A short, dated read on the Drug Tariff, contract and QOF changes that move a dispensing practice's income. This is general information, not advice. Confirm current figures against the primary source before acting.
DHSC has redetermined the August 2026 reimbursement prices for Rybelsus (semaglutide) 1.5mg, 4mg and 9mg tablets (30) from £78.48 to £120.00 a pack, after the list price rose on 5 August 2026. Reimbursement for any Rybelsus prescription dispensed in August 2026 is based on the new £120 list price, on both branded and generically written prescriptions, even though the August Drug Tariff still shows £78.48. Why it matters: These packs reimburse at £120 this month rather than the £78.48 printed in the August tariff, so reconcile August claims against the redetermined price.
DHSC has granted 165 price concessions for August 2026 across three updates, published on 14 August (56 lines), 18 August (118 lines) and 19 August (165 lines). The third update included apixaban 2.5mg tablets (60) at £2.20, aspirin 75mg dispersible tablets (100) at £9.86, lofepramine 70mg tablets (56) at £27.49 and prochlorperazine 3mg buccal tablets (50) at £28.08. Community Pharmacy England noted that applications for further medicines were still with the Department. Why it matters: A concession lifts reimbursement above base tariff only for the month it is granted, so August margin on these lines depends on buying below the concession price.
Community Pharmacy England updated its medicine supply notification for quetiapine on 13 August 2026: supply constraints affect quetiapine 50mg, 150mg, 200mg, 300mg and 400mg modified-release tablets. Immediate-release quetiapine tablets remain available, and unlicensed imports can be sourced from specialist suppliers where immediate-release is unsuitable. Why it matters: Constrained lines usually trade at or above tariff, so check the buying price on these strengths before dispensing at the listed reimbursement.
Eight products move from Part VIIIA Category C to Category H in the September 2026 Drug Tariff: alfuzosin 10mg modified-release tablets (30), diclofenac 100mg suppositories (10), felodipine 2.5mg, 5mg and 10mg modified-release tablets (28), fluticasone furoate 27.5micrograms/dose nasal spray (120 doses), nicotine 7mg/24hours transdermal patches (7) and sodium fluoride 0.05% mouthwash sugar free (250ml). That takes the total number of products in Category H to 19. The prices appear in the September 2026 Drug Tariff, available to view three working days before the end of August. Why it matters: Reimbursement on these eight lines moves onto a new pricing basis from 1 September, so re-check buying terms against the September tariff when it publishes.
As at 6 August 2026 the Serious Shortage Protocols in force were SSP087 for ramipril 1.25mg capsules, running to 30 October 2026, SSP079 to SSP082 for Estradot 25, 50, 75 and 100 microgram patches, and SSP060 and SSP061 for Creon 10000 and 25000 gastro-resistant capsules, all running to 2 October 2026. Why it matters: An SSP changes what may be supplied against a prescription, so check the protocol before substituting on any of these lines.
Eight price concessions agreed late in July 2026 rolled over into August under the DHSC late-request roll-over process: amiodarone 200mg tablets (28) at £5.00, bendroflumethiazide 2.5mg tablets (28) at £0.82, cyanocobalamin 50microgram tablets (50) at £5.95, enalapril 2.5mg tablets (28) at £5.51, flecainide 50mg tablets (60) at £2.21, haloperidol 5mg tablets (28) at £4.55, itraconazole 100mg capsules (15) at £9.30 and rivaroxaban 10mg tablets (30) at £2.00. Why it matters: These eight lines carried an uplifted reimbursement from the first day of August, so check stock you hold of them against the rolled-over price.
The sixth July update, published on 31 July 2026, took the total number of price concessions granted by DHSC for July 2026 to 212. Community Pharmacy England noted that applications for other medicines were still with the Department at that point, so the closing July figure may be higher. Why it matters: July claims reconcile against the final July concession list rather than base tariff, so confirm the closing figures before signing the month off.
From 1 August 2026 Part VIIIA Category C gained semaglutide 1.5mg, 4mg and 9mg tablets (Rybelsus), semaglutide 2mg/0.74ml solution for injection (Ozempic), rosuvastatin 5mg and 10mg orodispersible tablets (Enebium) and azelaic acid 20% cream 50g (Skinoren). Sodium valproate 1g modified-release granules sachets were repriced from £30.00 to £12.30 on a reference product change to Episenta. Azelaic acid 20% cream 30g and ciclesonide 160micrograms inhaler (60 dose) were deleted. Why it matters: A newly listed Part VIIIA line reimburses at the tariff price from 1 August, so check buying terms on these products against the new listing.
Semaglutide 1.5mg, 4mg and 9mg tablets (Rybelsus) and semaglutide 2mg/0.74ml solution for injection (Ozempic) carry the discount not deducted and out of pocket flags in the August 2026 Drug Tariff. Budesonide 4mg suppositories (Budenofalk) and posaconazole 40mg/ml oral suspension (Noxafil) kept their discount not deducted status through reference product changes. Why it matters: These are high-value lines newly flagged in the tariff, so check how your dispensing statement treats them before volume builds.
Seventeen Part IX appliances are flagged for deletion from the September 2026 Drug Tariff on Community Pharmacy England's Appliance Watch notice of deletion list, updated 29 July 2026. NHSBSA issues a three-month period of notice before an appliance is deleted from Part IX. Why it matters: A line coming off Part IX needs a substitute agreed before the September tariff takes effect, so review the notice list against what you stock.
The final June update, published on 2 July 2026, took the total number of price concessions granted by DHSC for June 2026 to 257. It included mirtazapine 15mg, 30mg and 45mg orodispersible tablets (30) at £2.34, £2.40 and £2.25. Why it matters: The final figure is the one June claims reconcile against, and it closed above the 254 lines reported in the fourth update.
The Category M prices that took effect on 1 July 2026 reflect adjustments for underlying market price movements during January to March 2026, plus an upwards adjustment to medicine margin of £24.3 million per quarter in light of the Medicines Margin Survey covering October to December 2025. Category M is repriced quarterly, so these prices stand until the next quarterly reset. Why it matters: Reimbursement on a large number of generic lines was set by this reprice and does not move again until the next quarterly reset, so buying terms are where margin is won in between.
NHSBSA states that the July 2026 Category M adjustment is made in accordance with the Community Pharmacy Contractual Framework for 2026/27, with the aim of delivering £1.1 billion in medicine margin during the financial year 2026/27. Why it matters: Medicine margin is delivered through Drug Tariff prices, so the annual target shapes how generously Category M and concession prices are set across the year.
Under the 2026/27 framework, previous over-delivery of £219 million up to the end of Quarter 2 of 2025/26 (30 September 2025) has been written off, and a further write-off of up to £73 million will be applied to Quarters 3 and 4 of 2025/26 based on the results of the Medicine Margin Survey. NHSBSA states that no price adjustments will be made in 2026/27 to recover any remaining over-delivery from 2025/26 after those write-offs. Why it matters: Written-off over-delivery is not recovered through lower tariff prices, so it removes a downward pull on reimbursement across 2026/27.
Supply of rivastigmine 4.6mg/24hours and 9.5mg/24hours transdermal patches is limited until late September 2026, on a notification issued on 3 December 2025 and last updated on 4 June 2026. Alzest transdermal patches (Dr Reddy's Laboratories) have been discontinued in all strengths. Care is needed if switching between daily and twice weekly rivastigmine patches. Why it matters: Scarce stock usually trades at or above tariff, so check the buying price on these strengths before dispensing.
Annex G Part 2 of the General Medical Services Statement of Financial Entitlements Directions 2026 sets the dispensing feescale for contractors authorised or required to provide dispensing services. From 1 April 2026 it pays 231.1p per prescription up to 480 prescriptions, falling in bands to 204.8p at 4,805 and over. The count is calculated separately for each individual dispensing practitioner, not for the practice as a whole. Why it matters: A practice-level prescription count lands further down the scale than any single practitioner's count, so reading the practice total off the table understates the fee earned.
Annex G Part 1 of the General Medical Services Statement of Financial Entitlements Directions 2026 sets the discount scale for dispensing contractors in thirteen bands, from 3.17% on a monthly total basic price of £1 to £2,000 up to 11.18% at £24,001 and above. It is banded on the total basic price per month of the prescriptions submitted, not on an item count. It is a separate instrument from the Drug Tariff Part V deduction scale, which applies to pharmacy contractors. Why it matters: The deduction taken from a dispensing practice comes off this scale, so a percentage quoted from the pharmacy Part V table is the wrong figure for a practice.
The 2026 payment rate for newer medicines under the Voluntary Scheme for Branded Medicines Pricing and Access is 14.5%, down from a record 22.9% in 2025. Companies continue to pay between 10% and 35% on sales of each older branded medicine to the NHS. Why it matters: Branded reimbursement follows manufacturers' list prices, so the rate shapes how those list prices move through 2026.
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.
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.
A weighted average of list prices from a basket of leading suppliers. Historically reset monthly; under reform since 2024 towards a quarterly, sales-data-based footing.
Cycle · quarterly (under reform)Reimbursed at the price of a named manufacturer or supplier specified in the Drug Tariff, used where there is no listed Part VIIIA generic price. The price tracks that one product rather than a market.
Cycle · as the listed source changesSet 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 · quarterlyA separate Part VIIIA category with its own listed prices, covering specific products (such as certain biosimilars and specials) priced under Category H arrangements. DHSC sets the price from suppliers' sales data, and it applies only where the drug is prescribed generically. Updated quarterly.
Cycle · quarterlyKnowing a line's Tariff price is only the start. Three further mechanisms decide whether you actually kept any of it.
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 is not the margin you kept.
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.
The first products are listed under the new Category H, a separate Part VIIIA category 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.
Category A reimbursement is under reform from monthly supplier-list pricing towards a quarterly basis driven by price-per-unit sales and volume data, which would smooth some month-to-month noise but lag the market by a quarter.
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.
RxMargin's live dashboard tracks every concession the moment it is published, across the whole market, alongside live wholesaler prices and the Drug Tariff, so your practice never reimburses below cost. Open the live dashboard →
Those are the same market-wide figures every practice sees, free. Look up any drug without an account; the full toolkit is free with NHS sign-in. Questions about your own lines? Get in touch.
RxMargin reconciles every dispensed line against the right category, the week's concessions and your real costs, then shows you what is recoverable.