Q: Are orodispersible tablets and oral lyophilisates interchangeable on a prescription?

A: From a clinical and patient perspective there is no difference between an orodispersible tablet and an oral lyophilisate – they are both ‘melt in the mouth’ tablets which can hasten drug action and improve adherence.

However, from a Drug Tariff and DM+D perspective they are separate and distinct generic descriptions which cannot be interchanged. Reimbursement will be based on each generic description as listed in the DT or DM+D.

For Example

In the Dictionary of Medicines and Devices the brand name Maxalt Melt 10mg has a generic description of rizatriptan 10mg oral lyophilisate sugar free. This generic description is listed in Part VIIIA of the Drug Tariff as a category C drug with remuneration based on the price of Maxalt Melt.

A prescription for rizatriptan 10mg orodispersible tablets sugar free cannot be filled with Maxalt Melt because the generic descriptions do not match – although clinically indistinguishable, you will not be reimbursed correctly for supplying the Maxalt brand. This interpretation also extends to other drugs which have both descriptions listed in the DM+D.

Further to this, as of December 2013 the distinct generic description of rizatriptan 10mg orodispersible tablets sugar free is being added to the drug tariff as a category A drug. Reimbursement for this prescription will be based on this listed price.

For a fuller discussion of orodispersible dosage forms please see our CPD-Mini article: Orodispersible formulations.

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