№ files_lp_4_process_3_116785
Guidance for pharmacy contractors on claiming out-of-pocket expenses for eligible NHS prescription items, detailing conditions, evidence requirements, and verification outcomes.
Year: 2023–2025
Region / Country: England
Topic: Pharmacy reimbursement and expense claims
Document type: Guidance document
Issuing organization: NHS England
Target audience: Pharmacy contractors
Scope: Out-of-pocket expense claims for NHS prescriptions
Relevant regulations: Drug Tariff Part II Clause 12
Verification process: Post Payment Verification (PPV)
Exceptions: Cefuroxime 5% preservative-free eye drops additional fixed payment
Claim requirements: Exceptional circumstances, non-frequent supply, reasonable steps to avoid expenses
Financial impact: £3.5 million paid; £600,000 recovered from ineligible claims
Appeals: NHS Resolution (NHSR) outcomes on disputed claims
Date updated: December 2025
Price: 8 / 10 USD
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