Health Insurance (Pharmaceutical Benefit) (General Provisions) (No. 2) (Amendment No. 15) (Jersey) Order 2023


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Health Insurance (Pharmaceutical Benefit) (General Provisions) (No. 2) (Amendment No. 15) (Jersey) Order 2023

Made                                                                                                   23rd March 2023

Coming into force                                                                                  1st May 2023

THE MINISTER FOR SOCIAL SECURITY makes this Order under Articles 15, 17 and 36 of the Health Insurance (Jersey) Law 1967 –

1        Health Insurance (Pharmaceutical Benefit) (General Provisions) (No. 2) (Jersey) Order 2002 amended

This Order amends the Health Insurance (Pharmaceutical Benefit) (General Provisions) (No. 2) (Jersey) Order 2002.

2        Article 1(2) (interpretation) deleted

Article 1(2) is deleted.

3        Article 6 (period of supply) substituted

For Article 6 there is substituted –

"6      Period of supply of pharmaceutical benefit

(1)     An approved prescribing practitioner, other than a dentist, must not give a prescription for the supply of pharmaceutical benefit to a person for a period exceeding 90 days.

(2)     An approved prescribing practitioner who is a dentist must not give a prescription for the supply of pharmaceutical benefit to a person for a period exceeding 30 days.

(3)     An approved prescribing practitioner must not give more than one prescription for the same pharmaceutical benefit at any one time.

(4)     However, an approved prescribing practitioner may give up to 4 prescriptions in respect of the same pharmaceutical benefit at any one time if the prescriptions are for consecutive periods of supply.

(5)     An approved prescribing practitioner must not during a period of treatment give a further prescription to a person for the same pharmaceutical benefit unless the practitioner is satisfied that it is necessary or desirable to do so for the purpose of the treatment and –

(a)     the pharmaceutical benefit is intended for the continuation of the treatment after the expiry of the present period of treatment and the prescription is dated no earlier than 21 days before the end of that period;

(b)     the prescription is for an increase in dosage; or

(c)     the prescription is to replace pharmaceutical benefit previously supplied on prescription and destroyed or lost.

(6)     An approved supplier must not supply pharmaceutical benefit ordered on a prescription –

(a)     before the effective date of the prescription; or

(b)     which does not comply with the requirements of this Article.”.

4        Article 9 (prescription costs payable by the Minister) substituted

For Article 9 there is substituted –

“9      Calculation of prescription costs payable by the Minister

(1)     The amount to be paid by the Minister to an approved supplier for each item of pharmaceutical benefit supplied on a prescription in respect of an insured person or a dependant of an insured person is the sum of –

(a)     the basic price of the ingredients calculated in accordance with the Drug Tariff as at the date of supply;

(b)     the appropriate basic dispensing fee in Table 1 of Schedule 5; and

(c)     any additional dispensing fee or fees in Table 2 of Schedule 5.

(2)     However, if paragraph (3) applies, the amount to be paid under paragraph (1) is the amount that would be payable under that paragraph if each instalment had been supplied on a separate prescription. 

(3)     This paragraph applies if the prescription –

(a)     was signed by an approved medical practitioner;

(b)     specifies that it is to be supplied in instalments at stipulated intervals or on given dates; and

(c)     at the time of supply is for a substance or product that is in Part 1, 2 or 3 of Schedule 2 to the Misuse of Drugs (Jersey) Law 1978.”.

5        Part 1 of Schedule 2 (terms and conditions to be observed by an approved supplier) amended

In Part 1 of Schedule 2, in paragraph 3, “direct” is deleted.

6        Schedule 4 (pharmaceutical benefit which may be supplied for 90 days on any one prescription) deleted

Schedule 4 is deleted.

7        Schedule 5 (dispensing fees) substituted

For Schedule 5 there is substituted –

“Schedule 5

dispensing fees

(Article 9(1)(b) and (c))

TABLE 1: BASIC DISPENSING FEES

 

Date of supply and description

Fee in pence for each item of pharmaceutical benefit supplied on a prescription

1

In the period of 8 months beginning on 1st May 2023 –

 

(a)

for supply by an approved supplier of each of the first 50,000 items of pharmaceutical benefit

401

(b)

for supply by an approved supplier of each item of pharmaceutical benefit after the first 50,000 items

340

2

In 2024 –

 

(a)

for supply by an approved supplier of each of the first 50,000 items of pharmaceutical benefit

433

(b)

for supply by an approved supplier of each item of pharmaceutical benefit after the first 50,000 items

367

3

In 2025 and for each ensuing period of 12 months –

 

(a)

for supply by an approved supplier of each of the first 50,000 items of pharmaceutical benefit in each calendar year

467

(b)

for supply by an approved supplier of each item of pharmaceutical benefit in each calendar year after the first 50,000 items

396

TABLE 2: ADDITIONAL DISPENSING FEES

Description

Fee in pence for each item of pharmaceutical benefit supplied on a prescription

Prescription endorsed “C.D.” by the approved supplier for drugs listed in Schedules 2 or 3 to the Misuse of Drugs (General Provisions) (Jersey) Order 2009

128

Prescriptions endorsed “C.D.” by the approved supplier for chlordiazepoxide, diazepam, flurazepam, lorazepam, nitrazepam, oxazepam, zolpidem or zopiclone

43

Urgent additional dispensing fees (see Notes)

 

Category 1

1756

Category 2

2118

Expensive items additional dispensing fees

 

Cost of item of pharmaceutical benefit –

 

£75 – £99.99

300

£100 – £199.99

500

£200 – £499.99

1000

£500 or over

2500

Notes

(1)     Category 1 urgent additional dispensing fees are payable only if –

(a)     the prescription is endorsed –

(i)      “URGENT” by the approved prescribing practitioner, and

(ii)      by the approved supplier with the date and time of dispensing;

(b)     the prescription is supplied on a day other than a Sunday or a public holiday; and

(c)     the supply is made –

(i)      when the supplier’s premises are not open for supply, and

(ii)      on the same day the prescription is written, or the following day if supplied after midnight.

(2)     Category 2 urgent additional dispensing fees are payable only if –

(a)     the prescription is endorsed –

(i)      “URGENT” by the approved prescribing practitioner, or “DISPENSED URGENTLY” by the approved supplier, and

(ii)      by the approved supplier with the date and time of dispensing;

(b)     the prescription is signed by the patient (or the patient’s representative);

(c)     the prescription is supplied on a Sunday or a public holiday; and

(d)     the supply is made –

(i)      when the supplier’s premises are not open for supply, and

(ii)      on the same day the prescription is written, or the following day if supplied after midnight.

(3)     The urgent additional dispensing fees are not payable for prescriptions supplied by an approved supplier when the supplier’s premises are open for supply in accordance with a scheme prepared by the Minister under Article 4.”.

8        Schedule 6 (reduction of amount payable to approved suppliers) deleted

Schedule 6 is deleted.

9        Citation and commencement

This Order may be cited as the Health Insurance (Pharmaceutical Benefit) (General Provisions) (No. 2) (Amendment No. 15) (Jersey) Order 2023 and comes into force on 1st May 2023.

Deputy M.E. Millar of St. John, St. Lawrence and Trinity

Minister for Social Security

 


Page Last Updated: 23 Mar 2023