Introduction

The Drug Tariff is not an arbitrary list; it contains only those products that are tried and tested; so it tends to exclude the latest products. The exact criteria for selection are not published, but it may not be a coincidence that products with a lower unit cost have, in the past, had a greater chance of quick inclusion than more expensive products. This, it might be suggested, shows a lack of understanding of the principles of wound management: a higher unit cost might apply to a product which needs applying less frequently and/or requires less time and skill to apply. Such a product might be more cost effective over a period of time.

The Drug Tariff has also shown obscure prejudice against certain areas; cavity wound dressings, and dressings for malodorous wounds have fared badly.

Recently, however, the Drug Tariff seems to have become more closely related to the market place and to patients' needs. New products, particularly those with a CE mark, and new sizes/formulations of existing products, appear to reach the Tariff more easily.

The Drug Tariff matters, because products that are not included cannot be obtained on an FP10 prescription (England and Wales; GP10 in Scotland) a dressing is officially unobtainable for NHS patients outside of hospital. (Hospitals are not bound by the Drug Tariff; they are free to draw up their own lists of acceptable purchases - but that is another story!). In practice, non-Tariff dressings are obtained by the time honoured techniques of begging, stealing and borrowing. Hospital staff need to be aware of the Drug Tariff and its limitations, in order to plan for continuity of wound management as patients go home.

This article (and its companion, Dressings on the Drug Tariff) reflect on information already available in the Drug Tariff [1], arranged in tables for convenience. These articles intentionally exclude obsolete dressings and gauze swabs which are used for cleansing purposes as well as items like paraffin gauze which are still available on community prescription, but are rarely the dressing of choice[2], particularly those impregnated with antibiotics which are an anachronism to be avoided. Colonization and contamination are not an indication for topical antibiotics, rather an imperative to effect wound healing as quickly as possible, and any sign of significant wound infection is an indication for appropriate systemic antibiotics.

This article consists of the information on bandages taken from the May 1998 version of Dressings on the Drug Tariff, updated and enlarged to include three new sections:
Cotton, polyamide and elastane bandage
Knitted elastomer and viscose bandage
Knitted polyamide & cellulose contour bandage
The details and links have been checked, and price changes are included from the latest (October) edition of the Drug Tariff.

Cotton conforming bandages

• Prices refer to individual items
• [1] Type A
• [2] Type B

Cotton, Polyamide and Elastane Bandage

Knitted elastomer and viscose bandage

• Prices refer to individual items
• Length refers to stretched length in all cases
• [1] BS Compression type 2 bandage; for 'light support'
• [2] BS Compression type 3a bandage; for 'light compression'.

Extensible high compression bandages

• Prices refer to individual items
• Length refers to stretched length in all cases
• Setopress is a P.E.C. high compression bandage; Polyamide, Elastane and Cotton Compression (high) Extensible Bandage (PECCHE).
• Tensopress is a V.E.C. High Compression bandage; Viscose, Elastane and Cotton Compression (high) Extensible Bandage (VECCHE).

Knitted polyamide & cellulose contour bandage

• Length refers to stretched length in all cases

Zinc paste bandages

• Prices refer to individual items

Final Note

This article is not intended to provide advice on the suitability of a particular dressing for a particular wound; it is intended simply to be a guide to dressings availability in Great Britain. The warnings and uses given are indicative only, and are largely taken from the Drug Tariff [1] and the British National Formulary [2], but any opinions expressed are those of the author. Readers are urged to refer to manufacturers' information and published research before using any dressing. The Drug Tariff is updated on a monthly basis and is available on subscription from HMSO.

Other Drug Tariff articles in World Wide Wounds

Earlier Editions, which include bandages

Edition 3.1 (07 May 1998)
Edition 3.0 (16 Feb 1998)
Edition 2.0 (19 Sept 1997)
Edition 1.1 (31 July 1997)
Edition 1.0 (14 July 1997)

References

1. Department of Health. Drug Tariff. London: HMSO, November 1998

2. British National Formulary. London BMA/RPSGB, September 1998