Out Of Pocket Expenses (OOP): Important addition to clause 12 (OOP) in the March 2024 England & Wales Drug Tariff

Numark Information Services would like to bring this addition to Clause 12 to our members’ attention. It can be seen below in bold.

Clause 12 Out of Pocket Expenses 

Where, in exceptional circumstances, out-of-pocket expenses have been incurred in obtaining a drug, appliance or chemical reagent other than those priced in Part VIIIA Category A and M, Part VIIIB, Part VIIID, Part IXA, Part IXR of the Tariff and all other specials and imported products not listed and not required to be frequently supplied by the contractor, or where out-of-pocket expenses have been incurred in obtaining oxygen from a manufacturer, wholesaler or supplier specially for supply against a prescription, where such expenses on any occasion exceed 50p payment of the full amount may be made where the contractor sends a claim giving particulars to the Pricing Authority on the appropriate prescription form. The endorsement shall be ‘XP’ or ‘OOP’ to indicate the contractor has taken all reasonable steps to avoid claiming. 

An exception to this will be made for Cefuroxime 5% preservative free eye drops, for which there will be an additional fixed out-of-pocket expense payment of £50 automatically applied without the need for any ‘XP’ or ‘OOP’ endorsements. This payment will also be retrospectively applied to all prescriptions for this item dispensed between the months of April 2023 to February 2024. Other applicable fees and allowances will continue to be paid as usual.