Published: 13/01/22

Summary

This circular sets out fees payable for participating community pharmacy contractors in the provision of antiviral treatments in COVID-19 positive non-hospitalised patients.

DL (2021) 52 set out information for healthcare professionals on the targeted deployment of COVID-19 medicines for non-hospitalised patients. From 22 December 2021, individuals identified as being at very high risk of deterioration, hospitalisation or death from COVID-19 may be able to access new COVID-19 treatments via the NHS.

Each Health Board has established a single point of contact telephone number for eligible high-risk individuals to contact for an assessment of their suitability for treatment. The single point of contact telephone numbers are available on NHS Inform.

Each Health Board has established service arrangements with prescribing capability for centralised medical clinical assessment of individuals who contact the single point of contact telephone number. At this time, there is no expectation that these medicines will be prescribed in primary care unless part of locally agreed service arrangements.

To be most effective, these treatments need to be administered as soon as practically possible after receiving a positive PCR test and symptom onset. These treatments are in addition to vaccinations, which still remain the best way to protect everyone.

New COVID-19 Treatments

Where treatment is required, the clinical commissioning policy (last updated 24 December 2021) recommends the Neutralising monoclonal antibodies (nMAB), sotrovimab as the first-line treatment option for eligible patients; this is likely to involve the individual travelling to a day clinic at a hospital to receive treatment. Where an nMAB is contraindicated or the administration of an nMAB is not possible, individuals may be treated with a five-day course of molnupiravir.

In such cases, Health Boards may seek to utilise part of the community pharmacy network for the safe and effective dispensing and home delivery of molnupiravir, and any future COVID-19 antivirals, to individuals who are suitable for treatment. Not all Health Boards may choose the community pharmacy network to dispense antiviral treatments to those individuals identified as eligible for treatment.

Participation

Participation of community pharmacy contractors in the provision of COVID-19 antivirals is at the discretion of the Health Board. Only those pharmacy contractors who have been engaged by the Health Board to provide a service will be eligible for any fees payable.

Pharmacy contractors providing COVID-19 antiviral treatments and home deliveries must have in place appropriate Standard Operating Procedures as required by the Health Board to meet service provision, including home delivery and alongside any specific requirements which may be set out in the clinical commissioning policy.

Health Boards are asked to ensure that Practitioner and Counter Fraud Services (PCFS) are provided with details of participating pharmacy contractors. Please see template at Annex A.

Fees

Whilst work is ongoing on the longer term development arrangements for antiviral treatments, the Scottish Government will centrally fund the provision of COVID-19 antivirals to eligible non-hospitalised patients via community pharmacy for the current financial year.

Following discussion with Community Pharmacy Scotland, the Scottish Government has agreed a service fee per dispensed item of £45. Community pharmacy contractors will be eligible for a delivery fee should there be a requirement for treatment to be delivered to a patient’s place of residence.

A delivery fee of £8 will be payable for journeys up to 10 miles i.e. £8 for those below a 20 mile round trip. A delivery fee of £12 will be payable for journeys above this.

Payments will be subject to post payment verification / Health Board check.

Claims Process

The following process should be used to ensure the appropriate fee payment and delivery fee is applied to each dispensing:

• UCF claim under ‘COV’ service

• PMR systems should have the item in their drug dictionary for selection / claim. Claim as normal for quantity dispensed. No price endorsement required.

• UCF claim to include OTH endorsement with SDD for short delivery or LDD for long delivery

Supply Chain

The supply of COVID-19 antivirals will be managed by NSS National Procurement (NP). NSS NP will work with Health Boards on stock allocation. At this point in time, given the very limited supply, community pharmacies will only be able to access oral antivirals where there is agreement with the Health Board that the pharmacy will support the dispensing of these medicines to eligible individuals. Arrangements will be communicated locally by the Health Board.