Reimbursement of INR self-monitoring devices (coagulometers) and disposable test strips:
1. Do I have to pay for the disposable test strips?
The disposable test strips are available on NHS prescription and can be prescribed by your GP. If you pay for your NHS prescriptions, you will have to pay the standard NHS prescription charge (currently, £8.05 per item). However, if you do not pay for your prescriptions, or have a current valid exemption certificate, you will not have to pay for the strips. The test strips have been available on prescription since 2002.
2. What is the legal basis for making the strips available on prescription? A number of blood testing strips are available for prescription under Part IXR of the Drug Tariff for the England and Wales, which is compiled on behalf of the Department of Health by the NHS Business Services Authority, NHS Prescription Services.
In the current (June 2014) version of the Drug Tariff, test strips for the following three meters are available on NHS prescription: Alere INRatio, Coaguchek XS PT and ProTime 3 cuvettes.1,2
3. My GP is refusing to give me a prescription for the strips. Can he or she do this?
Yes. The decision whether or not to prescribe the strips rests with the treating clinician following agreement with the patient as to the most appropriate monitoring method for them. This means that some GPs will be happy to prescribe the strips, particularly if they support you self-monitoring your INR levels, but others will not. Although this may seem very unfair, it is not illegal.
Some GPs might also be acting on instructions not to prescribe from their local Clinical Commissioning Group (CCG) – see question 4 below.
4. My GP has told me that he cannot prescribe the strips because it is no longer allowed. Is this correct?
No. The Drug Tariff make it clear that the disposable test strips can be prescribed on NHS prescription at the discretion of the GP.
However, each CCG is permitted to introduce whatever policy on self-monitoring it sees fit. We are aware that some CCGs are refusing to meet the cost of the strips, either for financial reasons, or because they do not support self-monitoring.
Unfortunately, this is a matter for each CCG to decide. Although this may seem very unfair, it is not illegal.