The out of pocket expenses endorsement lets pharmacy contractors and GP practices claim for extra costs they’ve received when finding certain:
- Drugs
- Appliances
- Chemical Reagents
This would be in exceptional circumstances and for items not regularly supplied by your pharmacy or practice.
It can also be where expenses have been incurred in obtaining oxygen from a manufacturer, wholesaler or supplier for supply against a prescription.
What can be claimed as out of pocket expenses
Out of pocket expenses of 51p or above can be claimed.
The costs incurred finding specific items can be claimed. This includes:
- postage and packaging
- handling
- cost of phone calls to manufacturers or suppliers to order products
Items eligible for out of pocket expenses
The out of pocket expenses clause only applies to:
- Part VIIIA Category C
- Readily available medicinal products outside of Part VIIIA, including ACBS
- Part IXB
- Part IXC
If a prescription is written for a specific brand, or a manufacturer has been specified on the main body, out of pocket expenses can be claimed.
Items not eligible for out of pocket expenses
Out of pocket expenses cannot be claimed on:
- Part VIIIA drugs which are category A or M
- Part IXA and IXR appliances
- Part VIIIB and Part VIIID
- All other unlicensed specials and imports
Claiming out of pocket expenses
To claim out of pocket expenses, the prescribed item must be endorsed with:
- ‘OOP’ or ‘XP’
- details of the claim
- the total amount being claimed
Cefuroxime 5% preservative free eye drops
There's an additional fixed out of pocket expense payment of £50. This is automatically applied and you do not need to endorse any ‘XP’ or ‘OOP’.
This payment will be retrospectively applied to all claims for this item dispensed between the months of April 2023 to February 2024.
Other applicable fees will continue to be paid as normal.