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Endorsing FP10 Prescriptions
(Last updated 27/02/2007)
Learning Objectives
On completion of this package you will
- Know who can dispense FP10 prescriptions
- Be able to endorse prescriptions to show what product has been supplied when necessary
- Be able to identify prescriptions that require endorsement because extra dispensing fees will be paid (for dispensers in community pharmacies)
- Understand which prescriptions require endorsing for zero discount (for dispensers in community pharmacies)
- Be able to calculate how many professional/dispensing fees are due and how many patient charges should be collected if the patient pays for their prescriptions
The package is divided into the following sections:
People who supply drugs or appliances on FP10 prescriptions have to hold a contract to provide Pharmaceutical Services. The Drug Tariff published by the PPA sets out the rules for the reimbursement and remuneration of contractors who provide these services. The rules sometimes do not apply to all types of contractors. This package is applicable to both community pharmacies and dispensing doctors and where the rules do not apply to dispensing doctors this is clearly indicated. You will find it useful to look at the Drug Tariff as you work your way through this package.
Endorsements That Clarify What Has Been Dispensed
 Every dispensing contractor will be reimbursed the basic price of the drug or appliance that has been dispensed. The basic price of the drug is defined in the Drug Tariff Part II Clause 8. If the drug, appliance or chemical reagent is included in the Drug Tariff Parts VIII or IX, the basic price is the price listed in the Drug Tariff. If a drug is not listed in Part VIII of the Tariff, the basic price is the list price, for supplying to contractors, published by the manufacturer, wholesaler or supplier. Follow this link for more information on Parts VIII and IX. |
When a drug that is not in Part VIII is available in different pack sizes, the basic price will be based on the pack size to be used for a prescription for the quantity ordered. For products in Part VIII or IX the pack sizes to be used in calculating the basic price are listed.
Sometimes it is clear from the prescription exactly what product and which pack size should be used to determine the basic price. However the dispenser may need to endorse the prescription to show more information about the product or the pack size.
For generic products listed in Part VIII of the Drug Tariff no endorsement is required except for the few items that are listed with more than one pack size.
For generic products not listed in Part VIII of the Drug Tariff, endorsements to show the source of supply of the product and the pack size are required. However if there is only one source of supply and one pack, no endorsement is necessary.
For proprietary products endorsement of the pack size is only required if there is more than 1 pack size available. If there is more than 1 pack size available and no endorsement is present reimbursement will either be on the basis of the common pack size (Drug Tariff Part VII) or if no common pack size by using the next largest pack size to the quantity ordered.
For items that are rarely prescribed, the supplier, pack size and basic price excluding VAT need to be endorsed. For products that are prescribed by a formula, the dispenser can either supply the product by dispensing extemporaneously in the dispensary or by asking a specials manufacturer to prepare the product for dispensing. If a specials manufacturer is used, the prescription must be endorsed with the relevant details i.e. source of supply and the price.
 Consider the following examples of products that can be prescribed on FP10. What endorsement (if any) would you make on the prescription? Reading the Drug Tariff Part II Clauses 9 and 10 will help you find the answers. You will also need to consult Part VIII of the Drug Tariff. |
Click on the titles to find the answers e.g. on Example 1
 Endorsements That Clarify What Has Been Dispensed |
Example 1
When a product is prescribed by generic name you should check whether it is listed in Part VIII of the Drug Tariff. Codeine linctus 15mg/5ml sugar free is listed in Part VIII as Category A. The only endorsement that might be required would be the pack size. There is however only 1 pack size listed in Part VIII and therefore no endorsement is necessary. The prescription will be priced using the Part VIII price. If a pack size different from the Part VIII pack was endorsed, it would be ignored. If a pharmacist endorsed the FP10 with the name of a proprietary brand of codeine linctus, this would not be accepted since the product is in Part VIII.
Products listed in Category A are readily available from a number of manufacturers/suppliers.
Example 2
Dexamethasone tablets 2mg are listed in Part VIII as Category A. The only endorsement required for products in Part VIII is the pack size if more than one pack size is listed. Dexamethasone tablets 2mg are listed as pack sizes of 50, 100 and 500. Depending on which pack the dispenser used, he or she would endorse accordingly. If the pack size were not endorsed, the prescription would be priced using the 500 pack size because this is listed as the common pack.
Example 3
Docusate capsules 100mg are included in Part VIII Category C. This means that they are priced based on a particular brand or particular manufacturer, in this case the Dioctyl price will be used. There are 2 pack sizes listed in Part VIII and therefore the endorsement is the pack size used for dispensing. If there were no endorsement, the prescription would be priced using the nearest pack size to the quantity ordered on the prescription.
Example 4
Ginger Syrup is included in Part VIII Category E. This is an item that is normally extemporaneously prepared. No endorsement is required because the prescription will be processed using the Part VIII price and pack size stated. An additional fee will be paid if it is dispensed in a pharmacy and the prescriber orders an extemporaneously prepared liquid preparation to be supplied in more than one container (see Drug Tariff Part IIIA 2C)
Example 5
This is a preparation that has to be extemporaneously prepared and therefore an additional fee will be paid if it is dispensed in a pharmacy. The Dispenser needs to endorse the prescription extemporaneously dispensed before they will receive the additional fee. Each of the ingredients in the formula is listed in Part VIII as Category A with only one pack size. No endorsement is needed for the pack or quantity supplied.
Example 6
Metronidazole suppositories 500mg are not listed in Part VIII and therefore Part 11 Clause 9 requires the endorsement of the brand name or the name of the manufacturer or wholesaler from whom the supply was purchased. There are several suppliers of metronidazole suppositories and either a proprietary or a generic product could be supplied. A pack size would only need to be endorsed if there was more than 1 pack size available.
Example 7
Nimodipine tablets 30mg are not listed in Part VIII and therefore Part II Clause 9 requires the endorsement of either the brand name or the name of the manufacturer or wholesaler from whom the supply was purchased. In this example Nimodipine is only available as one brand (proprietary product) and if you don’t endorse the brand name or supplier, the prescription will be processed because the Prescription Pricing Division will know that Nimotop will have been dispensed. You do not need to endorse the pack size because Nimotop 30mg tablets are only available in 1 pack size.
Example 8
Keflex tablets 250mg are a proprietary product that is priced according to the manufacturer’s list price. Did you notice that the prescriber had completed the number of days’ treatment box? Before dispensing you would calculate that 28 tablets are required. Many dispensers would endorse the actual quantity given as well as the pack size when the number of days’ treatment box has been used. If there were no endorsement it would be calculated that 28 tablets were required and the common pack size would be used to price the prescription because Keflex tablets 250mg are included in the list of drugs with a commonly used pack size in Part VII.
Example 9
Atenolol 50mg tablets are included in Part VIII Category M. Only one pack size of 28 tablets is listed. No endorsement has to be made but the dispenser may wish to add one because Atenolol tablets are supplied in a calendar pack (see Drug Tariff Part II Clause 10C). The prescriber has ordered 30 tablets. The dispenser could supply 28 tablets because this is the quantity in the calendar pack. However the dispenser could also decide that the prescriber's intention is for the patient to receive the exact quantity ordered and therefore supply 30 tablets. If the dispenser supplies the exact quantity, the quantity must be endorsed e.g. 30/28 or 30 ex 28. If there is no endorsement of the quantity, it will be assumed that the number of packs or sub-packs nearest to the quantity ordered has been supplied.
Products listed in Category M are readily available from a number of manufacturers/suppliers. The Department of Health determines the price they will pay for a product in Category M.
Example 10
Trinordiol tablets are a proprietary product and therefore the prescription must be endorsed with the pack size. They are available as a calendar pack containing 3 strips of 21 tablets. The difficulty for the dispenser is what did the prescriber mean by 3 x OP. The abbreviation OP is usually understood to mean original pack. Did the prescriber intend 3 strips i.e. 63 tablets or 3 packs i.e. 189 tablets. 63 tablets provide 3 months treatment and 189 tablets provide 9 months treatment. If the prescription is not endorsed to show how many tablets have been supplied, it will be referred back to the dispenser to clarify the quantity.
The abbreviation OP is best avoided since it causes confusion.
Example 11
Oilatum Emollient bath additive is a proprietary product and therefore the prescription must be endorsed with the pack size. The GP has prescribed 300ml but the product is actually available in 250ml and 500ml packs. The arrangements for supplying special containers apply to this product (see Drug Tariff Part II Clause 10B) because it is not appropriate to repack the product. The dispenser should supply the quantity in the special container (or containers) nearest to that ordered and endorse the FP10 with the number and size of those containers. In this case the endorsement should be 1 x 250ml.
Example 12
Crinx bandage is an appliance in Part IX of the Drug Tariff. No endorsement is required because the prescription provides sufficient information for the product to be priced.
Example 13 Bordered Granuflex is an appliance in Part IX of the Drug Tariff. If no endorsement is present, the prescription will be priced on the assumption that 2 individual dressings have been supplied not 2 boxes of 10 dressings. The dispenser cannot endorse the prescription to show that 2 boxes were dispensed because the prescriber has not clearly specified that his or her intention was to prescribe 20 dressings.
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