Advance Notification of Amendments to the October 2015 Drug Tariff

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1 Advance Notification of Amendments to the October 2015 Drug Tariff ADDITIONS Part I - Drugs And Preparations Special Container Drug Qty Price Alpha tocopheryl acetate 500mg/ 5ml oral suspension 100ml A Aluminium chloride 20% solution 20ml 3.51 C Driclor 60ml 2.51 C Anhydrol Forte 75ml 3.01 C Driclor Azelastine 0.05% eye drops 8ml 6.40 C Optilast Betamethasone 0.1% / Neomycin 0.5% ear/eye/nose drops 10ml 2.39 C Betnesol-N Canagliflozin 100mg tablets C Invokana Canagliflozin 300mg tablets C Invokana Coal tar extract 2% shampoo 125ml Neutrogena T/Gel 3.61 C Therapeutic shampoo 250ml Neutrogena T/Gel 5.38 C Therapeutic shampoo Desmopressin 120microgram oral lyophilisates sugar free C DesmoMelt C DDAVP Melt Desmopressin 240microgram oral lyophilisates sugar free C DesmoMelt Desmopressin 60microgram oral lyophilisates sugar free C DDAVP Melt Dexamethasone 3.8mg/1ml solution for injection vials A Febuxostat 120mg tablets C Adenuric Febuxostat 80mg tablets C Adenuric Hyoscine hydrobromide 600micrograms/1ml solution for injection ampoules A Ibuprofen 5% spray 35ml 3.26 C Ibuleve Speed Relief Ibuprofen 5% spray 100ml 6.18 C Ibuspray Isosorbide dinitrate 20mg modified-release tablets C Isoket Retard 20 Isosorbide dinitrate 40mg modified-release tablets C Isoket Retard 40 Page 1 of 14

2 ADDITIONS Continued Lidocaine 5% / Phenylephrine 0.5% nasal spray 2.5ml A Lidocaine 5% medicated plasters 30 (6x 5) C Versatis Lidocaine 5% ointment A A H Pharmaceuticals 15g 6.18 C Ltd Liraglutide 6mg/ml solution for injection 3ml pre-filled disposable devices C Victoza Miconazole 2% powder 20g 2.58 C Daktarin Midodrine 2.5mg tablets C Bramox Midodrine 5mg tablets C Bramox Naproxen 500mg / Esomeprazole 20mg modifiedrelease tablets C Vimovo Nifedipine 40mg modified-release tablets C Fortipine LA 40 Oxytetracycline 3% / Hydrocortisone 1% ointment 30g 5.01 C Terra-Cortril Prednisolone 5mg/5ml oral solution unit dose 10 Logixx Pharma C (2x 5) Solutions Ltd Salicylic acid 16.7% / Lactic acid 16.7% paint 10ml 1.71 C Salactol Valsartan 160mg tablets C Macleods Pharma UK Ltd Valsartan 80mg tablets C Macleods Pharma UK Ltd Part II Chemical Reagents Detection Strips, Blood For Glucose Biosensor Strips - to be read only with the appropriate meter ihealth Part III Appliances Bladder Instillation Chondroitin Sulfate Gepan Instill (contains chondroitin sulfate 0.2%) pre-filled syringe 40ml Catheters, Urinary, Urethral (A)(ii) Nélaton Catheter ('ordinary' cylindrical Catheter) Single use Wellspect HealthCare Wellspect HealthCare LoFric (non PVC) pack of 30 (Tiemann Tip) ( ) Wellspect HealthCare LoFric Primo non-pvc with integrated water pocket pack of 30 (Tiemann Tip) ( ) (A)(v) Nélaton Catheter with Water Container and Urine Drainage Bag Wellspect HealthCare LoFric Hydro-Kit (non PVC) pack of 20 (Tiemann Tip) ( ) Page 2 of 14

3 ADDITIONS Continued Elastic Hosiery Accessories Rolly Electrical Stimulation Device Per pack Accel-Heal 6 unit Eye Products Eye Compress MGDRx EyeBag Eye Drops - Carmellose Carmellose 0.5% (Medicom Healthcare) (10ml bottle) 7.49 Lumecare Tear Drops (10ml bottle) 0.95 Eye Drops - Sodium Chloride ODM5 (10ml preservative free bottle) Hypodermic Equipment Needles for Pre-filled and Reusable Pen Injectors Glucoject pack of 100 4mm/32 gauge mm/31 gauge mm/31 gauge mm/31 gauge mm/29 gauge mm/29 gauge 5.95 Lancets - Sterile, Single-Use Advocate (Diabetes Care Technology Ltd) 0.31mm/30 gauge GlucoRx Safety lancets 1.6mm/30 gauge (GlucoRx Ltd) 1.8mm/28 gauge mm/26 gauge mm/23 gauge Low Friction Products Dyna-Tek price per pair Heel Boot 3.99 Page 3 of 14

4 ADDITIONS Continued Lymphoedema Garments Sigvaris Advance Arm Sleeves Advance 1 Low Compression (14-18mmHg) with Seamless Hand Piece and Grip Top Long, Normal XS, S, M, L, XL with Seamless Hand Piece and Grip Top Plus Size Long, Normal XS, S, M, L, XL with Seamless Hand Piece without Grip Top Long, Normal XS, S, M, L, XL Advance 2 Medium Compression (20-25mmHg) with Seamless Hand Piece and Grip Top Long, Normal XS, S, M, L, XL with Seamless Hand Piece and Grip Top Plus Size Long, Normal XS, S, M, L, XL with Seamless Hand Piece without Grip Top Long, Normal XS, S, M, L, XL Advance 3 High Compression (30-40mmHg) with Grip Top/no Hand Piece Long, Normal S, M, L, XL with Grip Top/no Hand Piece Plus Size Long, Normal S, M, L, XL with Hand Piece and Grip Top Long, Normal S, M, L, XL with Hand Piece and Grip Top Plus Size Long, Normal S, M, L, XL Sigvaris Cotton Class 1 (18-21mmHg) Thigh High Open Toe Short, Normal, Long XXS XL Thigh High Open Toe Plus Short, Normal, Long XXS XL Thigh High Closed Toe Short, Normal, Long XXS XL Thigh High Closed Toe Plus Short, Normal, Long XXS XL Thigh High Closed Toe with Grip Top Short, Normal, Long XXS XL Thigh High Closed Toe with Grip Top Plus Short, Normal, Long XXS XL Thigh High Open Toe with Sensinnov Grip Top Short, Normal, Long XXS XL Thigh High Open Toe with Sensinnov Grip Top Plus Short, Normal, Long XXS XL Thigh High Closed Toe with Sensinnov Grip Top Short, Normal, Long XXS XL Thigh High Closed Toe with Sensinnov Grip Top Plus Short, Normal, Long XXS XL Panty Open Toe Normal, Long XXS XL Panty Open Toe Plus Normal, Long XXS XL Panty Closed Toe Normal, Long XXS XL Panty Closed Toe Plus Normal, Long XXS XL Price per peice Thigh High Closed Toe with Waist Attachment (Left or Short, Normal, Long XXS - XL Right) Thigh High Closed Toe with Waist Attachment (Left or Right) Plus Short, Normal, Long XXS XL Page 4 of 14

5 ADDITIONS Continued Class 2 (23-32mmHg) Thigh High Open Toe Short, Normal, Long XXS XL Thigh High Open Toe Plus Short, Normal, Long XXS XL Thigh High Closed Toe Short, Normal, Long XXS XL Thigh High Closed Toe Plus Short, Normal, Long XXS XL Thigh High Open Toe with Sensinnov Grip Top Short, Normal, Long XXS XL Thigh High Open Toe with Sensinnov Grip Top Plus Short, Normal, Long XXS XL Thigh High Closed Toe with Sensinnov Grip Top Short, Normal, Long XXS XL Thigh High Closed Toe with Sensinnov Grip Top Plus Short, Normal, Long XXS XL Price per peice Thigh High Closed Toe with Waist Attachment (Left or Short, Normal, Long XXS - XL Right) Thigh High Closed Toe with Waist Attachment (Left or Right) Plus Short, Normal, Long XXS XL Class 3 (33-46mmHg) Thigh High Open Toe with Grip Top Short, Normal, Long XXS XL Thigh High Open Toe with Grip Top Plus Short, Normal, Long XXS XL Thigh High Closed Toe with Grip Top Short, Normal, Long XXS XL Thigh High Closed Toe with Grip Top Plus Short, Normal, Long XXS XL Panty Open Toe Short, Normal, Long XXS XL Panty Open Toe Plus Short, Normal, Long XXS XL Panty Closed Toe Short, Normal, Long XXS XL Panty Closed Toe Plus Short, Normal, Long XXS XL Price per peice Thigh High Closed Toe with Waist Attachment (Left or Short, Normal, Long XXS - XL Right) Thigh High Closed Toe with Waist Attachment (Left or Right) Plus Short, Normal, Long XXS XL Sigvaris Magic Class 1 (18-21mmHg) Thigh High Knobbed Grip Top Open Toe Short, Normal, Long XXS XL Thigh High Knobbed Grip Top Open Toe Plus Short, Normal, Long XXS XL Thigh High Knobbed Grip Top Closed Toe Short, Normal, Long XXS XL Thigh High Knobbed Grip Top Closed Toe Plus Short, Normal, Long XXS XL Class 2 (23-32mmHg) Thigh High Knobbed Grip Top Open Toe Short, Normal, Long XXS XL Thigh High Knobbed Grip Top Open Toe Plus Short, Normal, Long XXS XL Thigh High Knobbed Grip Top Closed Toe Short, Normal, Long XXS XL Thigh High Knobbed Grip Top Closed Toe Plus Short, Normal, Long XXS XL Page 5 of 14

6 ADDITIONS Continued Sigvaris MTM Comfort Class 1 (18-21mmHg) One-legged Panty Open Toe One-legged Panty Closed Toe Panty Bodyform Open Toe Panty Bodyform Closed Toe Class 2 (23-32mmHg) One-legged Panty Open Toe One-legged Panty Closed Toe Panty Bodyform Open Toe Panty Bodyform Closed Toe Sigvaris MTM Cotton Class 1 (18-21mmHg) One-legged Panty Open Toe One-legged Panty Closed Toe Class 2 (23-32mmHg) One-legged Panty Open Toe One-legged Panty Closed Toe Class 3 (34-46mmHg) One-legged Panty Open Toe One-legged Panty Closed Toe Sigvaris MTM Traditional (formerly Sigvaris MTM) (23-32mmHg) One-legged Panty Open Toe One-legged Panty Closed Toe One-legged Panty Open Toe Full Compression One-legged Panty Closed Toe Full Compression Panty Bodyform Open Toe Panty Bodyform Closed Toe (34-46mmHg) One-legged Panty Open Toe One-legged Panty Closed Toe One-legged Panty Open Toe Full Compression One-legged Panty Closed Toe Full Compression Panty Bodyform Open Toe Panty Bodyform Closed Toe Page 6 of 14

7 ADDITIONS Continued (49-59mmHg) Below Knee Open Toe Below Knee Closed Toe One-legged Panty Open Toe One-legged Panty Closed Toe One-legged Panty Open Toe Full Compression One-legged Panty Closed Toe Full Compression Panty Bodyform Open Toe Panty Bodyform Closed Toe Oscillating Positive Expiratory Pressure Device Lungflute Silk Garments Skinnies Silk Tubular Sleeves 33cm long cm long Stockinette Elasticated Tubular Bandage BP Size 4.5cm 6.25cm 6.75cm 7.5cm 8.75cm 10.0cm 1230cm 17.5cm Ref A B C D E F G J Quantity 0.5m 1m 0.5m 1m 0.5m 1m 0.5m 1m 0.5m 1m 0.5m 1m 0.5m 1m 0.5m 1m Surgrip Surgical Adhesive Tapes Impermeable Plastic Synthetic Adhesive Tape BP 1988 Blue Dot 2.5cm x 5m cm x 5m cm x 5m 0.54 Permeable, Apertured Non-Woven Synthetic Adhesive Tape BP 1988 Blue Dot Plastic Perforated Medical Tape 1.25cm x 10m cm x 10m 0.30 Blue Dot Retention Soft Cloth Surgical Tape 5cm x 10m cm x 10m 1.90 Permeable Non-Woven Synthetic Adhesive Tape BP 1988 Size 1.25 cm 2.5 cm Quantity 10m 10m Blue Dot Microporous Blue Dot Silk Zinc Oxide Adhesive Tape Blue Dot Zinc Oxide Tape 2.5cm x 10m 0.48 Page 7 of 14

8 ADDITIONS Continued Tracheostomy And Laryngectomy Appliances Tracheostomy Breathing Aids SpiroTect HME System SpiroTect Antibacterial Cassette pack of 30 Lateral PCT Tracheostomy and Laryngectomy Protectors SpiroTect Protector, Antibacterial pack of 10 Small PTA Large PTA DELETIONS Part I - Drugs And Preparations Special Container Drug Qty Price Aspirin 300mg suppositories A Bimatoprost 300micrograms/ml eye drops 3ml C Lumigan Sucralfate 1g tablets C Antepsin Sucralfate 1g/5ml oral suspension sugar free 250ml 6.36 C Antepsin Part III Appliances Sigvaris MTM Cotton Class 1 (18-21mmHg) Below Knee Xtra Maxi Closed Toe Normal, Long XS, S, M, L, XL Below Knee Xtra Maxi Closed Toe Plus Normal, Long XS, S, M, L, XL Class 3 (33-46mmHg) Below Knee Xtra Maxi Closed Toe Normal, Long XS, S, M, L Below Knee Xtra Maxi Closed Toe Plus Normal, Long XS, S, M, L Page 8 of 14

9 AMENDMENTS Part I - Drugs And Preparations Special Container Duloxetine 20mg gastro-resistant capsules C Yentreve Duloxetine 20mg gastro-resistant capsules M Duloxetine 30mg gastro-resistant capsules C Cymbalta Duloxetine 30mg gastro-resistant capsules M Duloxetine 40mg gastro-resistant capsules C Yentreve Duloxetine 40mg gastro-resistant capsules M Duloxetine 60mg gastro-resistant capsules C Cymbalta Duloxetine 60mg gastro-resistant capsules M Eplerenone 50mg tablets A Eplerenone 50mg tablets M Oxcarbazepine 300mg tablets A Oxcarbazepine 300mg tablets M Risperidone 1mg/ml oral solution sugar free 100ml A Risperidone 1mg/ml oral solution sugar free 100ml 6.27 M Sevelamer 800mg tablets C Sevelamer 800mg tablets M Page 9 of 14

10 AMENDMENTS Continued Part III Appliances Dressings Vapour-permeable Adhesive Film Dressing IV3000 (Intravenous/Sub-Cutaneous Therapy) 5cm x 6cm 1-Hand cm x 7cm Non-winged peripheral cm x 9cm Ported peripheral cm x 12cm PICC line cm x 12cm Central line cm x 14cm Ported 1.60 IV3000 (Intravenous/Sub-Cutaneous Therapy) Ported 5cm x 6cm cm x 7cm 0.56 Ported 7cm x 9cm 0.73 Ported 9cm x 12cm cm x 12cm 1.40 Ported 11cm x 14cm 1.60 Lymphoedema Garments Sigvaris 500 Class 3 (34-46mm Hg) Below Knee Open Toe Short, Long S, M, L Below Knee Open Toe Plus Short, Long S, M, L Below Knee Open Toe Short, Long S, M, L, XL Below Knee Open Toe Plus Short, Long S, M, L, XL Sigvaris Cotton Class 1 (18-21mmHg) Below Knee Open Toe Plus Normal, Long XS, S, M, L, XL Below Knee Open Toe Plus Normal, Long XXS, XS, S, M, L, XL Below Knee Xtra Closed Toe Normal, Long XXS, XS, S, M, L, XL Below Knee Xtra Closed Toe Plus Normal, Long XS, S, M, L, XL Below Knee Closed Toe (formerly Below Knee Xtra Normal, Long XXS, XS, S, M, L, XL Closed Toe) Below Knee Closed Toe Plus (formerly Below Knee Xtra Closed Toe Plus) Normal, Long XXS,XS, S, M, L, XL Thigh High Open Toe with Grip Top Plus Short, Normal, Long XS, S, M, L, XL Thigh High Open Toe with Grip Top Plus Short, Normal, Long XXS, XS, S, M, L, XL Page 10 of 14

11 AMENDMENTS Continued (Left or Right) (Left or Right) Plus (Left or Right) (Left or Right) Plus Short, Normal, Long XS, S, M, L Short, Normal, Long XS, S, M, L Short, Normal, Long XXS, XS, S, M, L, XL Short, Normal, Long XXS, XS, S, M, L, XL Class 2 (23-32mmHg) Below Knee Open Toe Plus Short, Normal, Long XS, S, M, L, XL Below Knee Xtra Closed Toe Normal, Long XXS, XS, S, M, L, XL Below Knee Xtra Closed Toe Plus Normal, Long XS, S, M, L, XL Below Knee Open Toe Plus Short, Normal, Long XXS, XS, S, M, L, XL Below Knee Closed Toe (formerly Below Knee Short, Normal, Long XXS, XS, S, M, L, XL Xtra Closed Toe) Below Knee Closed Toe Plus (formerly Below Knee Xtra Closed Toe Plus) Short, Normal, Long XXS, XS, S, M, L, XL Below Knee Open Toe Plus with Grip Top Normal, Long XS, S, M, L, XL Below Knee Open Toe Plus with Grip Top Normal, Long XXS, XS, S, M, L, XL Below Knee Closed Toe Plus with Grip Top Normal, Long XS, S, M, L, XL Below Knee Closed Toe Plus with Grip Top Normal, Long XXS, XS, S, M, L, XL Thigh High Open Toe with Grip Top Plus Short, Normal, Long XS, S, M, L, XL Thigh High Open Toe with Grip Top Plus Short, Normal, Long XXS, XS, S, M, L, XL Thigh High Closed Toe with Grip Top Plus Short, Normal, Long XS, S, M, L, XL Thigh High Closed Toe with Grip Top Plus Short, Normal, Long XXS, XS, S, M, L, XL Panty Open Toe Normal, Long XXS, XS, S, M, L, XL Panty Open Toe Plus Normal, Long XS, S, M, L, XL Panty Closed Toe Normal, Long XXS, XS, S, M, L, XL Panty Closed Toe Plus Normal, Long XS, S, M, L, XL Panty Open Toe Short, Normal, Long XXS, XS, S, M, L, XL Panty Open Toe Plus Short, Normal, Long XXS, XS, S, M, L, XL Panty Closed Toe Short, Normal, Long XXS, XS, S, M, L, XL Panty Closed Toe Plus Short, Normal, Long XXS, XS, S, M, L, XL Page 11 of 14

12 AMENDMENTS Continued (Left or Right) (Left or Right) Plus (Left or Right) (Left or Right) Plus Short, Normal, Long XS, S, M, L Short, Normal, Long XS, S, M, L Short, Normal, Long XXS, XS, S, M, L, XL Short, Normal, Long XXS, XS, S, M, L, XL Class 3 (33-46mmHg) Below Knee Open Toe Normal, Long XS, S, M, L Below Knee Open Toe Plus Normal, Long XS, S, M, L Below Knee Xtra Closed Toe Normal, Long XS, S, M, L Below Knee Xtra Closed Toe Plus Normal, Long XS, S, M, L Below Knee Xtra Open Toe (formerly Below Normal, Long XXS, XS, S, M, L, XL Knee Open Toe) Below Knee Xtra Open Toe Plus (formerly Normal, Long XXS, XS, S, M, L, XL Bleow Knee Open Toe Plus) Below Knee Xtra Closed Toe Normal, Long XXS, XS, S, M, L, XL Below Knee Xtra Closed Toe Plus Normal, Long XXS, XS, S, M, L, XL (Left or Right) (Left or Right) Plus (Left or Right) (Left or Right) Plus Short, Normal, Long XS, S, M, L Short, Normal, Long XS, S, M, L Short, Normal, Long XXS, XS, S, M, L, XL Short, Normal, Long XXS, XS, S, M, L, XL Page 12 of 14

13 AMENDMENTS Continued Sigvaris Magic Class 1 (18-21mmHg) Thigh High Grip Top Open Toe Female Short, Normal, Long XXS, XS, S, M, L, XL Thigh High Grip Top Open Toe Plus Female Short, Normal, Long XXS, XS, S, M, L, XL Thigh High Grip Top Closed Toe Female Short, Normal, Long XXS, XS, S, M, L, XL Thigh High Grip Top Closed Toe Plus Female Short, Normal, Long XXS, XS, S, M, L, XL Thigh High Lace Grip Top Open Toe (formerly Short, Normal, Long XXS, XS, S, M, L, XL Thigh High Grip Top Open Toe Female) Thigh High Lace Grip Top Open Toe Plus Short, Normal, Long XXS, XS, S, M, L, XL (formerly Thigh High Grip Top Open Toe Plus Female) Thigh High Lace Grip Top Closed Toe Short, Normal, Long XXS, XS, S, M, L, XL (formerly Thigh High Grip Top Closed Toe Female) Thigh High Lace Grip Top Closed Toe Plus (formerly Thigh High Grip Top Closed Toe Plus Female) Short, Normal, Long XXS, XS, S, M, L, XL Class 2 (23-32mmHg) Thigh High Grip Top Open Toe Female Short, Normal, Long XXS, XS, S, M, L, XL Thigh High Grip Top Open Toe Plus Female Short, Normal, Long XXS, XS, S, M, L, XL Thigh High Grip Top Closed Toe Female Short, Normal, Long XXS, XS, S, M, L, XL Thigh High Grip Top Closed Toe Plus Female Short, Normal, Long XXS, XS, S, M, L, XL Thigh High Lace Grip Top Open Toe (formerly Short, Normal, Long XXS, XS, S, M, L, XL Thigh High Grip Top Open Toe Female) Thigh High Lace Grip Top Open Toe Plus Short, Normal, Long XXS, XS, S, M, L, XL (formerly Thigh High Grip Top Open Toe Plus Female) Thigh High Lace Grip Top Closed Toe Short, Normal, Long XXS, XS, S, M, L, XL (formerly Thigh High Grip Top Closed Toe Female) Thigh High Lace Grip Top Closed Toe Plus (formerly Thigh High Grip Top Closed Toe Plus Female) Short, Normal, Long XXS, XS, S, M, L, XL Page 13 of 14

14 AMENDMENTS Continued Venous Ulcer Compression System Per pack Ulcer X Medical Stocking & Compression Liner Pack Open Toe (Sigvaris Britain Ltd) (pack contains 1 stocking and 2 liners mmHg) Available in Short and Long lengths Small, Medium, Large Ulcer X Medical Stocking & Compression Liner Pack Open Toe (Sigvaris Britain Ltd) (pack contains 1 stocking and 2 liners mmHg) Available in Short and Long lengths Small, Medium, Large, Extra Large Medical Stocking & Compression Liner Pack Open Toe Plus (pack contains 1 stocking and 2 liners mmHg) Available in Short and Long lengths Small, Medium, Large Medical Stocking & Compression Liner Pack Open Toe Plus (pack contains 1 stocking and 2 liners mmHg) Available in Short and Long lengths Small, Medium, Large, Extra Large Compression Liner Pack Closed Toe (pack contains 4 liners mmHg) Available in Short and Long lengths Small, Medium, Large Compression Liner Pack Closed Toe (pack contains 4 liners mmHg) Available in Short and Long lengths Small, Medium, Large, Extra Large 28 th September 2015 Pharmaceutical web site: From the homepage go to Services, FPS Pharmaceutical Services. Page 14 of 14

Advance Notification of Amendments to the February 2015 Drug Tariff

Advance Notification of Amendments to the February 2015 Drug Tariff ADDITIONS Zero Discount Acumor XL 16mg capsules Acumor XL 24mg capsules A-CYS 600mg capsules A-CYS 600mg tablets Addiphos solution for