with all the products in there. So from April 2021, the paper drug tariff was uh ceased, and now it's available online, as many of your members know, via a PDF file and also an online version as well.
SPEAKER_01And we'll put the we'll put the links to those on the website as well.
SPEAKER_00What I do know is there has been a prescription pricing function available in England since 1911. Now, what that looked like, I'm not sure, but suffice to say, we've been pricing prescriptions for more than 100 years.
SPEAKER_01Wow, that's a long time. So, in terms of other resources, the DMD is another important resource. What does that add to the drug tariff and why should practices use it?
SPEAKER_00So the DMD that that stands for the Dictionary of Medicines and Devices, and this is a great resource for practices and dispensary contractors to use. It's available in the public domain. Just put in your search engine DMD browser and it'll bring up the DMD browser. And you can enter into the search engine any drug, either in a generic format or proprietary format, and that will list all the drugs available under that particular heading. It's a great source of understanding what brands are available, what brands are being discontinued. It contains the list price of that particular product. And the question I tend to get asked most ailes from dispensing practices is how can I find out if a particular item has a personally administered attribute? It's all in the Demon Day browser. I would encourage all practices at least to go and have a look at it and say, does this give me some more information that'll help me to make my endorsements and my submissions clearer and more accurate?
SPEAKER_01Any other resources, reimbursement resources that uh people should be looking at?
SPEAKER_00Anything outside the drug tariff, such as concession prices, we post our website and we post them as soon as we possibly can, once we've got full agreement from the Department of Health and Social Care.
SPEAKER_01Advance information in the drug tariff, this is something that I think is a useful section. Uh it's right at the beginning of the drug tariff. When does advance information become available? And what kind of information does it include?
SPEAKER_00Any product that's been deleted from part nine will be annotated with a notice of deletion three months in advance of being removed. Then the page numbers of these products will be identified in the advanced notice of the preface in the month prior to being deleted. Now, I mentioned part nine because as I said earlier, if a product is not listed in part nine, it will not be allowed for payment. So that's why it's important to be up to date and up to speed with part nine products. For part eight products, so these are the basic prices of the drugs, the basic drugs that are prescribed and dispensed in community in the community. Most amendments to part eight will be listed in the advanced notice of the preface in the month prior to the amendment.
SPEAKER_01Can I ask whether BSA has any input into those changes? Uh or do you just reflect what the Department of Health would like to happen? And what advanced knowledge do you have of those changes?
SPEAKER_00That's a really good question. As I said at the outset, the NHS BSA is a directive function of the Department of Health. So everything we do is under their direction. So fundamentally, our our organization is there to make payments to dispensary contractors. And just to be clear, we we don't have any remit to stop payments or withhold payments. And because the drug tariff is unequivocal, we we don't have any facility to exercise discretion. Well, I know that can cause consternation between certain members, but but we can't. So anything that is decided, any of the prices, any of the changes, any of the category changes, within category A, C, H and M, they're all decided by the Department of Health and Social Care. The only input we may have will be to supply information. Information for pharma companies, such as maybe sales data or supply data, which we would gain under the current information regulations. And those are the health service products regulations of 2018. So that's the input we have. We have provide data information, but ultimately the decision for any change to the drug tariff is made by the Department of Health and Social Care.
SPEAKER_01And talking of changes, Category H, that is the new boy, the new kid on our block. Tell us about this. Where can it be found in the drug tariff and what are the criteria for products to move into category H?
SPEAKER_00Category H is a subcategory of Part 8A. So I mentioned Part 8A are details the basic prices of drugs that are uh prescribed and dispensed in primary care. There are other categories, as I'm sure your members will know: category A, category C, and category M as well. But category H, as you rightly say, is the new category. It's used for drugs which are not readily available as licensed generic medicines, but are available for more than one supplier. And that's the difference between category H against category C. Category C products are only really attributed to medicines that are available from one single supplier. So again, information related to category H, reimbursement prices, we get the information using the Health Service Products Regulations Act, and that information then is supplied directly to the Department of Health and Social Care, and they will then decide whether or not that product then moves into a category H. Think in March drug tariff, we have 11 products listed in category H. I think the plan is that these change on a quarterly basis. I think we look at March, June, September, December.
SPEAKER_01Is there any logic to the fact that the cycle for category H is not in sync with category M? Is there any reason why it should be in sync? Is there any logic to why it isn't in sync?
SPEAKER_00I honestly don't know the answer to that question. I know they are different in in terms of the data that we collect and the data that's then published in the drug tariff. I'll be speculating. It might be workload and other requests of farmer companies. I'm not really sure. But that that's that's the direction of the Department of Health. That's how they want it to be done at the moment. That's not to say that in some point in the future that may well change. Decision would lead to sit with the Department of Health.
SPEAKER_01Just for the moment, it's uh we have category H in March, June, September, and December. And uh Category M will be April, July, October, and January. We do see with Category M the odd non-routine updates, something that uh is added to category M or taken out outside that routine quarterly change. Is that something that is possible with category H, do you think?
SPEAKER_00Well, it's definitely possible. I guess anything is possible. I think with the volatility that currently exists in the market and the issues across the world, you know, that that's definitely a possibility. But but again, it's not a decision that the NHS BSA make. It would have to be directed by the Department of Health.
SPEAKER_01Category M. And what's the criteria for products to move into category M?
SPEAKER_00Okay, so category M drugs are readily available as licensed generic medicines. Category M reimbursement prices are set using information again that we obtain from suppliers using the health service products regulations. The following pack sizes are considered when calculating the category M reimbursal prices. So for any tablets or capsules, all prescription only medicine pack sizes up to and including 120 unit dosages are considered. For liquids and creams, which include special containers, up to and including 500 mil or 500 grams. Now, if a pack size for a product listed in this part exceeds the quantities I've just described there, the listed pack side is the only pack side that is considered when calculating the price. And just for further clarity, because the category M pricing system is a price adjustment mechanism that ensures the delivery of the retain margin that has been agreed with Community Pharmacy England. And that's why the category M price is then changed accordingly.
SPEAKER_01There's a lot of products in it. Um 600 plus.
SPEAKER_00614, I think, in March.
SPEAKER_01Yeah, it's it's a very big category. It's difficult for practices to keep a track of. We we do publish those uh on our website as well, and we have a spreadsheet that provides the historical access and sorted, etc., by percentage change, percentage, any sorted any which way you possibly would like to sort it. Yeah, it it's it's a big category and it has an impact on margins.
SPEAKER_00It it does, but we do we do publish those category and price changes on our website, as well as obviously listening them, listening in them in the drug tariff. So the information is out there, but yeah, I accept that there's a lot of products there to consider.
SPEAKER_01Is that information that could be available more than three days in advance? I I seem to remember in my dim and distant past that Category M used to be available well ahead of its month of actual introduction to three weeks ahead. It seems to be slipping further and further back in the month. Today is the 27th of March, and we don't have the figures yet for April. Is there any particular reason for that?
SPEAKER_00Again, we we will publish the data and the prices as soon as we get formal direction from the Department of Health and Social Care to do so. As soon as they agree those prices, and as soon as we get to know them, we will publish on the website. So yeah, it's it's not that we're delaying it. We just need that direction from the Department of Health.
SPEAKER_01So, best practice with the drug tariff, apart from reading it, being aware of it, looking at the advance information when it's published and available, what can dispensing practices do to reduce surprises, usually unwelcome ones when it comes to their reimbursement?
SPEAKER_00The drug tariff provides information regarding any changes to part eight and part nine in the preface. So please, I would say check those changes and be prepared for them as and when they come. If we have to make changes that are outside the drug tariff for whatever reason, and that might be concession prices, that might be category M, we will always publish them on our website.
SPEAKER_01The NHS BSA website, prescription services division, we'll put the link into the notes. It's super resource of information. It is it is very well updated. We do cover that information, repeat that information on our website, but you can read it on BSA first. Well done to your team.
SPEAKER_00And I would say as well, within the drug tariff page or the NHS BSA website, we've got user guides. I think we have links to our knowledge base. And as always, there's a customer helpline there, an email address. You know, if anybody has specific disport questions, come to us and we'll answer them. And I say that there's a news page on there which provides further updates.
SPEAKER_01Thank you very much, Philip. It's been really educational, really useful. Hopefully, dispensing practices can improve their use of the drug tariff on the back of it. I'm Elsa Cahun. This is the DDA podcast. Thank you very much.
SPEAKER_00Thank you.