SCOTTISH DRUG TARIFF MONTHLY NOTICE OF AMENDMENTS. June 2015

Scottish Drug Tariff: Amendment sheets for June 2015 Information Services Gyle Square 1 South Gyle Crescent EDINBURGH EH12 9EB Telephone : 0131 275 6972 Fax : 0131 275 7606 www.isdscotland.org SCOTTISH DRUG TARIFF MONTHLY NOTICE OF AMENDMENTS June 2015 This document is prepared by the evadis Team, Healthcare Information Group, Information Services Division. Enquiries to: NSS.evadis@nhs.net The complete Scottish Drug Tariff is published on the ISD Scotland website: www.isdscotland.org The following amendments take effect from 1st June 2015. Amendments to Part 1 Annex A (Zero Discount list) There are no Additions or Deletions for June 2015 Amendments to Part 1 Annex B (Prescription Charges) ADDITIONS LIST OF CONTRACEPTIVE DRUGS TO BE DISPENSED FREE OF CHARGE ON AN ENGLISH PRESCRIPTION FORM a. Progestogen only Etonogestrel 68mg implant Feanolla Isteranda c. Under 50 Micrograms of Oestrogen Aidulan 20 Aidulan 30 Alenini Alenvona Cleosensa Dretine Eribelle Ethinylestradiol 20microgram / Desogestrel 150microgram tablets Ethinylestradiol 30microgram / Desogestrel 150microgram tablets Ethinylestradiol 30microgram / Drospirenone 3mg tablets Ethinylestradiol 20microgram / Gestodene 75microgram tablets Ethinylestradiol 30microgram / Gestodene 75microgram tablets Maexeni Munalea 20 Munalea 30 1

Scottish Drug Tariff: Amendment sheets for June 2015 ADDITIONS The following additions apply to Part 2 (Dressings) LYMPHOEDEMA GARMENTS Juzo Hostess Lengths Sizes Class 1 (18-21mm Hg) Per pair Tights open toe Standard, Short I VI 5000 Class 2 (23-32mm Hg) Tights open toe Standard, Short I VI 5000 Juzo Soft Rib Lengths Sizes Class 1 (18-21mm Hg) Per pair Below Knee Closed Toe Standard, Short I VI 2542 Class 2 (23-32mm Hg) Below Knee Closed Toe Standard, Short I VI 2542 WOUND MANAGEMENT DRESSINGS Soft Polymer Wound Contact Dressing with Polyurethane Foam Film Backing Sterile CE Aquacel Foam Adhesive 10cm x 20cm 260 10cm x 30cm 495 Soft Polymer Wound Contact Dressing with Polyurethane Foam Film Backing Impregnated with Antimicrobial Agents Kendall AMD Antimicrobial Foam Border Gentle Adhesion 4.4cm x 8.3cm 280 8.9cm x 8.9cm 360 8.9cm x 14cm 567 14cm x 14cm 745 19cm x 19cm 1433 2

Scottish Drug Tariff: Amendment sheets for June 2015 The following additions apply to Part 3 (Appliances) CATHETERS Gauge (Ch) (A)i Nelaton Catheter ( Ordinary cylindrical catheter) WyMedical Ltd WyCath Uncoated 4 eyelets soft tip catheter Pack of 30 (Standard) U4SM12-U4SM14 12-14 4350 (A)ii Nelaton Catheter ( Ordinary cylindrical catheter) Clinimed Ltd Curan Lady Pack of 30 Female CL08 8 4140 EAR WAX SOFTENING MEDICAL DEVICES Ear Drops - Sodium Bicarbonate Alissa Healthcare 10ml 125 EYE PRODUCTS Eye Drops - Sodium Hyaluronate Hylo-Fresh (10ml preservative free bottle) 495 The following additions apply to Part 5 (Incontinence Appliances) INCONTINENCE SHEATHS Manufacturer Appliance OrderNo Qty Jade-Euro Med Ltd Jade Ultra Flex Short Clear Sheath (Self-adhesive) 25mm (small) M310 30 4682 29mm (medium) M320 30 4682 32mm (intermediate) M330 30 4682 36mm (large) M340 30 4682 41mm (ex-large) M350 30 4682 Jade Ultra Flex Extra Clear Sheath (Self-adhesive extra wide application of adhesive) 25mm (small) M610 30 4682 29mm (medium) M620 30 4682 32mm (intermediate) M630 30 4682 36mm (large) M640 30 4682 41mm (ex-large) M650 30 4682 3

Scottish Drug Tariff: Amendment sheets for June 2015 The following additions apply to Part 9 (Chemical Reagents) CHEMICAL REAGENTS Pack URINE TESTING REAGENTS DETECTION STRIPS FOR KETONURIA (ACETONURIA) GlucoRx KetoRx Sticks 2GK 50 225 BLOOD GLUCOSE TESTING STRIPS (ii) Biosensor strips to be read only with the appropriate meter OneTouch Select Plus 50 999 (v) Colorimetric Cassette - to be read only with appropriate meter Betachek C50 100 2998 DELETIONS The following deletion applies to Part 2 (Dressings) WOUND MANAGEMENT DRESSINGS Silicone Topical Gel & Cream Zeraderm Gel 15g tube 1650 The following deletion applies to Part 3 (Appliances) CATHETERS Balloon Size (ml) Gauge (Ch) (A)i Nelaton Catheter ( Ordinary cylindrical catheter) Bard Ltd Bard Reliacath Plastic Pack of 5 Female D5031 18 752 (iii) For Long Term Use Adult L.IN.C Medical Systems Ltd All silicone catheter with integral balloon Pack of 1 Male 08501205 5 12 550 08501405 5 14 550 08501610 10 16 550 08501810 10 18 550 Female 085012051 5 12 550 085014051 5 14 550 085016101 10 16 550 4

Scottish Drug Tariff: Amendment sheets for June 2015 CATHETERS cont. Balloon Gauge (Ch) Size (ml) (iii) For Long Term Use Adult L.IN.C Medical Systems Ltd 2 Way Foley All Silicone Pack of 1 08500601 1 6 795 08500803 3 8 795 08501003 3 10 795 (J) Urinary Suprapubic Catheters L.IN.C Medical Systems Ltd 2 Way All-Silicone Suprapubic catheter with integral balloon & central opening Pack of 1 Paediatric 08470803 3 8 1095 08471003 3 10 1095 Female 08471205 5 12 1095 08471405 5 14 1095 08471610 10 16 1095 08471810 10 18 1095 08472010 10 20 1095 08472210 10 22 1095 08472410 10 24 1095 Long 08451205 5 12 1095 08451405 5 14 1095 08451610 10 16 1095 08451810 10 18 1095 08452010 10 20 1095 08452210 10 22 1095 08452410 10 24 1095 2 Way All-Silicone Suprapubic catheter with integral balloon, central opening & shaped tip Pack of 1 084612051 5 12 1095 084614051 5 14 1095 084616101 10 16 1095 084618101 10 18 1095 084620101 10 20 1095 The following deletion applies to Part 9 (Chemical Reagents) CHEMICAL REAGENTS BLOOD GLUCOSE TESTING STRIPS (iii) Biosensor disc to be read only with appropriate meter Every x 3 15 drums of 6 strips each 2535 5

Scottish Drug Tariff: Amendment sheets for June 2015 OTHER CHANGES The following change applies to Part 2 (Dressings) WOUND MANAGEMENT DRESSINGS Soft Silicone Wound Contact Dressing with Polyurethane Foam Film Backing Sterile CE Mepilex 10cm x 11cm 266 11cm x 20cm 439 15cm x 16cm 482 20cm x 21cm 728 Now reads Mepilex XT 10cm x 11cm 266 11cm x 20cm 439 15cm x 16cm 482 20cm x 21cm 728 Topical Negative Pressure System Accessories Kendall Kerlix AMD Gauze 11.4cm x 3.7m 162 Now reads Kerlix AMD Gauze 11.4cm x 3.7m 162 6

Information Services Gyle Square 1 South Gyle Crescent EDINBURGH EH12 9EB Telephone : 0131 275 6972 Fax : 0131 275 7606 www.isdscotland.org SCOTTISH DRUG TARIFF MONTHLY NOTICE OF PRICE AMENDMENTS June 2015 This document is prepared by the evadis Team, Healthcare Information Group, Information Services Division. Enquiries to: NSS.evadis@nhs.net The complete Scottish Drug Tariff is published on the ISD Scotland website: www.isdscotland.org The following price changes listed become effective from 1 st June 2015. Prices in pence per item, unless otherwise stated. The following price changes apply to Part 2 (Dressings) ABSORBENT COTTONS Absorbent Cotton BP 25g 75 76 100g 172 173 500g 579 583 Absorbent Cotton, Hospital Quality 500g 377 379 ADHESIVE DRESSING REMOVER STERILE SILICONE BASED Pack size Appeel Sterile single use wipes 30 1519 1529 foam applicator 5 375 377 BANDAGES Cotton Crepe Bandage BP 1988 Elastocrepe 7.5cm x 4.5m 307 309 10cm x 4.5m 394 397 Flexocrepe 7.5cm x 4.5m 307 309 10cm x 4.5m 394 397 1

BANDAGES cont. Crêpe Bandage BP 1988 7.5cm x 4.5m 137 138 10cm x 4.5m 179 181 15cm x 4.5m 260 262 Elastic Adhesive Bandage BP 5cm x 4.5m 361 364 7.5cm x 4.5m 523 526 10cm x 4.5m 695 700 Open-Wove Bandage Type 1 BP 1988 7.5 cm x 5m 78 79 10 cm x 5m 102 103 Suspensory Bandage, Cotton Type 1. Cotton net bag with draw tapes and webbing waistband (Each in a carton or envelope). Small 169 170 Medium 169 170 Large 169 170 Ex-Large 179 181 Type 2. Cotton net bag with elastic edge and webbing waistband (Each in a carton or envelope). Small 187 189 Medium 193 194 Large 200 201 Ex-Large 208 209 Type 3. Cotton net bag with elastic edge and webbing waistband with insertion of elastic centre-front (each in a carton or envelope). Small 202 203 Medium 202 203 Large 202 203 Ex-Large 209 210 CHIROPODY APPLIANCES Adhesive Felt Zinc oxide or acrylic adhesive spread on semi-compressed wool felt. Size 10cm x 22.5m x 5mm thick 208 209 Animal Wool for Chiropody BP 25g 98 99 Bunion Rings Self-adhesive, semi-compressed felt: Thick Wallet of 4 100 101 Corn rings Self-adhesive, semi-compressed felt 5mm Thick Wallet of 9 100 101 2

DRESSINGS Multiple Pack Dressing No 1 (Drug Tariff) Contents packed in a carton: - Absorbent Cotton BP (Inter-leaved) 25g Absorbent Cotton Gauze BP Sterile 90cm x 1m Open-Wove Type 1 Bandages BP 3 x 5cm x 5m per carton 428 431 Sterile Dressing Pack The Pack contains a selection of sterile dressings required in special nursing procedures (usually for post-operative re-dressing of wounds) when performed in the home by a nurse or doctor. per pack 53 54 The Sterilised Pack contains: - 8.5cm x 20cm 1 Gauze and Cotton Tissue pad 10cm x 10cm 4 Gauze Swabs 12-ply 0.9g approx. 4 Cotton Wool Balls, large 45cm x 50cm 1 Absorbent Paper Towel 50cm x 50cm 1 Water repellent inner wrapper (opens out as sterile working field). To be supplied in the individual pack, sealed and sterilised as received from the manufacturer or wholesaler. Sterile Dressing Pack with Non-Woven Pads (Vernaid) per pack 52 53 The Sterilised Pack contains: - 10cm x 20cm 1 Non-woven Fabric Covered Dressing Pad 10cm x 10cm 4 Non-woven Fabric Swabs 4 Absorbent Cotton Wool Balls 50cm x 45cm 1 Absorbent Paper Towel 50cm x 50cm 1 Water repellent inner wrapper (opens out as a sterile working field) Vapour - Permeable Adhesive Film Dressing with absorbent pad (Syn: Semi-Permeable Adhesive Dressing) Hydrofilm Plus 5cm x 7.2cm 17 18 3

GAUZES Absorbent Cotton Gauze Type 13 Light BP (Sterile) 90cm x 1m 113 114 90cm x 3m 236 238 90cm x 5m 368 371 90cm x 10m 705 710 25m (Not sterilised) 1615 1626 Absorbent Cotton and Viscose Ribbon Gauze BP 2.5cm x 5m 94 95 GAUZE AND COTTON TISSUE BP (Gamgee-Blue Label) 500g 734 739 GAUZE AND COTTON TISSUE (Gamgee-Pink Label) 500g 536 540 LINTS Absorbent Lint BPC 73 100g 287 289 500g 1206 1214 LYMPHOEDEMA GARMENTS Juxta-Fit Style Length Sizes Price(p) (per piece) Armsleeve (Right, Left) Standard, Long 1,2,3,4,5,6 17205 17317 Hand Wrap (Right, Left) XS,S,M,L,XL 2370 2385 Lower Legging 28cm S,M,L,XL,XXL 13278 13364 36cm S,M,L,XL,XXL 13278 13364 Lower Legging Extra Wide 28cm M,L,XL 12867 12951 Calf 36cm M,L,XL 12867 12951 Ankle Foot Wrap, Interlocking S,M,L 3718 3742 Ankle Foot Wrap, Closed Heel S,M,L 3718 3742 Juxta-Fit Essentials (per piece) Upper Leg with Knee Piece (Right, Left) 45cm XS,S,M,L,XL 14051 14142 55cm XS,S,M,L,XL 14051 14142 (per pair) Full Leg Liner Sock 1718 1730 4

LYMPHOEDEMA GARMENTS cont. Mediven Active Sizes Class 1 (18-21mm Hg) (Per pair) Below Knee Closed Toe I VII 2789 2807 Below Knee Closed Toe Petite I VII 2789 2807 Class 2 (23-32mmHg) (Per pair) Below Knee Closed Toe I VII 2820 2838 Below Knee Closed Toe Petite I VII 2820 2838 Mediven 95 Whitaker Pouch II IV 3467 3490 Mediven for men Class 1 (18-21mmHg) (Per pair) Below Knee Closed Toe I Vil 2792 2810 Below Knee Closed Toe Petite I Vil 2792 2810 Class 2 (23-32mm Hg) (per pair) Below Knee Closed Toe I Vil 2824 2842 Below Knee Closed Toe Petite I Vil 2824 2842 Mediven Elegance Sizes Class 1 (18-21mm Hg) (Per pair) Below Knee Closed Toe I VII 2813 2831 Below Knee Closed Toe Petite I VII 2813 2831 Thigh Length with Top Band Closed Toe I VII 5404 5439 Thigh Length Petite Top Band Closed Toe I VII 5040 5073 Thigh Length Extra Wide Closed Toe Top Band I VII 5404 5439 Thigh Length Extra Wide Petite Closed Toe Top I VII Band 5040 5073 Tights Closed Toe I VII 5477 5513 Tights Closed Toe Petite I VII 5477 5513 Class 2 (23-32mm Hg) (Per pair) Below Knee Closed Toe I VII 2813 2831 Below Knee Closed Toe Petite I VII 2813 2831 Thigh Length with Top Band Closed Toe I VII 5404 5439 Thigh Length Petite Top Band Closed Toe I VII 5040 5073 Thigh Length Extra Wide Closed Toe Top Band I VII 5404 5439 Thigh Length Extra Wide Petite Closed Toe Top I VII Band 5040 5073 Tights Closed Toe I VII 5477 5513 Tights Closed Toe Petite I VII 5477 5513 5

LYMPHOEDEMA GARMENTS cont. Mediven Harmony Class 1 (15-21mmHg) (per piece) Armsleeve I VIII 1479 1489 Armsleeve Extra Wide I VIII 1479 1489 Armsleeve with Grip Top I VIII 1971 1984 Armsleeve with Grip Top Extra Wide I VIII 1971 1984 Combined Armsleeve I VIII 2683 2700 Combined Armsleeve Extra Wide I VIII 2683 2700 Combined Armsleeve with Grip Top I VIII 3176 3197 Combined Armsleeve with Grip Top Extra Wide I VIII 3176 3197 Glove II VII 4141 4168 Class 2 (23-32mmHg) Armsleeve I VIII 1588 1598 Armsleeve Extra Wide I VIII 1588 1598 Armsleeve with Grip Top I VIII 2081 2095 Armsleeve with Grip Top Extra Wide I VIII 2081 2095 Combined Armsleeve I VIII 2793 2811 Combined Armsleeve Extra Wide I VIII 2793 2811 Combined Armsleeve with Grip Top I VIII 3286 3307 Combined Armsleeve with Grip Top Extra Wide I VIII 3286 3307 Glove II VII 4360 4388 Mediven Mondi MTM Order No. Class 1 (18-21mm Hg) Per Piece Below Knee DTMK1 3338 3360 Thigh Length DTMT1 3887 3912 Thigh Length with Waist Attachment DTMW1 5483 5519 Class 2 (23-32mm Hg) Below Knee DTMK2 3496 3519 Thigh Length DTMT2 4292 4320 Thigh Length with Waist Attachment DTMW2 5893 5932 Class 3 (34-46mm Hg) Below Knee DTMK3 3917 3943 Thigh Length DTMT3 4829 4860 Thigh Length with Waist Attachment DTMW3 6047 6086 NB: The above garments are available with optional extras. These are priced separately. See below Closed Toe DTTOE 102 103 Silicone Topband DTTB 778 783 Zip DTZIP 2155 2169 6

LYMPHOEDEMA GARMENTS cont. Mediven Plus Sizes Class 1 (18-21mm Hg) (per pair) Below Knee Open Toe I VII 2833 2852 Below Knee Open Toe Petite I VII 2833 2852 Below Knee Open Toe Extra Wide I VII 3233 3254 Below Knee Open Toe Petite Extra Wide I VII 3233 3254 Thigh Length Petite Silicone Top Open Toe I VII 5078 5111 Thigh Length Silicone Top Open Toe I VII 5444 5480 Thigh Length Extra Wide Open Toe Silicone Top I VII 5424 5459 Thigh Length Extra Wide Petite Open Toe Silicone Top I VII 5059 5092 (price each) Thigh Length Waist Attachment Right Open Toe I VII 2845 2863 Thigh Length Petite Waist Attachment Right Open Toe I VII 2845 2863 Thigh Length Waist Attachment Left Open Toe I VII 2845 2863 Thigh Length Petite Waist Attachment Left Open Toe I VII 2845 2863 Class 2 (23-32mm Hg) Below Knee Open Toe I VII 2833 2852 Below Knee Open Toe Petite I VII 2833 2852 Below Knee Open Toe Extra Wide I VII 3233 3254 Below Knee Open Toe Petite Extra Wide I VII 3233 3254 Thigh Length Petite Silicone Top Open Toe I VII 5078 5111 Thigh Length Silicone Top Open Toe I VII 5444 5480 Thigh Length Extra Wide Open Toe Silicone Top I VII 5424 5459 Thigh Length Extra Wide Petite Open Toe Silicone Top I VII 5059 5092 (price each) Thigh Length Waist Attachment Right Open Toe I VII 2845 2863 Thigh Length Petite Waist Attachment Right Open Toe I VII 2845 2863 Thigh Length Waist Attachment Left Open Toe I VII 2845 2863 Thigh Length Petite Waist Attachment Left Open Toe I VII 2845 2863 Class 3 (34-46mm Hg) (per pair) Below Knee Open Toe I VII 3111 3131 Below Knee Open Toe Petite I VII 3111 3131 Below Knee Open Toe Extra Wide I VII 3533 3556 Thigh Length Petite Silicone Top Open Toe I VII 5667 5704 Thigh Length Silicone Top Open Toe I VII 5667 5704 Thigh Length Extra Wide Open Toe Silicone Top I VII 5646 5683 Thigh Length Extra Wide Petite Open Toe Silicone Top I VII 5646 5683 (price each) Thigh Length Waist Attachment Right Open Toe I VII 3131 3151 Thigh Length Petite Waist Attachment Right Open Toe I VII 3131 3151 Thigh Length Waist Attachment Left Open Toe I VII 3131 3151 Thigh Length Petite Waist Attachment Left Open Toe I VII 3131 3151 7

PLASTERS Nx Belladonna Adhesive Plaster BP Medium 19cm x 12.5cm 146 147 Large 28cm x 17.5cm 254 255 STOCKINETTE Cotton Stockinette Bleached BP Synonym: Cotton Stockinette) Heavyweight 10cm x 6m 488 491 SURGICAL ADHESIVE TAPES Plasters Impermeable Plastic Adhesive Tape BP (Waterproof Strapping) Sleek 2.5cm x 3m 142 143 2.5cm x 5m 212 214 5cm x 5m 269 271 7.5cm x 5m 392 394 Zinc Oxide Adhesive Tape BP 1988 1.25cm x 5m 101 102 2.5cm x 5m 147 148 5cm x 5m 249 250 7.5cm x 5m 374 376 SWABS Filmated Gauze Swab 10 cm sq Pack of 100 384 386 Non-Sterile Pads of 8-ply gauze 10 cm sq. Pack of 100 143 144 Non-Woven Fabric Swabs Filmated Non-Woven Fabric Swab Non Sterile 10 cm x 10 cm Pack of 100 378 381 8

VENOUS ULCER COMPRESSION SYSTEM Per Pack Juxta CURES Compression System 15150 15248 (Medi UK Ltd) (Pack contains Juxta CURES, 2 standard anklets and 2 liners) Short, Standard, Long Comfort Leg Liner 1319 1327 (Pack contains 2 liners) Comfort Compression Anklet 1116 1123 (Pack contains 2 anklets) Mediven Ulcer Kit (Medi UK Ltd) Medical stocking & compression liner (pack contains one over stocking and 2 liners) Size Standard Length Kit i, ii, iii, iv, v, vi, vii 3205 3226 Petite Length Kit i, ii, iii, iv, v, vi, vii 3205 3226 Liner Pack (pack contains 2 liners) i, ii, iii, iv, v, vi, vii 1718 1729 WOUND MANAGEMENT DRESSINGS Protease Modulating Matrix Sterile Indications: All chronic wounds clear of necrotic tissue and visible sign of infection. Durafiber Square 5cm x 5cm 90 91 10cm x 10cm 215 217 15cm x15cm 405 408 Rectangular 2cm x 45cm 218 219 4cm x 10cm 116 117 4cm x 20cm 170 171 4cm x 30cm 256 257 ELECT Superabsorber Square 10cm x 10cm 94 95 20cm x 20cm 199 200 Rectangular 10cm x 20cm 111 112 20cm x 30cm 250 252 9

WOUND MANAGEMENT DRESSINGS (contd.) Topical Negative Pressure System Accessories Avance Round Drain 981 987 Avance Transparent Film 614 618 Avance Y Quick Connector 274 275 Wound Dressing Pack Avance Dressing Kit Foam with ViewPad Small 1961 1974 Medium 2271 2286 Large 2684 2701 Foam with Mepitel & Small 2247 2262 ViewPad Medium 2887 2906 Large 3916 3942 Gauze with ViewPad Small 1600 1610 Medium 2013 2026 Large 2581 2597 Wound Drainage Collection Device Avance Canister & Tubing Kit Canister with Solidifier 300ml 1961 1974 800ml 2581 2597 The following price changes apply to Part 3 Appliances ARM SLINGS Web, adjustable 202 203 CATHETERS Gauge (Ch) Price (see Note 1) (p) (A) ii Nelaton Catheters ( ordinary cylindrical catheter) single use SpeediCath Compact Plus Female 28810-28814 10-14 4795 4826 P220 Wellspect HealthCare Lofric Per 25 (Non-PVC) Per 30 (Male) 4000825-4002225 8-22 4074 4101 (Female 15cm) 4040825-4041425 8-14 4183 4211 (Female 20cm) 4030825-4031825 8-18 4183 4211 (Paediatric 20cm) 4010625 6 4183 4211 (Paediatric 30cm) 4020825-4021825 8-10 4183 4211 10

CATHETERS cont. Gauge (Ch) Price (see Note 1) (p) (A) ii Nelaton Catheters ( ordinary cylindrical catheter) single use Wellspect HealthCare Lofric Primo with integrated water pocket Per 30 Non-PVC (Female 15cm) 4140825-4141425 8-14 4662 4693 (Female 20cm) 4130825-4131825 8-18 4662 4693 (Paediatric) 4110625 4111025 6-10 4662 4693 Wellspect HealthCare Lofric Sense Per 30 (Female 15cm) 4160825-4161425 8-14 4662 4693 Wellspect HealthCare LoFric Hydro-Kit Per 20 Female 4230825-4231825 8-18 3853 3878 Paediatric 4210825-4211025 8-10 3853 3878 HYPODERMIC EQUIPMENT HYPODERMIC NEEDLES Specification 2B(ii) The needles shall be of length not less than 12mm and the following diameters may be supplied: Pack size 0.5mm(25g), 0.45mm(26g) and 0.4mm(27g) 100 292 294 For order on GP10 & GP10 (N) only. U100 Insulin Syringes with needle sterile, single use (disposable) Sterile: intended for single use only for the injection of U100 insulin. NB. Intended for use immediately after filling, and not for containing insulin over extended periods of time. Each scale graduation represents one unit on the 0.3ml and 0.5ml syringes and two units on the 1.0ml syringe. The graduations on the syringes are clearly numbered at every 5 units on the 0.3ml and 0.5ml syringes and at every 10 units on the 1.0ml syringe. Where no indication on prescription 0.5ml should be dispensed unless the dosage of insulin indicates otherwise Needles not less than 12mm long shall have needle diameters as follows: 0.45mm(26G), 0.4mm(27G), 0.36mm(28G), 0.33mm(29G) and 0.3mm (30G) Per 10 Size 0.5ml syringe with needle 153 154 1ml syringe with needle 154 155 Needles 8mm long shall have needle diameters as follows: 0.33mm (29G) & 0.3mm (30G) Size 0.3ml syringe and needle 147 148 0.5ml syringe and needle 142 143 1.0ml syringe and needle 141 142 11

HYPODERMIC EQUIPMENT cont. Accessories Needle Clipping (Chopping) Device- for use with single use syringe. Consisting of a clipper to remove the needle from its hub, and incorporating a suitable receptacle from which the cut-off needles cannot be retrieved. Sufficiently robust to accommodate needles of diameter 0.45mm (26g) or finer & length: 16mm or shorter. Not generally suitable for use with lancets. Designed to hold approximately 1,200 such needles 143 144 1 Nx LATEX FOAM, ADHESIVE * 2 Specification 19 Raised cotton backed 22.5cm x 45cm x 7mm Pack of 4 1945 1986 ORAL FILM FORMING AGENTS Gelclair 21 x 15ml sachets 3305 3326 PESSARIES Ring Polythene - Specification 3 (ii) 7.5mm thick 50mm to 80mm (rising in 3mm) 206 207 85mm to 100mm (rising in 5mm) 206 207 110mm 206 207 PVC - Specification 3 (iii) 1.25cm thick 50mm to 80mm (rising in 3mm) 223 224 85mm to 100mm (rising in 5mm) 223 224 110mm 223 224 SYRINGES Bladder, Irrigating Polypropylene with catheter nozzle. Graduated from 0 to 100ml in 5ml, the graduation marked clearly numbered in multiples of 10. 100ml 454 457 1 The items within Part 3, which are NOT prescribable by nurses on forms GP10 (N) are annotated Nx. See Part 8b for details on Nurse Prescribing. 2 Items marked * are for order on GP10A only 12

TRUSSES NB Before the prescription can be dispensed the following details must be given by the prescriber: - (i) Single, or double, and the side, if single Price (p) (ii) Position e.g. Inguinal Scrotal (iii) Type e.g. Spring Truss Elastic Band Truss Spring Truss Specification 31(a) Spring Trusses shall conform to the British Standard 2930:1970 for Surgical Spring Trusses Inguinal Single Left or Right 3370 3392 Double 4702 4733 Inguinal Rat-tail Single Left or Right 4149 4176 Double 6201 6242 Femoral Single Left or Right 3723 3747 Double 5759 5796 Scrotal Single Left or Right 4149 4176 Double 6201 6242 Inguinal/Scrotal Double 5963 6002 Back Pads, fixed or sliding (if ordered). Extra 956 963 Slotted, polished, Spring Ends (if ordered) Single Extra 486 489 Double Extra 979 986 $ Special Trusses Specification 31(b) Single Extra 1074 1081 Double Extra 2119 2132 Replacement and Repairs - Understrap for inguinal or femoral trusses, as above 295 297 Elastic Band Truss - Specification 13 Elastic Band Trusses shall conform to the British Standard 3271:1970 for Surgical Elastic Band Trusses Inguinal Single Left or Right 2289 2304 Double 3812 3837 Scrotal Single Left or Right 2382 2398 Double 3880 3905 Umbilical single belt Left or Right 2598 2615 Umbilical double belt where specified by prescriber 3538 3561 $ Special Trusses Specification 13 Single Extra 673 677 Double Extra 975 981 $ Requirement for a "special" truss should normally be confirmed by the prescriber 13

The following price changes apply to Part 4 Elastic Hosiery Description of Articles Available Price Per Pair In Pence Compression Class Type of Garment Stock Sized Garments Made-to-measure Garments Knit Style I Circular Thigh 811 816 4291 4319 B. Knee 741 745 2684 2702 Light Wt Thigh 2171 2185 Elastic Net B. Knee 1695 1706 II Circular Thigh 1205 1213 4291 4319 B. Knee 1083 1090 2684 2702 Net Thigh 2171 2185 B. Knee 1695 1706 Flat Bed Thigh 4291 4319 B. Knee 2684 2702 III Circular Thigh 1428 1437 4291 4319 B. Knee 1228 1236 2684 2702 Flatbed Thigh 4291 4319 B. Knee 2684 2702 Accessories Price Per Item in Pence Additional Price for Fitted Suspender 70 71 Mediven 2 in 1 1251 1259 Spare Suspender for thigh stockings 70 71 Suspender Belt 540 544 14

Description of Articles Available Price Per Pair In Pence Compression Class Type of Garment Standard Stock Sized Garments Made-to-measure Garments Knit Style CII Circular Anklet 710 714 710 714 Kneecap 710 714 Flat Bed Anklet 1474 1484 1571 1582 Kneecap 1474 1484 1571 1582 Net Anklet 1395 1404 Kneecap 1159 1166 CIII Circular Anklet 990 996 990 996 Kneecap 946 952 946 952 Flat Bed Anklet 990 996 1571 1582 Kneecap 946 952 1571 1582 15

Stoma Appliances- Reimbursement Prices: Amendment sheets for June 2015 Information Services Gyle Square 1 South Gyle Crescent EDINBURGH EH12 9EB Telephone : 0131 275 6972 Fax : 0131 275 7606 www.isdscotland.org MONTHLY NOTICE OF AMENDMENTS TO STOMA APPLIANCES June 2015 This document is prepared by the evadis Team, Healthcare Information Group, Information Services Division. Enquiries to: NSS.evadis@nhs.net The following amendments to Stoma Appliances take effect from 1 st June 2015. Please note that potential additions to Stoma Appliances Reimbursement prices must be referred through National Procurement (NSS). The full list of Stoma Appliances Reimbursement prices is available at: http://www.isdscotland.org/health-topics/prescribing-and-medicines/stoma-supplies ADDITIONS COLOSTOMY BAGS Order Qty Price Manufacturer Appliance No (p) Convatec Ltd. Esteem+ Closed End Pouch Standard clear Mould to fit 20-30mm 413509 30 8550 30-40mm 413510 30 8550 ILEOSTOMY BAGS Order Qty Price Manufacturer Appliance No (p) Convatec Ltd. Esteem+ Drainable Pouch with ConvaTec Mouldable Technology and InvisiClose outlet Standard clear with filter Mould to fit 20-30mm 413515 10 3278 30-40mm 413516 10 3278 Standard clear without filter Mould to fit 20-30mm 413518 10 3120 30-40mm 413519 10 3120 Standard opaque with filter Mould to fit 20-30mm 413521 10 3278 30-40mm 413522 10 3278 1

Stoma Appliances- Reimbursement Prices: Amendment sheets for June 2015 SKIN PROTECTORS Order Qty Price Manufacturer Appliance No (p) Convatec Ltd. Stomahesive Seal 48mm x 4mm 413503 10 1881 48mm x 3mm 413504 10 1845 98mm x 3mm 413505 10 2512 TWO PIECE OSTOMY SYSTEMS Order Qty Price Manufacturer Appliance No (p) Convatec Ltd. Natura Accordion Flange, Durahesive 13-22mm (for 57mm pouches) 421036 5 1495 22-33mm (for 57mm pouches) 421037 5 1495 33-45mm (for 70mm pouches) 421038 5 1495 2