Advance Notification of Amendments to the August 2018 Drug Tariff ADDITIONS Zero Discount Brivaracetam 100mg tablets Brivaracetam 25mg tablets Brivaracetam 50mg tablets Brivaracetam 75mg tablets Maraviroc 25mg tablets Maraviroc 75mg tablets Stiripentol 500mg oral powder sachets Part I - Drugs And Preparations Special Container Drug Qty Price Adrenaline (base) 500micrograms/ 0.5ml (1 in 1,000) solution for 1 26.99 injection pre-filled disposable devices C Emerade Alfentanil 1mg/2ml solution for injection ampoules 10 6.34 C Rapifen Alprostadil 3mg/g cream 4 40.00 C Vitaros Brivaracetam 100mg tablets 56 129.64 C Briviact Brivaracetam 10mg tablets 14 34.64 C Briviact Brivaracetam 25mg tablets 56 129.64 C Briviact Brivaracetam 50mg tablets 56 129.64 C Briviact Brivaracetam 75mg tablets 56 129.64 C Briviact Carbimazole 10mg tablets 100 81.32 C Macleods Pharma UK Ltd Carbimazole 15mg tablets 100 115.98 C Macleods Pharma UK Ltd Ciprofloxacin 2mg/ml ear drops 0.25ml unit dose preservative free 15 6.01 C Cetraxal Colestipol 5g granules sachets sugar free 30 15.05 C Colestid Docusate 120mg/10g enema 6 28.00 C Norgalax Fentanyl 100microgram sublingual tablets sugar free 10 49.99 C Abstral Fentanyl 200microgram sublingual tablets sugar free 10 49.99 C Abstral Fentanyl 300microgram sublingual tablets sugar free 10 49.99 C Abstral Fentanyl 400microgram sublingual tablets sugar free 10 49.99 C Abstral Fentanyl 600microgram sublingual tablets sugar free 30 149.70 C Abstral Fentanyl 800microgram sublingual tablets sugar free 30 149.70 C Abstral Page 1 of 6
ADDITIONS Continued Glycopyrronium bromide 600micrograms/3ml solution for injection ampoules 10 14.27 A Guanfacine 1mg modified-release tablets 28 56.00 C Intuniv Guanfacine 2mg modified-release tablets 28 58.52 C Intuniv Guanfacine 3mg modified-release tablets 28 65.52 C Intuniv Guanfacine 4mg modified-release tablets 28 76.16 C Intuniv Hepatitis B (rdna) 10micrograms/ 0.5ml vaccine suspension for 1 injection pre-filled syringes 9.67 C Engerix B Hepatitis B (rdna) 20micrograms/ 1ml vaccine suspension for injection 1 pre-filled syringes 12.99 C Engerix B Insulin glulisine 100units/ml solution for injection 10ml vials 1 16.00 C Apidra Insulin glulisine 100units/ml solution for injection 3ml cartridges 5 28.30 C Apidra Levetiracetam 500mg/5ml solution for infusion vials 10 127.31 C Keppra Liquid paraffin light 82.8% bath additive 500ml Cetraben 5.75 C emollient Maraviroc 20mg/ml oral solution sugar free 230ml 230.44 C Celsentri Maraviroc 25mg tablets 120 147.09 C Celsentri Maraviroc 75mg tablets 120 441.27 C Celsentri Methylphenidate 50mg modifiedrelease capsules 30 62.52 C Medikinet XL Methylphenidate 5mg modifiedrelease capsules 30 24.04 C Medikinet XL Methylphenidate 60mg modifiedrelease capsules 30 67.32 C Medikinet XL Ondansetron 4mg orodispersible films sugar free 10 28.50 C Setofilm Ondansetron 8mg orodispersible films sugar free 10 57.00 C Setofilm Potassium chloride 375mg/5ml (potassium 5mmol/5ml) oral solution sugar free 500ml 8.43 C Kay-Cee-L syrup Proguanil 25mg / Atovaquone 62.5mg tablets 12 6.26 C Malarone Paediatric Sodium chloride 0.9% solution for injection 50ml vials 25 85.13 A Stiripentol 500mg oral powder sachets 60 493.00 C Diacomit Tramadol 75mg modified-release tablets 60 5.15 C Zytram SR Trazodone 100mg/5ml oral solution sugar free 120ml 179.30 A Page 2 of 6
ADDITIONS Continued Part III Appliances Wound Dressing Pack Pico 7 10cm x 20cm 128.09 10cm x 30cm 127.45 10cm x 40cm 146.86 15cm x 15cm 127.45 15cm x 20cm 127.45 15cm x 30cm 146.86 20cm x 20cm 146.86 25cm x 25cm 146.86 Pico 7 Multisite 15cm x 20cm 126.88 20cm x 25cm 145.48 Emollient And Barrier Preparations Epimax Paraffin-Free Cream 500g 3.99 Epimax Paraffin-Free Ointment 500g 4.99 Eye Products Eye Gel - Carbomer Evolve Carbomer 980 (10g preservative free tube) 2.80 Spacer/Holding Chamber Devices EasyChamber Spacer 3.98 EasyChamber Spacer with infant mask 6.53 EasyChamber Spacer with child mask 6.55 EasyChamber Spacer with adult mask 6.59 Tracheostomy And Laryngectomy Appliances Tracheostomy Breathing Aids Provox HME System ("Stomafilter") Provox StabiliBase OptiDerm 7318 7.56 Page 3 of 6
DELETIONS Part I - Drugs And Preparations Special Container Drug Qty Price Polymyxin B 10,000units/g / Bacitracin 500units/g ointment 20g 4.62 C Polyfax Sodium chloride 0.9% solution for injection 50ml vials 1 3.41 A Strontium ranelate 2g granules sachets sugar free 28 27.08 C Protelos Part II Chemical Reagents Detection Strips, Blood For Glucose Biosensor Strips - to be read only with the appropriate meter DiaCheck 50 9.00 SuperCheck Plus 50 9.45 SuperCheck 2 50 8.49 Part III Appliances Contraceptive Devices Vaginal Contraceptive Diaphragm Ortho All-Flex Diaphragm 65-80mm 8.35 Arcing - Arcing Spring (Type C) (rising in 5mm) Elastic Hosiery Class I Lt. Wt Elas. Net Thigh 22.39 B. Knee 17.47 Spacer/Holding Chamber Devices Fisio Chamber Vision 4.54 Fisio Chamber Vision with infant mask (0-3 years) 7.58 Fisio Chamber Vision with paediatric mask (3-6 years) 7.58 Fisio Chamber Vision with large mask (6 years - adult) 7.58 Page 4 of 6
AMENDMENTS Part I - Drugs And Preparations Special Container Aceclofenac 100mg tablets 60 9.63 C Aceclofenac 100mg tablets 60 9.63 A Calcipotriol 50micrograms/g ointment 30g 5.78 C Dovonex Calcipotriol 50micrograms/g ointment 30g 5.78 A Carbamazepine 125mg suppositories 5 120.00 C Essential Pharma Ltd Carbamazepine 125mg suppositories 5 120.00 A Diclofenac potassium 25mg tablets 28 3.87 C Accord Healthcare Ltd Diclofenac potassium 25mg tablets 28 3.87 C Actavis UK Ltd Isotretinoin 10mg capsules 30 14.54 C Roaccutane Isotretinoin 10mg capsules 30 14.54 A Morphine sulfate 30mg/1ml solution for injection ampoules 10 11.49 C Morphine sulfate 30mg/1ml solution for injection ampoules 10 11.49 A Martindale Pharmaceuticals Ltd Simple linctus paediatric 200ml 1.05 C Thornton & Ross Ltd Simple linctus paediatric 200ml 1.05 A Tetrabenazine 25mg tablets 112 100.00 C Tetrabenazine 25mg tablets 112 100.00 A Page 5 of 6
AMENDMENTS - continued Part III Appliances Bandages Multi-layer Compression Bandaging Aspen Medical Europe AndoFlex UBZ - 2 layer compression bandage kit with zinc (latex free) 7.5cm 5.29 10cm 6.40 AndoFlex TLC Zinc Lite - 2 layer compression kit (latex free) (formerly 7.5cm 5.29 AndoFlex UBZ - 2 layer compression bandage kit with zinc (latex free)) 10cm 6.40 Lymphoedema Garments Adore Class 1(18-21mmHg) Thigh High Standard, Petite S, M, L, XL 51.05 Thigh High Standard S, M, L, XL 51.05 Class 2 (23-32mmHg) Thigh High Standard, Petite S, M, L, XL 51.05 Thigh High Standard S, M, L, XL 51.05 Tracheostomy And Laryngectomy Appliances Tracheostomy Dressings - Sterile Trachi-Dress F 80mm x 100mm TR DRF 1002 1.48 This product code will change in the August 2018 Drug Tariff Trachi-Dress F 80mm x 100mm TR DRF 0002 1.48 27 th July 2018 Pharmaceutical web site: www.hscbusiness.hscni.net From the homepage go to Services, FPS Pharmaceutical Services. Page 6 of 6