A guide for dispensing practices

The Drug Tariff, explained — and why it never sits still.

The Tariff is the rulebook for what the NHS pays your dispensary back. Understanding its categories — and the reforms now reshaping them — is the difference between assuming you made margin and knowing it.

§ 01

What the Drug Tariff actually is

The Drug Tariff is published every month by the NHS Business Services Authority on behalf of the Department of Health and Social Care. It sets out what dispensing contractors — pharmacies and dispensing practices — are reimbursed for the medicines they dispense, plus the fees and allowances they're paid for dispensing them.

For dispensing practices the part that moves the money is Part VIIIA: the basic reimbursement prices for the generic medicines that make up the bulk of what you dispense. Each line sits in a category, and the category decides how its price is set — and how often it changes.

§ 02

Part VIIIA: the four categories

Three long-standing categories — A, C and M — and, from March 2026, a fourth: Category H. Each is priced on a different basis and a different clock.

Category A

How it's priced

A weighted average of list prices from the main suppliers (AAH and Alliance weighted more heavily than Teva and Accord). Historically reset monthly; since 2024 reforms it is moving onto a quarterly, sales-data-based footing.

Cycle · quarterly (reforming)
Category C

How it's priced

Reimbursed on the list price of a particular branded product or supplier. Used where a generic isn't readily available from multiple sources — so the price tracks one product rather than a market.

Cycle · as the listed source changes
Category M

How it's priced

Set from manufacturers' reported actual selling prices, then deliberately uplifted so the system delivers the agreed level of retained "margin" to dispensers. It is also the lever used to claw that margin back. Reset quarterly.

Cycle · quarterly
Category HNew · Mar 2026

How it's priced

A subset of multi-source Category C products moved into a new category. DHSC sets the price from suppliers' sales data, and it applies only where the drug is prescribed generically. Updated quarterly.

Cycle · quarterly
§ 03

The bits that turn reimbursement into margin

Knowing a line's Tariff price is only the start. Three further mechanisms decide whether you actually kept any of it.

ClawbackDeducted
A discount deduction — the "clawback" — is taken off reimbursement on a sliding scale, on the assumption you bought below Tariff. The more you're reimbursed, the higher the band. It quietly reduces what you actually receive on every line.
Dispensing feesAdded
A fee per item dispensed, paid on top of reimbursement, on its own schedule and revised in-year. For many practices the fee income is a material part of the contribution — and a cut to it (as in recent settlements) lands straight on the bottom line.
Price concessionsVolatile
When a product's market price spikes above its Tariff price — usually a supply problem — a concession price is granted for that month so dispensers aren't dispensing at a guaranteed loss. Concessions are issued month by month and frequently revised several times within the same month, which is why last month's numbers can't be trusted for this month.
The point

Reimbursement category, minus clawback, plus fees, against what you actually paid after rebates — resolved for the right week, for every line. Miss one moving part and the margin you think you made isn't the margin you kept.

§ 04

What's changing — and what to expect

Reimbursement is being steadily rebuilt around suppliers' real sales data. That means more accuracy for the NHS — and more frequent, harder-to-predict change for you.

March 2026 · live now

Category H arrives

The first multi-source products move from Category C into the new Category H, priced from sales data and updated quarterly (next change June 2026). Community Pharmacy England objected to the timing, warning it adds uncertainty to an already fragile supply chain — so expect early volatility as the list grows.

From 2024 · ongoing

Category A moves to quarterly, sales-based pricing

Category A reimbursement is transitioning from monthly supplier-list pricing to a quarterly basis driven by price-per-unit sales and volume data — smoothing some month-to-month noise but lagging the market by a quarter.

Direction of travel

More data-driven, more often

The common thread across Category M, the Category A reforms and now Category H is the same: prices set from real sales data, reviewed on quarterly cycles, with margin recovered more tightly. The net effect for a dispensary is less slack and more lines sitting close to the line between profit and loss — which is exactly where continuous, line-level monitoring earns its keep.

Don't assume the margin — see it, line by line.

RxMargin reconciles every dispensed line against the right category, the week's concessions and your real costs — then shows you what's recoverable.

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