Installment prescriptions

 

In England, supplies for opioid substitutes are given via installments on an FP10MDA. A maximum of 14 days supply can be written on the prescription.

 

The prescription is usually kept within the pharmacy so that the installments can be supplied. Standard prescription requirements apply, but the amount supplied and each installent and the time interval between installments must be specified. The first installment must be dispensed within 28 days of the date on the prescription.

 

The prescription must be marked with the date that each installment was dispensed and records for controlled drugs supply kept for 2 years after the last supply of an installment.

 

Installments should be dispensed on the date specified unless there is specific wording that if a patient doesn't collect several installments in one day, then they can collect the remainder, minus the days missed. If a patient misses more than 3 days dosing, then no supply should be made due to the risk of loss of tolerance and potential overdose.

 

Doses can be taken via Supervised Consumption by a pharmacist. This is usually during dose stabilisation (the first 3 months), after a relapse or if there are dose changes. This should continue until compliance with the regime is ensured.

 

All methadone prescriptions receive a £2.50 item level fee. Pharmacists should also endorse the number of packaged doses (PD) on the prescription. A PD fee of 55p is claimed per additional bottle of methadone prescribed. This is calculated as:

the total number of days supply given- number of patient interactions

 

The fee paid to pharmacists for supervised consumption will vary nationally as it is a locally enhanced service.