Original Pack Dispensing
Original Pack Dispensing (OPD) comes into effect for NHS dispensing in England on 1st January 2025.
Since October 2023, changes to the Human Medicines Regulations (HMRs) have allowed pharmacies to dispense up to 10% more or less than the quantity prescribed (OPD +/- 10% dispensing) for private prescriptions for POMs. Now, changes to NHS regulations allow the same for NHS prescriptions in England following consideration of suitability by the supervising pharmacist.
This will allow the flexibility to supply up to 10% more or less than the prescribed quantity, if that would mean the medicine could be dispensed in the manufacturer’s original pack, and other prescription requirements are fulfilled.
There is no obligation to use OPD +/- 10% dispensing and pharmacists will need to exercise their professional judgment to assess its suitability and the benefit to the individual patient, and it is not expected to be appropriate in all cases.
Examples of OPD being inappropriate are:
- Antibiotic courses
- Steroid courses
- Supplies in Monitored Dosage Systems
- Where there are concerns that the patient will otherwise not be able to follow the medicine regimen
- Prescriptions with additional information to restrict supply such as weekly supplies for vulnerable patients
OPD Reimbursement
Reimbursement for OPD +/- 10% dispensing will only apply to EPS prescriptions. The small percentage of FP10 paper prescriptions dispensed will continue to be reimbursed in line with current arrangements.
| Products that will be reimbursed for OPD +/- 10% dispensing | Products not included: |
| POMs | Special containers (including legal requirement to dispense valproate products in OPs) |
| Non-POMs (P, GSL, non-medicines including ACBS (Advisory Committee on Borderline Substances) products, food supplements, cosmetics, toiletries etc) | Unlicensed specials (Part VIIIB, Part VIIID and non-Tariff specials) |
| Schedule 5 Controlled Drugs (Sch 5 CDs) | Schedule 1-4 Controlled Drugs (Sch 1-4 CDs) |
| Part IXA, IXB, IXC and IXR Appliances | |
| Products supplied in accordance with Serious Shortage Protocols (SSPs) | |
| Products supplied in accordance with Patient Group Directions (PGDs) |
To avoid the need for any new endorsements for OPD, it was agreed that the NHS Business Services Authority will utilise the existing EPS dispensed quantity field within PMR systems to determine the correct payment. All other prescription endorsement requirements remain unchanged.
| Reimbursed for prescribed quantity | Reimbursed for dispensed quantity |
| If the dispensed quantity is the same as the prescribed quantity | If the dispensed quantity is up to 10% more than the prescribed quantity |
| If the dispensed quantity is more than 10% of the prescribed quantity | If the dispensed quantity is lower than the prescribed quantity |
OPD +/- 10% reimbursement examples
Product for dispensing - Lipitor 20mg chewable tablets available in pack sizes of 30 tablets Applying 10% rule to 28 = +/- 2.8 tablets (rounded up to 3) Can dispense either 28/30 or 1 x 30 |
Product to be dispensed – Nabumetone 500mg tablets (generic) available in pack sizes of 56 Applying 10% rule to 28 = +/- 2.8 tablets (rounded up to 3) OPD +/- 10% cannot be applied Can only dispense 28/56 |
Product for dispensing – Perindopril erbumine 4mg tablets available in pack sizes of 30 tablets Applying 10% rule to 56 = +/- 5.6 tablets (rounded up to 6) Can dispense either 56/30 or 2 x 30 |
Product to be dispensed – Co-codamol 8mg/500mg capsules available in packs sizes of 32 or 100 Applying 10% rule to 35 = +/- 3.5 capsules (rounded down to 3 as halfway) Can either dispense 35/32 or 35/100 or 1 x 32 |
Additional reimbursements
- Where an original pack is supplied following +/-10% OPD rules, pharmacies will no longer receive the 10p container allowance but will continue to be paid for non-OPD supplies i.e. requiring supply of split packs.
- For non-OPD supplies, Broken Bulk claims can continue to be made to claim payment for a complete pack of an eligible product where only a part-pack has been dispensed.
- If the +/-10% OPD rules has correctly been applied to supply a complete pack of an eligible product, any monthly price concessions granted will apply to the dispensed quantity
Advice for Pharmacy Teams
- Confirm when your PMR system will be enabled for OPD provision. Pharmacy teams can decide to opt out of OPD until the clinical support software is updated by PMR provider.
- Brief all dispensing staff on the OPD +/- 10% rules to include an understanding of inclusions and exceptions and develop an action plan for implementation.
- You do not have to confirm with the prescriber when choosing to use the +/- 10% rules during dispensing.
- Remember there is no obligation to use OPD dispensing if a patient requests the exact amount on the prescription.
Other resources from CPE: