Generics Costing More Than Tariff, and Concessions
Every month, some generics cost you more to buy than the NHS pays you back. Here is how to stop those scripts losing money, explained step by step.
The problem, in one picture
Think of the Drug Tariff as a menu where someone else sets the prices. Whatever you pay your wholesaler for the ingredients, the NHS pays you the menu price. Most of the time the menu price covers your costs. But for over 100 generics every month, the wholesale price climbs above the menu price, and every pack you dispense loses money.
During the month, NHSBSA Prescription Services also publishes concession prices for selected products. A concession replaces the tariff price for that month only. So wherever this page says “tariff price”, read “tariff or concession price”.
Try it: Apixaban 5mg tablets, pack of 56. The Drug Tariff pays a fixed £1.02, but the best wholesale price climbed to £2.52 (a real example from the June 2026 Dispex table). Drag the slider to change what your supplier charges you.
The fix: name what you were actually supplied
The Drug Tariff is not the only menu. The dm+d lists a reimbursement price for each manufacturer’s version of a generic. If you cannot obtain a generic at or below the tariff price, the dispenser can change the script to the brand or generic manufacturer actually supplied, and the doctor initials the change. You are then reimbursed that manufacturer’s dm+d price instead.
Try the five situations below and watch the script change. In every case you have been charged £1.19 for a pack of Sertraline 100mg, against a tariff price of £1.08 (the classic Dispex teaching example, June 2019 prices).
You paid £1.19 but the NHS reimburses the tariff price of £1.08. You lose 11p on every pack, and more once clawback is deducted.
⚠ Do not game the system
Sertraline TEVA is reimbursed at £28.00. Deliberately ordering TEVA so you can name it on the script is gaming, and gaming is illegal. The same applies to changing a script when you actually obtained the generic below the tariff price.
If your supplier happens to send you TEVA in the normal course of business, that is different: change the script to Sertraline TEVA, have the change initialled, and you will be reimbursed accordingly. The rule is simple: only ever name the product you were genuinely supplied.
The golden rule: this method only applies when you are supplied blind. You order your products generically and the wholesaler sends whichever generic they have in stock. What arrives in the tote is chance, and the method simply makes sure you are reimbursed fairly for it.
What should I do with this script?
Answer two questions and get the action for the script in front of you.
Short cut: the monthly Dispex table in the next step gives you this answer ready-made, for every affected generic and every manufacturer you might be sent.
Let the monthly table do the work
You do not need to look up the dm+d for every product yourself. At the beginning of each month Dispex publishes the full pricing table for members: generics currently costing more than tariff, every brand and manufacturer you might be supplied, the loss if you leave the script unchanged, and the exact action to take. A downloadable copy sits on the same page.
Click or tap a row to see what the advice means. These are real example rows from the June 2026 table, shown exactly as they appear in the tool: the colour of each row is the advice.
| Product Name | Tariff | Best Price | Loss without Changing | Brand Name | Advice |
|---|---|---|---|---|---|
| Apixaban 5mg tablets 56 tablet | 1.02 | 2.52 | -1.50 | No Price/Not Listed | Change & Endorse Best Price |
| Apixaban 5mg tablets 56 tablet | 1.02 | 2.52 | -1.50 | Apixaban 5mg tablets (Sandoz Ltd) 56 tablet | Change (no endorsement) |
| Apixaban 5mg tablets 56 tablet | 1.02 | 2.52 | -1.50 | Eliquis 5mg tablets (Bristol-Myers Squibb Pharmaceuticals Ltd) 56 tablet | Change (no endorsement) |
| Amlodipine 10mg tablets 28 tablet | 0.59 | 0.66 | -0.07 | Amlodipine 10mg tablets (Almus Pharmaceuticals Ltd) 28 tablet | Do not change |
Click any row above. Green rows mean change the script, amber rows mean change and endorse, pink rows mean leave the script alone.
⚠ Timing matters: wait until the end of the month before changing scripts. Concession prices can be announced at any point during the month, and the concession price has to be taken into account first. If a concession price turns out to be higher than the manufacturer’s price you have added to the main body of the script, you will lose out on reimbursement at that higher price.
Quick reference
Do nothing when
- You can obtain the generic at or below the tariff or concession price.
- The supplied manufacturer’s dm+d price is lower than the tariff price. Naming it would only cut your reimbursement.
Take action when you paid more than tariff
- Always: change the script to the brand or generic manufacturer supplied, and the doctor initials the change.
- Manufacturer in the dm+d with a price above tariff: nothing more needed. You are reimbursed the dm+d price.
- Manufacturer in the dm+d but with no price: also endorse the price you paid in the left hand endorsement column.
- Manufacturer not in the dm+d at all: also endorse the price you paid and the supplier in the left hand column.
| Situation | Action |
|---|---|
| Purchase price above tariff, manufacturer priced in dm+d above tariff | Change to brand or generic manufacturer supplied, initial the change |
| Manufacturer listed in dm+d, but no price shown | Change and initial, and endorse the price paid in the left hand endorsement column (or the script will be returned) |
| Manufacturer not listed in dm+d | Change and initial, and endorse the price paid and the supplier in the left hand column |
| Manufacturer’s dm+d price below tariff | Leave the script alone and take the tariff price |
Worked examples use the Dispex table data of 1st June 2026 (Apixaban, Amlodipine) and the classic Sertraline teaching example (June 2019 prices), for illustration only. Always check the current Drug Tariff, the monthly concession list, the dm+d browser and this month’s Dispex table before changing a script. Pricing data is taken from the dm+d browser, e-CASS and the mainline wholesaler discounts we have been able to verify. Need help? Reach out to the team.
