Endorsement Guidance for Oral Liquid Methadone

As well as the item level fee for the dispensed prescription, you are able to endorse and claim a Packaged Dose (PD) fee for each individual dose supplied in advance in daily dose containers. For example, if the patient comes in and collects seven days of separately packed medication, 6 PD fees can be claimed.

The PD fees are included in the NHS FP34 report summary estimate. See Viewing the FP34 Report for details.

Package Dose Examples

For a patient collecting three 20ml doses on a Friday to cover the weekend:

Friday doses	Tues	Wed	Thur	Fri	Sat	Sun	Mon	PD Fees
One container	20	20	20	60	0	0	20	0
Two containers	20	20	20	20,40	0	0	20	1 x PD
Three containers	20	20	20	20,20,20	0	0	20	2 x PD

• If you dispense all three doses together, for example, the three daily doses are in one container, with a suitable measuring device, you are not eligible to claim for any additional PD fees.

• If you dispense the Friday dose as a single dose, for example, for supervised consumption, with the Saturday and Sunday doses packaged together in one container with a suitable measuring device, you are eligible for one PD fee as one separate package was supplied for the Saturday and Sunday doses. The endorsement would show as PD1 on the left-hand side of the Dispensary Supply screen.

• If you dispense all three doses in separate containers, you are eligible for two PD fees as two separate packages were supplied for the Saturday and the Sunday doses in addition to the Friday dose. The endorsement would show as PD2 on the left-hand side of the Dispensary Supply screen.

Package Doses - Dispensing FP10(MDA)/WP10(MDA) Prescriptions

In the following scenario an FP10(MDA) form type is used to prescribe seven days of Methadone 1mg/ml oral solution, 10ml daily, 70ml in total, with daily instalment intervals except Thursday and Sunday which are collected in separate containers on Wednesday and Saturday respectively.

Use Instalment Dispensing within Pharmacy Manager to set the number of days' supply and the collection days.

Once the instalments are collected, the Dispensary Supply screen details the packaged dose endorsement guidance on the left-hand side, in this case two package doses (PD2).

The PD fee is the total number of separately packaged dosages supplied minus total number of pick-ups/interactions. In this example 7 – 5 = 2 PD fees.

The prescription counter at the bottom left corner displays the number of prescriptions dispensed / patient interactions assuming everything was collected on schedule.

Package Doses - Dispensing FP10/WP10 Prescriptions

Although instalment dispensing is not permitted on FP10/WP10 prescriptions, where you dispense each individual dose in a separate container, you can claim the additional package dose fees. However, the number of interactions/pick-ups is always one.

In the following scenario an FP10 form is used to prescribe seven days of Methadone 1mg/ml oral solution, 10ml daily, 70ml in total. When you dispense each individual dose in a separate container you can claim the addition PD fee, in this scenario PD6.

The quantity should be divided into daily doses, for example, 10,10,10,10,10,10,10. This equates to seven doses of 10ml each, resulting in seven labels being printed, one for each dose.

When the endorsement is shown, it indicates the PD fee, in this case PD6, and the prescription counter, in this case 1. This information applies to both electronic claims or printed endorsements on paper prescriptions.

Spilt Pack Fee

The split pack fee payment is only made where the total quantity prescribed (sum of all the doses) is outside of a pack size available from the manufacturer.

The three examples below explain whether a split fee is payable depending on the pack sizes available in the Dictionary of Medicines and Devices (DM+D):

• Methadone 1mg/ml oral solution - 100ml and 500ml

• Methadone 1mg/ml oral solution sugar free - 50ml, 100ml and 500ml

	Methadone 1mg/ml oral solution 100ml and 500ml pack sizes available	Methadone 1mg/ml oral solution SF 50ml, 100ml and 500ml pack sizes available
14 days x 29ml dosages (406ml)	Split pack fee payable, cannot dispense using whole packs	Split pack fee payable, cannot dispense using whole packs
14 days x 25ml dosages (350ml)	Split pack fee payable, cannot dispense using whole packs	Split pack fee not payable (100ml + 100ml + 100ml + 50ml)
14 days x 50ml dosages (700ml)	Split pack fee not payable (500ml + 100ml + 100ml)	Split pack fee not payable (500ml + 100ml + 100ml)