Regulation 16 Payment for drugs, medicines and listed appliances
The members of a fund-holding practice shall pay to the relevant Regional 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.
The amount referred to in paragraph (1) shall, subject to paragraph (7), be—
the price of the drugs, medicines or listed appliances calculated in accordance with paragraphs (3) and (4); minus
an amount representing a percentage of the price of the drug, medicine or listed appliance, calculated in accordance with paragraph (5), plus
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 representing the cost of the container or packaging in which the drug, medicine or listed appliance is supplied calculated in accordance with paragraph (6).
The price referred to in paragraph (2)(a) of a drug or medicine shall be—
where the name of the drug or medicine is listed in a list in the Drug Tariff which specifies a price for a specified quantity of that drug or medicine, the price so specified;
where the name of the drug or medicine is not so listed, the manufacturer’s list price.
The price referred to in paragraph (2)(a) of a listed appliance shall be the price of the appliance specified in the Drug Tariff.
The percentage referred to in paragraph (2)(b) shall be—
9.67 per cent. of the price of the drug, medicine or listed appliance where that drug, medicine or listed appliance has been supplied pursuant to an order given by or on behalf of a member of a fund-holding practice whose recognition has been granted by a Regional Health Authority; and
9.10 per cent. of the price of the drug, medicine or listed appliance where that drug, medicine or listed appliance has been supplied pursuant to an order given by or on behalf of a member of a fund-holding practice whose recognition has been granted by the Secretary of State.
The amount referred to in paragraph (2)(c) shall be 3.80 pence for each listed appliance and each quantity of a drug or medicine.
Where an amount calculated under paragraph 2(a), (b) or (c) is in any month not an exact number of pounds, any amount of fifty pence or more shall be rounded up to, and any amount less than fifty pence shall be rounded down to, the nearest whole pound.
In this regulation—
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“the Drug Tariff” means the statement published under regulation 28 of the National Health Service (General Medical and Pharmaceutical Services) Regulations 1974f1;
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“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.
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“manufacturer’s list price” means the price which the manufacturer of a drug or medicine or his agent publishes as being the price of that drug or medicine;
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“medicine” includes such chemical re-agents 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.
In this regulation, a drug or medicine is supplied in bulk when—
it is ordered by a member of a fund-holding practice for two or more patients of his;
those patients reside in a school or institution in which at least twenty persons reside;
the name of that school or institution is written on the order;
at least ten of the persons residing in the school or institution are patients of the member of the fund-holding practice ordering the drug or medicine.
Annotations
Footnotes
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S.I. 1974/160; regulation 28 was amended by S.I. 1985/955, article 2(6).