Advance Notification of Amendments to the November 2015 Drug Tariff

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Advance Notification of Amendments to the November 2015 Drug Tariff ADDITIONS Zero Discount Nutramigen 1 with LGG powder Nutramigen 2 with LGG powder Part I - Drugs And Preparations Special Container Drug Qty Price Benzoyl peroxide 5% / Clindamycin 1% gel 30g 13.14 C Duac Once Daily Benzoyl peroxide 5% / Clindamycin 1% gel 60g 26.28 C Duac Once Daily Budesonide 9mg modified-release tablets 30 75.00 C Cortiment Etonogestrel 68mg implant 1 83.43 C Nexplanon Levocarnitine 1.5g/5ml oral solution paediatric 20ml 71.40 A Lisinopril 5mg/5ml oral solution sugar free 150ml 154.11 C Essential Pharmaceuticals Ltd Neomycin 500mg tablets 100 34.69 C AMCo Raltegravir 100mg granules sachets 60 213.02 C Isentress Tretinoin 10mg capsules 100 223.30 C Intrapharm Laboratories Ltd Part II Chemical Reagents Detection Strips, Blood For Glucose Biosensor Strips - to be read only with the appropriate meter Dario Lite 50 9.95 ebchek 50 15.89 GlucoZen.auto 50 8.99 Page 1 of 6

ADDITIONS Continued Part III Appliances Anal Irrigation System Qufora Irrigation System (MacGregor Healthcare Ltd) Bed System (15 Irrigation Set) 53201-015 149.70 (Contains 1 water bag, 1 water pump, 15 rectal catheters 12mm, 15 collection bags) Bed System (15 Irrigation Set) 53001-015 149.70 (Contains 1 water bag, 1 water pump, 15 rectal catheters 21mm, 15 collection bags) Bed System (15 Irrigation Set) 53101-015 149.70 (Contains 1 water bag, 1 water pump, 15 rectal catheters 30mm, 15 collection bags) Ear Wax Softening Medical Devices Ear Drops - Olive Oil Oleax 15ml 1.40 Emollient And Barrier Preparations isomol Gel 100g 1.99 500g 3.99 Lymphoedema Garments Jobst Bella Lite Class 1(15-20mmHg) Price per piece Combined Armsleeve with Knitted Band Regular, Long S, M, L 26.56 Combined Armsleeve with Silicone Band Regular, Long S, M, L 29.22 Class 2 (20-30mmHg) Combined Armsleeve with Knitted Band Regular, Long S, M, L 27.65 Combined Armsleeve with Silicone Band Regular, Long S, M, L 30.23 Solidea Micromassage Arm Bands Class 1(15-21mmHg) Price per piece Armsleeve S, M, L, XL 29.70 Page 2 of 6

DELETIONS Part I - Drugs And Preparations Special Container Drug Qty Price Benzoyl peroxide 5% / Clindamycin 1% gel 25g 10.95 C Duac Once Daily 50g 21.89 C Duac Once Daily Calcium acetate 667mg capsules 200 14.40 C PhosLo Carbamazepine 100mg chewable tablets sugar free 56 3.16 C Tegretol Chewtab Clomipramine 75mg modified release tablets 28 8.83 C Anafranil SR Crotamiton 10% lotion 100ml 3.14 C Eurax Salbutamol 4mg modified-release capsules 56 8.08 C Ventmax SR Salbutamol 8mg modified-release capsules 56 9.69 C Ventmax SR Part III Appliances Catheters, Urinary, Urethral (A)(ii) Nélaton Catheter ('ordinary' cylindrical Catheter) Single use MacGregor Healthcare Ltd Qufora Onestep Intermittent Catheter pack of 30 (Male) (351406-351418) 6-18 41.70 (Female) (351206-351216) 6-16 41.70 Eye Products Eye Drops - Sodium Hyaluronate Rohto Dry Eye Relief (10ml bottle) 4.10 (20 x 0.5ml single unit) 4.75 Tracheostomy And Laryngectomy Appliances Tracheostomy Breathing Aids Prim-Air pack of 50 Kas II (Tinted, for night time use) 71-0952-24 H 91.22 Prim-Air Strip Fine Oval (Flesh tone, for sensitive skin) 71-0970-00 O 222.97 Fine Round (Flesh tone, for sensitive skin) 71-0970-00 R 222.97 Firm Round (Transparent with strong adhesive) 71-0974-00 R 134.29 pack of 50 Prima-Resist Air II HME for Prima-Resist/Low-Resist hands-free valves 71-0952-212H 228.04 Page 3 of 6

AMENDMENTS Zero Discount MSUD Anamix Junior oral powder 29g sachets MSUD Anamix Junior oral powder sachets TYR Anamix Junior oral powder 29g sachets TYR Anamix Junior oral powder sachets Part I - Drugs And Preparations Special Container Aminophylline 250mg/10ml solution for injection Aminophylline 250mg/10ml solution for injection 10 6.51 A 10 6.50 C Amlodipine 10mg/5ml oral solution sugar free 150ml 110.00 C Rosemont Hameln Pharmaceuticals Ltd Pharmaceuticals Ltd Amlodipine 10mg/5ml oral solution sugar free 150ml 121.00 A Amlodipine 5mg/5ml oral solution sugar free 150ml 72.00 C Rosemont Pharmaceuticals Ltd Amlodipine 5mg/5ml oral solution sugar free 150ml 79.20 A Ascorbic acid powder 100g 5.26 A Ascorbic acid powder 100g 5.26 C J M Loveridge Ltd Disulfiram 200mg tablets 50 31.00 C Antabuse Disulfiram 200mg tablets 50 91.73 A 180 180 200 200 3.10 C 3.10 C Nitrolingual 3.44 C 3.44 C Nitrolingual Page 4 of 6

AMENDMENTS Continued Ketoprofen 50mg capsules 112 15.14 C Orudis Ketoprofen 50mg capsules 112 17.20 C Tiloket Lidocaine 200mg/20ml (1%) solution for injection 10 8.75 A Lidocaine 200mg/20ml (1%) solution for injection Hameln Pharmaceuticals 10 8.75 C Ltd Lidocaine 400mg/20ml (2%) solution for injection 10 9.07 A Lidocaine 400mg/20ml (2%) solution for injection 10 9.00 C Terazosin 10mg tablets 28 8.10 A Terazosin 10mg tablets 28 7.87 C Hytrin Hameln Pharmaceuticals Ltd Part III Appliances Anal Irrigation System Qufora Irrigation System (MacGregor Healthcare Ltd) Bed System 53201-055 49.90 (Contains 1 water bag, 1 water pump, 5 rectal catheters 12mm, 5 collection bags) Bed System 53001-055 49.90 (Contains 1 water bag, 1 water pump, 5 rectal catheters 21mm, 5 collection bags) Bed System 53101-055 49.90 (Contains 1 water bag, 1 water pump, 5 rectal catheters 30mm, 5 collection bags) Bed System (5 Irrigation Set) 53201-055 49.90 (Contains 1 water bag, 1 water pump, 5 rectal catheters 12mm, 5 collection bags) Bed System (5 Irrigation Set) 53001-055 49.90 (Contains 1 water bag, 1 water pump, 5 rectal catheters 21mm, 5 collection bags) Bed System (5 Irrigation Set) 53101-055 49.90 (Contains 1 water bag, 1 water pump, 5 rectal catheters 30mm, 5 collection bags) Page 5 of 6

AMENDMENTS Continued Catheters, Urinary, Urethral (B)(ii)(a)Foley Catheter - 2 Way For Long Term Use - Adult Bard Ltd Bard Lubri-Sil Aquafil Hydrogel Coated Silicone with pre-filled syringe of sterile water pack of 1 (Male) (D1758) 10 12-22 9.41 (Female) (D1761) 10 12-16 9.41 Bard Lubri-Sil Aquafil Hydrogel Coated Silicone with pre-filled syringe of sterile water pack of 1 (Male) (D175812-22E) 10 12-22 9.41 (Female) (D176112-16E) 10 12-16 9.41 Bard Lubri-Sil Hydrogel Coated Silicone pack of 1 (Male) (D1768) 30 16-22 9.27 Bard Lubri-Sil Hydrogel Coated Silicone pack of 1 (Male) (D176816-22E) 30 16-22 9.27 28 th October 2015 Pharmaceutical web site: www.hscbusiness.hscni.net From the homepage go to Services, FPS Pharmaceutical Services. Page 6 of 6