New fee arrangements for oral liquid methadone
by Pharmacy Life - Published on 08 March 2013
Following its review of contractor data on methadone fees and supply, PSNC has announced that the Department of Health (DH) has agreed new fee arrangements for oral liquid methadone to be introduced from April 2013.
The revised system now includes a requirement for contractor endorsement and has been agreed following extensive modelling to ensure that it reflects the costs of dispensing in all scenarios.
On each occasion the pharmacist provides methadone to the patient ie, for each interaction or ‘pick-up’, contractors will continue to receive a professional fee, CD fee, consumables allowance and any relevant volume related fees.
The ‘item level fee’ for oral liquid methadone prescriptions (introduced in July 2012) will continue to be paid but will change to £2.50 per prescription.
As well as this fee, from April 2013 contractors will be able to claim a fee of 55pper additional dose packaged separately.
‘Additional’ doses are doses given to patients in addition to the dose they have come to collect from the pharmacy for that day i.e. either to take at home later on that day or to cover non-collection days.
For example, for a patient collecting three doses on a Friday to cover the weekend:
• If the contractor dispenses all three doses together (i.e. the three daily doses are in one container), with a suitable measuring device, the contractor would not be eligible to claim for any additional 55p fees.
• If the contractor dispenses the Friday dose as a single dose (eg, for supervised consumption) with the Saturday and Sunday doses packaged together in one container with a suitable measuring device, the contractor would be eligible for one 55p fee as one separate package was supplied for the Saturday and Sunday doses.
• If the contractor dispenses all three doses in separate containers, the contractor would be eligible for two 55p fees as two separate packages were supplied for the Saturday and the Sunday doses.
• If because of the volume, and the size of available containers, one dose is dispensed between two or more containers, the contractor is not eligible for another fee – ie, splitting one daily dose into multiple containers does not create eligibility for separate fees.
These fees will apply whether or not the prescriber has requested the additional containers on the prescription and will apply to both FP10 and FP10MDA prescriptions for oral liquid methadone.
Alongside these new fee arrangements, there has been a change to the terms of service included in the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013, which will come into effect as of 1April 2013. This will require pharmacists to make an assessment and decide the most appropriate method of packaging for oral liquid methadone for each patient whether that be:
(a) Each dose in a separate container;
(b) An original pack (or original packs); or
(c) The oral liquid methadone in some other way.
Guidance on the new endorsement requirements and the new terms of service will be made available on the PSNC website as soon as possible.