Health
Insurance (Pharmaceutical Benefit) (General Provisions) (No. 2) (Amendment No. 15) (Jersey)
Order 2023
Made 23rd March 2023
Coming into
force 1st May 2023
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
|
(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