The National Health Service (Fund-holding Practices) Regulations 1996

Payment for drugs, medicines and listed appliances

19.—(1) The members of a fund-holding practice shall, in respect of each month, pay to the Health Authority out of the allotted sum an amount determined in accordance with the following paragraphs of this regulation as the basic cost of the drugs, medicines and listed appliances supplied pursuant to orders given by or on behalf of members of the practice.

(2) The amount referred to in paragraph (1) shall, subject to paragraph (6), be—

(a) the net ingredient cost of the drugs, medicines or listed appliances calculated in accordance with paragraphs (3) and (4); minus

(b) an amount representing a percentage of the price of the drugs, medicines or listed appliances, which percentage—

(i) the Prescription Pricing Authority, or in Wales the Welsh Health Common Services Authority, in its calculation of the remuneration payable to pharmacists in accordance with Part II of the Drug Tariff, has determined is the total discount value applicable to items dispensed in that month divided by the total net ingredient cost of those items, multiplied by 100, and

(ii) has been published by the Secretary of State; plus

(c) except in the case of listed appliances supplied with, or in connection with, the supply of oxygen or drugs and medicines supplied in bulk, an amount specified in the Drug Tariff representing the cost of the container or packaging in which the drug, medicine or listed appliance is supplied.

(3) The net ingredient cost referred to in paragraph (2)(a) of a drug or medicine shall be—

(a) where the name of the drug or medicine is included in a list in the Drug Tariff which specifies a price for a specified quantity of that drug or medicine, the price so specified;

(b) where the name of the drug or medicine is not so listed, the manufacturer’s list price.

(4) The net ingredient cost of a listed appliance referred to in paragraph (2)(a) shall be the price of the appliance specified in the Drug Tariff.

(5) Where an amount calculated under paragraph 2(a), (b) or (c) is in any month not an exact number of pounds, any amount of 50 pence or more shall be rounded up to, and any amount less than 50 pence shall be rounded down to, the nearest whole pound.

(6) In this regulation—

“the Drug Tariff” means the statement published under regulation 18 of the National Health Services (Pharmaceutical Services) Regulations 1992(1);

“listed appliance” means an appliance which is included in a list for the time being approved by the Secretary of State for the purposes of section 41 of the 1977 Act;

“manufacturer’s list price” means the price which the manufacturer of a drug or medicine or his wholesaler or supplier publishes as being the price of that drug or medicine;

“medicine” includes such chemical reagents as are included in a list for the time being approved by the Secretary of State for the purposes of section 41 of the 1977 Act;

“Prescription Pricing Authority” means the special health authority now constituted by the Prescription Pricing Authority Constitution Order 1990 pursuant to section 11 of the 1977 Act(2);

“Welsh Health Common Services Authority” means the special health authority now constituted by the Welsh Health Common Services Authority Constitution Order 1990(3).

(7) For the purposes of this regulation, a drug or medicine is supplied in bulk only when—

(a) it is ordered by a member of a fund-holding practice for two or more of his patients;

(b) those patients reside in a school or institution in which at least 20 persons reside;

(c) the name of that school or institution is written on the order; and

(d) at least 10 of the persons residing in the school or institution are patients of the member of the fund-holding practice who ordered the drug or medicine.

(1)

S.I. 1992/662 amended by S.I. 1994/2402, 1993/2451 and 1995/644.

(2)

S.I. 1990/1718. The Prescription Pricing Authority was originally established by the Prescription Pricing Authority (Establishment and Constitution) Order 1974 (S.I. 1974/9) which was revoked and replaced by S.I. 1978/331 (itself revoked and replaced by S.I. 1990/1718).

(3)

S.I. 1990/2647. The Welsh Health Common Services Authority was originally established as the Welsh Health Technical Services Organisation under the Welsh Health Technical Services Organisation (Establishment and Constitution) Order 1973 (S.I. 1973/1624). It was re-established as the Welsh Health Common Services Authority under S.I. 1985/996 (itself revoked and replaced by S.I. 1990/2648).