SCOTTISH DRUG TARIFF MONTHLY NOTICE OF AMENDMENTS. November 2017

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Information Services Gyle Square 1 South Gyle Crescent EDINBURGH EH12 9EB Telephone : 0131 275 6972 www.isdscotland.org SCOTTISH DRUG TARIFF MONTHLY NOTICE OF AMENDMENTS November 2017 This document is prepared by the evadis Team, Healthcare Information Group, Information Services Division. Enquiries to: NSS.evadis@nhs.net The complete Scottish Drug Tariff is published on the ISD Scotland website: www.isdscotland.org The following amendments take effect from 1st November 2017. The following amendments apply to Part 1 ANNEX A (ZERO DISCOUNT LIST) ADDITIONS Pyridostigmine bromide 180mg modified-release capsules Maviret Tabs 100mg/40mg (Discount Rate applies from 1 st October 2017) Glecaprevir / Pibrentasvir Tabs100mg/40mg (Discount Rate applies from 1 st October 2017) Esbriet 267mg Tabs (Discount Rate applies from 1 st October 2017) Esbriet 801mg Tabs (Discount Rate applies from 1 st October 2017) Pirfenidone 267mg Tabs (Discount Discount Rate applies from 1 st October 2017) Pirfenidone 801mg Tabs (Discount Rate applies from 1 st October 2017) DELETIONS Capexion 1mg capsules Demorem 4mg/5ml oral solution Prezista 150mg tablets Revlimid 20mg capsules OTHER CHANGES APO-go solution for injection ampoules (ALL) APO-go 50mg/5ml solution for injection ampoules Triptorelin acetate 11.25mg powder and solvent for suspension for injection vials Triptorelin 11.25mg powder and solvent for suspension for injection vials 1

ADDITIONS The following additions apply to Part 2 (DRESSINGS) PLANTAR PRESSURE OFFLOADING DEVICE Kerraped Plus All Purpose Boot Small, Medium, Large, Extra Large 1950 SURGICAL ADHESIVE TAPES Soft Silicone Fixation Tape Hypafix gentle touch 2.5cm x 2.5cm 550 5cm x 5xm 1176 10cm x 5cm 1647 15cm x 5cm 2000 10cm x 2cm 1000 TRACHEOSTOMY AND LARYNGECTOMY APPLIANCES TRACHEOSTOMY BREATHING AIDS Provox HME System (Stomafilter) Pack of 10 Provox Adhesive Strips 8015 2320 each Provox Freehands Support Flat 8021 5670 Medium 8022 5670 Deep 8023 5670 Pack of 15 Provox FreeHand Support Adhesive 8024 4215 Pack of 15 Provox Luna Adhesive 8014 7897 Pack of 30 Provox Luna HME 8013 7680 2

WOUND MANAGEMENT DRESSINGS Cavity Dressing AlgiSorb 3cm x 30cm 204 Polyurethane Foam Film Dressing Sterile Indications: Moderate to heavily exuding wounds Without Adhesive Border Lyofoam Max T Square 9cm x 9xm 125 Protease Modulating Matrix Sterile 1 Primary Wound Dressing 10ml Spray (approx coverage 378cm 2 ) 2500 17ml Spray (approx coverage 640cm 2 ) 4224 Soft Silicone Wound Contact Dressing with Polyurethane Foam Film Backing Sterile CE With Silicone Adhesive Border Kliniderm Foam Silicone Heel Border 20cm x 20.8cm 659 The following additions apply to Part 3 (APPLIANCES) CATHETERS, ACCESSORIES L.IN.C. Medical Systems Ltd LockBand LB-F01 Pack of 10 1600 CATHETERS, URINARY, URETHRAL (A)ii Nelaton Catheter ( Ordinary cylindrical catheter) Single Use Pack of 30 Clinimed Ltd Curran Man Male CM12-CM16 12-16 4590 MacGregor Healthcare Ltd Pack of 30 Qufora Onestep Hydrophillic Intermittent Catheter Male (351412-351416) 12-16 3750 Female (351210-351214) 10-14 3750 HYPODERMIC EQUIPMENT Needles for Pre-filled and Reusable Pen Injectors Pack of 90 BD Viva 6mm/31 gauge 364 3

SPACER/HOLDING CHAMBER DEVICES AeroChamber Plus Flow-Vu Anti-Static 522 AeroChamber Plus Flow-Vu Anti-Static youth (5+ years) 522 AeroChamber Plus Flow-Vu Anti-Static with small mask for infants (0-18 872 months) AeroChamber Plus Flow-Vu Anti-Static with medium mask for children (1-5 872 years) AeroChamber Plus Flow-Vu Anti-Static with adult small mask 872 AeroChamber Plus Flow-Vu Anti-Static with adult large mask 872 The following additions apply to Part 5 (INCONTINENCE APPLIANCES) NIGHT DRAINAGE BAGS Great Bear Healthcare Ltd S GB6 3 litre sterile night bag with 120cm tube, sample port, non-return valve and lever action tap 10430U 10 1730 The following additions apply to Part 9 (CHEMICAL REAGENTS) DETECTION SENSOR, INTERSTITIAL FLUID FOR GLUCOSE * FreeStyle Libre Sensor (contains 1 sensor, 1 sensor applicator and 1 wipe) 1 each 3500 *This product should only be prescribed after assessment by an appropriate specialist i the treatment of diabetes mellitus, in accordance with local guidance as may be provided. 4

DELETIONS The following deletions apply to Part 2 (DRESSINGS) GAUZE DRESSINGS (IMPREGNATED) Paraffin Gauze Sterile Dressing BP (Syn Tulle Gras Dressing) Normal Loading 175-220g/m 2 Paragauze 10cm x 10cm 28 WOUND MANAGEMENT DRESSINGS Hydrocolloid Dressing Semi-permeable Sterile Sterile One Piece Pack Without Adhesive Border Comfeel Plus Triangular 18cm x 20cm 578 Hydrogel Dressing Sterile Hyiodine 22g 1995 50g 3500 Protease Modulating Matrix Sterile Mextra Superabsorbent Square 10cm x 10cm 125 Rectangular 10cm x 15cm 151 10cm x 20cm 173 15cm x 20cm 244 20cm x 25cm 299 20cm x 30cm 385 The following deletions apply to Part 3 (APPLIANCES) CATHETERS, URINARY, URETHRAL CATHETERS Gauge (Ch) Price (A)i Nelaton Catheter ( Ordinary cylindrical catheter) Bard Reliacath Paediatric D5032 8 767 Plastic LUMBAR FABRIC SUPPORT Allardyce Healthcare Nx FRONT DEPTH 8 BACK DEPTH 11 Waist sizes 25-28 ; 29-32 ; 33-36 ; 37-40 ; 41-44. 1450 5

The following deletions apply to Part 5 (INCONTINENCE APPLIANCES) LEG BAGS Bard Ltd S * Urisac Range: Leg bags with push/pull outlet and foam velcro straps *750 ml, long tube 7664 10 1787 *750 ml, short tube 7665 10 1713 INCONTINENCE SHEATHS FIXING STRIPS & ADHESIVES Manufacturer Appliance Order Qty Price No Manfred Original Latex Skin Adhesive in a 28g tube Sauer UK Ltd with a long pipette/nozzle applicator 50.01 2 942 Pure Latex Skin Adhesive, without any skin care components giving a stronger bond, in a 28g tube with a long pipette/nozzle applicator. 50.00 2 926 Lanolin Free Latex Skin Adhesive for people allergic to lanolin, in a 28g tube with a long pipette/nozzle applicator. 50.03 2 926 50% reduction in skin care components, with a 28g tube with a long pipette/nozzle applicator. 50.05 2 926 2% Resin giving a stronger bond than the original adhesive 50.01, in a 28g tube with a long pipette/nozzle applicator. Should only be tried after 50.01 is found to be too weak. 50.20 2 926 12% Resin giving a stronger bond than the 2% resin adhesive 50.20, in a 28g tube with a long pipette/nozzle applicator. Should only be tried after 50.20 is found to be too weak. 50.22 2 926 Synthetic Skin Adhesive in a 28g tube with a long pipette/nozzle applicator 50.36-2 2 1652 Synthetic Skin Adhesive in a 45mL bottle with a brush in the lid 50.36 1 1652 Double-sided adhesive strip 6

OTHER CHANGES The following changes apply to Part 2 (DRESSINGS) WOUND MANAGEMENT DRESSINGS Alginate Dressing Sterile Algisorb 5cm x 5cm 55 10cm x 10cm 110 10cm x 20cm 270 15cm x 25cm 495 Alginate Dressing Sterile AlgiSorb 5cm x 5cm 55 10cm x 10cm 110 10cm x 20cm 270 15cm x 25cm 495 The following changes apply to Part 3 (APPLIANCES) CATHETERS Gauge (Ch) Price (A)i Nelaton Catheter ( Ordinary cylindrical catheter) Bard Reliacath Paediatric D5032 8-10 767 Plastic CATHETERS Gauge (Ch) Price (A)i Nelaton Catheter ( Ordinary cylindrical catheter) Bard Reliacath Paediatric D5032 10 767 Plastic 7