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The Drug Tariff and wound management

Author(s)

Andrew Heenan
RGN RMN BA(Hons)

Email: andrew2@heenan.net

Contents
Published: Mar 2004
Last updated: Jul 2004
Revision: 1.1

Keywords: Drug Tariff; wound management; dressings; bandages.

Introduction

In the UK, the availability of dressings for use in patients' homes is dictated by the Drug Tariff[1]. This monthly publication defines what may be prescribed in the community (and paid for by the National Health Service).

The Drug Tariff is not an arbitrary list; it contains only those products that are tried and tested and therefore 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.

In recent years, the Drug Tariff has become closely related to the market place and to patients' needs. New products, and new sizes/formulations of existing products, reach the Tariff more quickly.

The Drug Tariff matters, as products that are not included cannot be obtained on an FP10 prescription (England and Wales; GP10 in Scotland); thus a dressing may be officially unobtainable for NHS patients outside of hospital. Since hospitals are not bound by the Drug Tariff, and are free to draw up their own lists of products, 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.

With this in mind, a set of articles has been produced to reflect information available in the Drug Tariff [1], arranged in tables for convenience. They intentionally exclude obsolete dressings and gauze swabs (used for cleansing purposes) as well as items such as paraffin gauze, which are still available on community prescription, but are rarely the dressing of choice [2], particularly those impregnated with antibiotics. Colonisation 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.

Each article should be used as a guide to dressing availability in Great Britain and is not intended to provide advice on the suitability of a particular dressing for a particular wound. 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.

These articles include most of the products in the Drug Tariff that are used in wound care, and will build to a comprehensive resource over the next few editions. This month, a new section features polyurethane dressings.

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.

Related articles

The articles related to the Drug Tariff include:

This set of articles is based on an earlier series, Dressings on the Drug Tariff, which ran from July 1997 to November 1998. The final edition was subdivided, with a separate Bandages on the Drug Tariff:

References

1. Prescription Pricing Authority, Department of Health. Drug Tariff. London: The Stationery Office, June 2004.

2. British National Formulary. London: BMA/RPSGB, March 2004.




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