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Part III
List of Appliances
Part III
List of Appliances
Contents:
Notes
Absorbent Cottons
Acne Treatment
Adhesive Dressing Remover Sterile – Silicone Based
Anal Irrigation System
Applicators - Vaginal
Arm Slings
Auto Inflation Device (For The Treatment Of Glue Ear)
Bacterial Decolonisation Products
Bladder Instillation
Breast Reliever
Breast Shields
Cellulose Wadding
Cervical Collars
Chiropody Appliances
Contraceptive Devices
Cotton Wools
Cycloidal Vibration Accessories
Devices for Adjunctive Treatment of Hypertension
Douches
Droppers
Dry Mouth Products
Ear Wax Softening Medical Device
Elastic Hosiery
Emollient And Barrier Preparations
Eye Products
Finger Cots
Finger Stalls
Gauzes
Gauze Tissues
Head Lice Device
Hernia Support Garments
Hypodermic Equipment
Indwelling Pleural Catheter Drainage Systems
Inhalation Solutions
Inspiratory Muscle Training Devices
Insufflators Plastics - for inhalation of fine powders
Irrigation Solutions
Jaw Rehabilitation Device
Latex Foam, Adhesive
Leg Ulcer Wrap
Lint
Low Friction Garments
Lubricant Gels
Micro-Enema – Sodium Citrate
Nasal Products
Nipple Shields, Plastic
Oral Film Forming Agents
Oscillating Positive Expiratory Pressure Device
Peak Flow Meters
Pelvic Toning Devices
Perineal Massage Appliances
February 2015
1
2
3
3
3
3
5
5
5
5
5
5
5
5
5
6
6
7
7
7
7
7
7
8
8
11
13
16
16
16
17
17
17
18
26
26
26
26
26
27
27
28
28
28
29
29
29
30
30
30
31
31
31
Part III
List of Appliances
Pessaries
Physical Debridement Device
Plantar Pressure Offloading Device
Plasters
Potassium Hydroxide Solution
Prosthetic Adhesives
Protectives
Silk Garments
Sodium Hyalauronate Injection
Spacer/Holding Chamber Device
Spinal Alignment Cushion
Stockinette
Stoma Appliances
Surgical Adhesive Tapes
Surgical Sutures*
Skin Adhesive, Sterile
Skin Closure Strips, Sterile
Swabs
Synovial Fluid
Syringes
Topical Skin Coolants
Trusses
Urinals, Portable
Ultrasound Therapy System Accessories
Vacuum Pumps And Constrictor Rings For Erectile Dysfunction
Vaginal Dilator
Vaginal Moisturisers
Vaginal Ph Correction Products
Venous Ulcer Compression System
Wound Drainage Pouches
32
35
35
35
36
36
36
37
42
42
42
43
50
51
53
55
55
55
56
57
57
57
58
58
59
62
62
62
63
66
Notes
1.
Definition - The appliances that may be supplied against orders on Form HS21 are listed below and must conform to the
specifications shown. These specifications include published official standards i.e. BP, BPC or relevant British Standard
or the Drug Tariff Technical Specification. It should be emphasised that any appliance must conform to the entry in this
part of the Tariff as well as with the official standard or technical specification quoted therein.
2.
Sealed Packets - These are those which are “tamper-evident” - sealed with an easily detachable device that prevents
removal of the contents without the seal being broken. Additionally in the case of sterile products: once a sealed package
has been opened it should not be possible to re-seal it easily. Where an appliance, other than a bandage, required by the
Tariff to be supplied in a sealed packet is ordered of a quantity or weight not listed in the Tariff, the quantity ordered
should be made up as nearly as possible with the smallest numbers of sealed packets available for the purpose. Where
the quantity ordered is less than the smallest quantity/weight, supply the smaller pack. The quantity of material in each
packet supplied should be recorded on the prescription form.
3.
Weights - All weights specified in the Tariff in respect of appliances are exclusive of wrappings and packing material.
4.
Invoice price - This is the price chargeable for the appliance to the contractor by the manufacturer, wholesaler or supplier.
5.
Technical specifications. Numbered Drug Tariff technical specifications are listed in Part XII.
6.
The list of preparations that may be prescribed by nurses on Form HS 21(N) is shown in Part IX B.
preparations that may be prescribed by extended nurse formulary practitioners is shown in Part IX C.
February 2015
2
The list of
Part III
List of Appliances
Absorbent Cottons
To be supplied in suitable tamper evident packaging as received from the manufacturer or wholesaler.
(See note 2)
each
Absorbent Cotton BP
25g
0.75
Where no quantity is stated on the prescription the
100g
1.72
25g pack is to be supplied.
500g
5.79
Absorbent Cotton, Hospital Quality
Specification 1
To be supplied only where specifically ordered.
100g
500g
1.19
3.77
50ml
25ml
12.00
13.00
5ml
10.00
5
100ml
5ml
30
3.75
16.50
1.13
15.19
Acne Treatment
Aknicare
Cream
Lotion
Aknicare SR
Skin Roller
Adhesive Dressing Remover Sterile – Silicone Based
Appeel Sterile foam applicator
Appeel Sterile medical adhesive remover spray
Appeel Sterile single use sachet
Appeel Sterile single use wipes
Anal Irrigation System
Aquaflush Actif Irrigation Cone System (Oakmed Ltd)
Starter Set
AFAS
(Contains 1 water bag, 1 pump, 1 hook for water bag, 1 extension tube, 5 cones
wrapped in glove/disposal bag, 1 strap, 1 washbag)
Monthly Set
AFAM
(Contains 1 water bag, 1 pump, 1 hook for water bag, 15 cones wrapped in
glove/disposal bag)
Aquaflush Compact System (Oakmed Ltd)
Starter Set
(Contains 1 pump, 5 cones, 5 glove/disposal bags, 1 wash bag)
Monthly Set
(Contains 1 pump, 15 cones, 15 glove/disposal bags)
101.00
AFCS
33.28
AFCM
59.50
Aquaflush Quick System (Oakmed Ltd)
Starter Set
AFQS
(Contains 1 water bag, 1 pump, 1 hook for water bag, 1 extension tube, 5 cones, 5
glove/disposal bags, 1 strap. 1 washbag)
Monthly Set
AFQM
(Contains 1 water bag, 1 pump, 15 cones, 15 gloves/disposal bags)
77.65
101.86
Pack of 2
6.00
Per Pair
AFStrap
4.99
Aquaflush Extension Tubes
AFExtn
Aquaflush Straps
February 2015
77.00
3
Part III
List of Appliances
Anal Irrigation System – cont.
IryPump S (B Braun Medical)
IryPump S Set
IryCone+
IryPump Container
29120E
29220E
29240E
each
485.00
59.50
41.20
Peristeen System
(System includes 1 control unit, 2 rectal catheters, 1 water bag, 2 straps)
Small
(System includes 1 control unit, 2 rectal catheters, 1 water bag, 1 strap)
29121
74.78
29126
74.78
Peristeen Accessory Unit
(Contains 15 rectal catheters, 1 water bag)
Small
(Contains 15 rectal catheters, 1 water bag)
29122
130.33
29127
130.33
Peristeen Rectal Catheters
Small
(Contains 10 rectal catheters)
29123
29128
Pack of 10
83.32
83.32
Peristeen Straps
29124
Per Pair
5.34
Pack of 2
29125
7.48
Peristeen Tubes
Qufora Irrigation System (MacGregor Healthcare Ltd)
Mini Set
53601-015
(Contains 1 hand pump, 15 cones)
Bed System
53201-055
(Contains 1 water bag, 1 water pump, 5 rectal catheters 12mm, 5 collection bags)
Bed System
53001-055
(Contains 1 water bag, 1 water pump, 5 rectal catheters 21mm, 5 collection bags)
Bed System
53101-055
(Contains 1 water bag, 1 water pump, 5 rectal catheters 30mm, 5 collection bags)
Balloon System - Base Set
58101-002
(Contains 1 control with velcro strap, 1 water bag, 2 rectal balloon catheters medium)
Balloon System - Base Set
58102-002
(Contains 1 control with velcro strap, 1 water bag, 2 rectal balloon catheters small)
Balloon System - Accessory Set
58201-015
(Contains 1 water bag, 15 rectal balloon catheters medium)
Balloon System - Accessory Set
58202-015
(Contains 1 water bag, 15 rectal balloon catheters small)
Balloon System - Catheter Set
58301-010
(Contains 10 rectal balloon catheters medium)
Balloon System - Catheter Set
58302-010
(Contains 10 rectal balloon catheters small)
Qufora Toilet System (MacGregor Healthcare Ltd)
Starter Set
(Contains 1 pump, 1 water bag, 5 cones, 5 waste bags,1 toilet bag)
Monthly Set
(Contains 1 pump, 1 water bag, 15 cones, 15 waste bags)
February 2015
4
each
59.00
49.90
49.90
49.90
70.00
70.00
115.00
115.00
79.00
79.00
QTS
each
77.80
QTM
101.66
Part III
List of Appliances
Applicators - Vaginal
Plastics syringe-type applicator with transparent or translucent barrel and opaque or translucent
plunger. The end of the barrel has an internal screw thread. (Length not less than 11cm and capacity
not less than 5ml).
Type 1. (Gynest) (formerly Ortho)
1.60
NB:
1. Where an Ortho pack ordered by the prescriber does not include an applicator, and the
contractor considers that one is required, an Gynest Vaginal Applicator should be supplied
and the prescription form endorsed accordingly.
Arm Slings
Web, Adjustable
2.02
Auto Inflation Device (For The Treatment Of Glue Ear)
Otovent
4.90
Bacterial Decolonisation Products
Prontoderm Foam
Prontoderm Nasal Gel
200ml bottle
30ml tube
3.63
5.14
Bladder Instillation
Hyaluronic Acid
Cystistat (conatains 40mg of sodium hyaluronate)
Hyaluronic Acid and Chondroitin Sulfate
iAluRil
(contains 800mg of sodium hyaluronate and 1g sodium chondroitin sulfate)
50ml
98.00
50ml
88.00
Breast Reliever
Plasticised PVC polymer bulb with glass receiver
60ml approx
4.86
Breast Shields
Per Pair
4.57
Plastic circular - (Not to be confused with Nipple Shields)
Cellulose Wadding
Cellosene
500g
2.20
23562000
23562100
23562200
2.62
2.62
2.62
OA8009
OA8016
OA8023
2.40
2.40
2.40
Cervical Collars
Eesiness Soft Cervical Foam Collar
Small
Medium
Large
Clini Cervical Collar
Small (44cm)
Medium (48cm)
Large (53cm)
February 2015
5
Part III
List of Appliances
Chiropody Appliances
Adhesive Felt
Zinc oxide or acrylic adhesive spread on semicompressed surgical wool felt (each in envelope)
10.5cm x 8.3cm x 5mm thick
10.00cm x 22.5cm x 5mm thick
1.03
2.08
25g
0.98
Animal Wool BP
(Syn. Animal Wool for Chiropody)
(Long Strand Lamb's Wool for Chiropody)
Box
1.00
Bunion Rings
Self-adhesive, semi-compressed felt (in box of 4 pieces)
Corn Rings
Self-adhesive, semi-compressed felt (in box of 9 pieces)
5mm thick
1.00
Contraceptive Devices
Intrauterine Contraceptive Device
Each of the products is unique and patients should be individually assessed to ascertain the most suitable device. Insertion
techniques differ significantly between devices and practitioners should ensure they are proficient in the technique required for a
device before fitting it, and undertake training as appropriate.
Ancora 375 Cu
Copper T380 A
Flexi-T 300
Flexi-T+380
GyneFix intrauterine contraceptive implant
Load 375
Mini TT380 Slimline
Multiload CU 375
Multi-Safe 375
NeoSafe T380
Nova-T 380
Novaplus T380 Ag (Normal, Mini)
Novaplus T380 Cu (Normal,Mini)
Optima Tcu380A
Steriload
T-Safe 380A QL
TT380 Slimline
UT380 Short
UT380 Standard
7.95
8.95
9.47
10.06
27.11
8.52
12.46
9.24
8.96
13.31
15.20
12.50
10.95
9.65
9.65
10.47
12.46
11.22
11.22
(NOTE: Prescribers have been advised that pain during and after insertion of Multiload CU250 or Multiload CU250 Short,
Multiload CU375 or Multi-Safe 375 is more likely to occur in nulliparous than in parous women.)
** To be supplied in individual sealed carton containing the sealed and sterilised pack as received from the manufacturer or
wholesaler.
Vaginal Contraceptive Caps (Pessaries)
The size of the pessary and the type must be specified by the prescriber.
Silicone
CE Marked
FemCap Soft Silicone Cap
22mm, 26mm & 30mm
February 2015
6
15.29
Part III
List of Appliances
Contraceptive Devices – cont.
Vaginal Contraceptive Diaphragm
The size of the diaphragm, and the type must be specified by the prescriber.
Milex Silicone Diaphragm
Omniflex – Coil Spring (Type B)
60-90mm
(rising in 5mm)
Arcing – Arcing Spring (Type C)
60-90mm
(rising in 5mm)
Ortho All-Flex Diaphragm
Arcing – Arcing Spring (Type C)
65-80mm
(rising in 5mm)
9.31
9.31
8.35
Cotton Wools
See Absorbent Cottons
Cycloidal Vibration Accessories
Pack of 3
15.00
Vibro-Pulse
Devices for Adjunctive Treatment of Hypertension
each
132.00
ReSPeRATE
Douches
Vaginal fittings
Douche can and fittings white polypropylene, complete with two piece
fittings, tube and instructions, singly packed - no rectal fittings)
1 litre
each
5.12
Droppers
Glass, with bull-nose or curved flat end and fitted with good quality rubber teat (each in
box). Where appropriate, a dropper should be supplied with eye, ear and nasal drops
(see Part V, CONTAINERS)
0.35
Dry Mouth Products
Saliva Replacement and Stimulating Products
A.S Saliva Orthana Spray
Aequasyal Spray (formerly Aquoral Spray)
Biotene Moisturising Mouthwash
Biotene Oralbalance Gel
Oralieve Moisturising Mouth Gel
Salivix
SST Saliva Stimulating Tablets (see also Part IXa)
Xerostom Mouthwash
Xerostom Pastilles
Xerostom Salvia Substitute Chewable Capsules
Xerostom Saliva Substitute Gel
Xerostom Toothpaste
Xerotin Spray
February 2015
7
50ml
500ml refill bottle
40ml
500ml
50g
50ml
50 pastilles
container of 100
250ml bottle
30 pastilles
40 capsules
25ml
50ml tube
100ml
4.92
34.27
9.85
5.67
4.46
2.96
3.55
4.86
3.13
2.85
3.42
2.28
2.85
6.86
Part III
List of Appliances
Ear Wax Softening Medical Device
Ear Drops - Olive Oil
Alissa Healthcare
Arjun
Care (Thornton & Ross)
St Georges Medical Ltd
Ear Drops - Sodium Bicarbonate
Thornton & Ross
10ml
10ml
10ml
10ml
20ml
1.42
1.25
1.42
1.40
2.70
10ml
1.25
Elastic Hosiery
Graduated Compression Hosiery
Explanation of garments available
Class I
Light (Mild) Support
Compression at ankle 14mm Hg - 17mm Hg
Indications: Superficial or early Varices. Varicosis during pregnancy
Styles:
Thigh length/below knee with knitted in heel (reciprocated)
Class II
Indications:
Styles:
Class III
Indications:
Styles:
Medium (Moderate) Support
Compression at ankle 18mm Hg - 24mm Hg
Varices of medium severity
Ulcer treatment and prevention of recurrence
Mild oedema
Varicosis during pregnancy
Anklets and kneecaps: for soft tissue support
Thigh length/below knee with knitted in heel (reciprocated)
Strong Support
Compression at ankle 25mm Hg - 35mm Hg
Gross Varices
Post-Thrombotic Venous Insufficiency
Gross oedema
Ulcer Treatment and prevention of recurrence
Anklets and kneecaps: for soft tissue support
Thigh length/below knee open or knitted in heel (reciprocated)
General Notes
Prescribing
Before the prescription can be dispensed the following details must be given to the prescriber.
1. Quantity - Single or Pair
2. Article including any accessories
3. Compression Class I, II or III
Constructional Specification
The Complete Structural Specification, as well as performance requirements are contained in the Drug Tariff Technical
Specification 40.
Specially Made Garments
1. In cases where stock sizes are not suitable for patients owing to irregular limb dimensions, surgical stockings in the
prescribed compression class, to be made to the patient’s individual measurements should be specified.
2. All such garments are specially shaped during manufacture and may have a knitted-in or open heel and open or
knitted in toe.
Sizing
All articles must conform to BS 6612: 1985 with regard to size designation.
Labelling
All articles must state clearly on the packaging that they conform to the Drug Tariff Technical Specification 40. The packaging
should also provide clear washing instructions in conformity with handwashing at 40°C as defined in BS 2747 and washing
instructions should be durably and clearly marked on each garment. The packaging should clearly define the garments'
percentage fibre content.
February 2015
8
Part III
List of Appliances
Elastic Hosiery cont
DESCRIPTION OF ARTICLES AVAILABLE
Compression
Type of Garment
Class
Knit
Style
CLASS I
Circular
Lt Wt Elastic Net
CLASS II
Circular
Net
Flat Bed
CLASS III
Circular
Flat Bed
Standard Stock Sized
Garments
Price Per Pair
Thigh
B Knee
Thigh
B Knee
Thigh
B Knee
Thigh
B Knee
Thigh
B Knee
Thigh
B Knee
Thigh
B Knee
8.11
7.41
14.28
12.28
Acti-Glide
Additional Price for Fitted Suspender
Arm Butler
Easy-Slide (application aid for Open toe Stockings)
EZY-As compression hosiery applicator
EZY-As compression hosiery applicator handles
Foot Butler
GUS Comfort
Juzo Easy Fit
Juzo Easy Fit XL
Magnide
Mediven 2 in 1
Sockaid
Spare Suspender for Thigh Stockings
Suspender Belt Drug Tariff Specification No. 13
NB
42.91
26.84
21.71
16.95
42.91
26.84
21.71
16.95
42.91
26.84
42.91
26.84
42.91
26.84
12.05
10.83
Accessories
Made to Measure
Garments
Price Per Pair
Price Per Item
14.40
0.70
8.00
S,M,L,XL
12.22
32.40
15.25
8.00
14.28
33.99
33.99
M,L
14.04
12.51
12.99
0.70
5.40
The reimbursable price for one item is half the price of a pair.
More than one prescription charge is payable where more than one piece of elastic hosiery is
supplied.
*All such garments are specifically shaped during manufacture and may have a knitted in or
open heel or knitted in toe with the following exceptions:Class II/III - Flat bed knit can only be supplied with closed heel and open toe.
NOTE: Prescriptions should be endorsed with the style, i.e. fabric or knit supplied.
For Above Knee Stockings - see Thigh Length
February 2015
9
Part III
List of Appliances
Elastic Hosiery cont
Compression
Class
Class II
Type of Garment
Knit
Style
Circular
Anklet
Kneecap
Anklet
Kneecap
Anklet
Kneecap
Anklet
Kneecap
Anklet
Kneecap
Flat Bed
Net
Class III
Circular
Flat Bed
NB
Standard Stock Sized
Garments
Price Per Pair
Made to Measure
Garments
Price Per Pair
7.10
7.10
14.74
14.74
9.90
9.46
9.90
9.46
7.10
15.71
15.71
13.95
11.59
9.90
9.46
15.71
15.71
The reimbursable price for one item is half the price of a pair.
More than one prescription charge is payable when more than one piece of elastic hosiery is
supplied.
Hosiery Made To Individual Measurements
1.
Surgical Stockings made to the patient’s individual measurements are available in all 3
compression classes and should be specified or supplied whenever irregular limb dimensions
are present and cannot be fitted with stock sizes.
2.
All garments are specially shaped during manufacture and must have a knitted-in or open heel
and open toe.
3.
Seams and finishes must be designed to form no restrictions and must be flat and soft against
the limb.
Manufacturing Guidelines For Made To Measure Garments
1.
2.
Class I and Class II hosiery can be made using the following methods:
a.
Manufactured from open mesh elastic net fabric, cut to shape and seamed.
b.
Shaped or fashioned to individual requirements containing knitted, or knitted and
inlaid, elastomeric threads.
Class III hosiery can be made as follows:
Shaped or fashioned to individual requirements with knitted, or knitted and inlaid, elastomeric
threads.
NB
Elastodiene and elastane threads must be covered for knitting yarns. In the case of hosiery
made with inlaid elastomeric threads they may remain uncovered.
February 2015
10
Part III
List of Appliances
Emollient And Barrier Preparations
Aproderm Cream
45g
450g
100g
500g
250g
50g
500g pump
250ml Aerosol
50g
150g
500g
1050g
200ml
500ml
125g
450g
250g
500g
50ml
300ml
125g
500g
150ml Aerosol
240ml Aerosol
500g
50g pump
500g pump
125g
500g
1kg
100g
500g pump
250g
500g
125g
500g
1kg
500ml
250ml
500ml
100g
500g
1050g
250ml
500ml
450ml
250ml
500ml
500g
125g
250g
500g
500g
50g
500g
Aquamax Cream
Aquamax Wash
Aquamol
AriPro
Cetraben Cream
Cetraben Lotion
Cetraben Ointment
Dexeryl Cream
Diprobase Lotion
Emelpin Ointment
Emollin
Enopen Cream
Epaderm Cream
Epaderm Ointment
Epimax Cream
Fifty:50 Ointment
Hydromol Ointment
LPL 63.4 bath additive and emollient
QV Bath Oil
QV Cream
QV Gentle Wash
QV Intensive Ointment
QV Skin Lotion
Soffen Cream
Thirty:30 Ointment
ZeroAQS Cream
Zerobase Cream
February 2015
11
1.53
4.74
1.89
3.99
2.99
1.22
6.40
7.50
1.40
3.98
5.99
11.62
4.00
5.64
3.49
5.39
3.16
5.90
1.28
3.49
3.08
5.22
3.97
6.35
5.99
1.70
6.95
3.85
6.53
12.02
0.75
2.49
1.83
3.66
2.88
4.89
9.09
3.10
2.88
4.71
2.04
5.86
11.94
3.14
5.24
5.65
3.14
5.24
4.79
3.81
4.29
6.47
3.29
1.04
5.26
NEW
NEW
NEW
Part III
List of Appliances
Emollient And Barrier Preparations Cont
Zerocream
Zeroderm Ointment
Zerodouble Gel
Zeroguent Cream
Zerolatum Emollient Bath Additive
Zeroneum Bath Additive
Preparations containing Menthol
AquaSoothe 1%
AquaSoothe 2%
Arjun Cream 0.5%
Arjun Cream 1%
Arjun Cream 2%
Preparations containing Sodium Hyaluronate
Atopiclair
Atopiclair Lotion
Xclair
Preparations containing Urea
Balneum Cream
ClearZal Hard Skin Remover
Dermatonics Once Heel Balm
Flexitol 10% Urea Cream
Flexitol Hand balm
Flexitol Heel balm
Flexitol Skin Balm
imuDERM emollient
Preparations for the treatment of Radiation Induced Dermatitis
R1 gel
R2 lotion
Symptomatic Relief of Chickenpox
Care ViraSoothe Gel
February 2015
12
50g
500g
125g
500g
100g
475g
100g
500g
500ml
500ml
1.17
4.08
2.41
4.10
2.25
4.71
2.33
6.99
4.79
4.48
100g
500g
50g
500g
500g
100g
500g
500g
3.70
15.43
1.86
15.43
15.30
3.25
15.30
15.30
40ml
100ml
120ml
50g
6.20
12.40
14.80
17.00
50g pump
500g pump
100g
75ml
200ml
150g
500g
75g
40g
75g
200g
500g
100g
200g
500g pump
2.85
9.97
4.30
3.60
8.50
5.00
11.77
3.50
2.75
3.80
9.40
14.75
4.50
8.20
6.50
30 x 6g
168 x 1g
18.20
24.15
50g
75g
3.34
4.86
Part III
List of Appliances
Eye Products
Artificial Eye Lubricant
Opsil
Standard
Thick
15ml
15ml
5.10
5.10
Eye Baths
Squat shape, with finger grips, rigid plastics smooth inner surface and base, and rounded
rim
Eye Drops – Carmellose
Carmellose 0.5% (Alissa Healthcare)
(10ml Bottle)
(30 x 0.4ml single dose unit)
Carmellose 0.5% (Medicom Healthcare)
(30 x 0.4ml single dose unit)
Carmize 0.5%
(10ml bottle)
(30 x 0.4ml preservative free single dose unit)
(90 x 0.4ml preservative free single dose unit)
Carmize 1%
(10ml bottle)
(30 x 0.4ml preservative free single dose unit)
(60 x 0.4ml preservative free single dose unit)
Cellusan 1%
(30 x 0.4ml preservative free single dose unit)
Cellusan Light 0.5%
(30 x 0.4ml preservative free single dose unit)
Lumecare Advance Carmellose 0.5%
(10ml Bottle)
Lumecare Singles Carmellose 0.5%
(30 x 0.4ml single dose unit)
Melophthal 0.5%
(30 x 0.4ml single dose unit)
Melophthal 1%
(30 x 0.4ml single dose unit)
Optive 0.5%
(10ml bottle)
Optive Plus 0.5%
(10ml bottle)
PF Drops Carmellose 0.5%
(10ml preservative free bottle)
PF Drops Carmellose 1%
(10ml preservative free bottle)
Xailin Fresh 0.5%
(30 x 0.4ml single dose unit)
Eye Drops – Dispensers
ComplEye
Opticare
Opticare Arthro 5
Opticare Arthro 10
7.49
5.75
5.75
7.49
5.75
15.53
8.49
3.00
6.00
3.00
5.75
6.99
5.72
5.75
3.00
7.49
7.49
7.49
7.49
3.84
(for 2.5, 5, 10, 15 & 20ml bottles)
(for 2.5 & 5ml bottles)
(for 10, 15 & 20ml bottles)
2.00
4.92
4.92
4.92
(28 x 0.8ml single dose unit)
(10ml bottle)
(10ml bottle)
(10ml bottle)
(30 x 0.7ml single dose unit)
(10ml bottle)
4.66
4.66
7.49
7.49
6.69
6.69
Eye Drops - Hydroxypropyl Guar
Systane
Systane Gel Drops
Systane Balance
Systane Ultra
February 2015
0.25
13
Part III
List of Appliances
Eye Products cont
Eye Drops – Hypromellose
Hydromoor
(30 x 0.4ml single dose unit)
Hypromellose 0.3% (Alissa Healthcare)
(10ml preservative free bottle)
Hypromol
(10ml preservative free bottle)
Lumecare Hypromellose 0.3% Eye Drops
(10ml bottle)
Lumecare Hypromellose 0.3% Eye Drops
(30 x 0.5ml single dose unit)
Preservative free
Mandanol
(10ml bottle)
PF Drops Hypromellose 0.3%
(10ml preservative free bottle)
Tear-Lac
(10ml preservative free bottle)
SoftDrops 0.3% Eye Drops
(10ml bottle)
(30 x 0.5ml preservative free single dose unit)
Xailin Hydrate
(10ml bottle)
Eye Drops - Polyvinyl Alcohol
PVA 1.4% Tubilux
15ml
Eye Drops - Sodium Chloride
Hypersal 5%
(10ml bottle)
NaCI 5%
(20 x 0.45ml preservative free single
(Essential Pharmaceiticals Ltd)
dose unit)
PF Drops Sodium Chloride 5%
(10ml preservative free bottle)
Sodium Chloride 5% (Alissa Healthcare)
(10ml bottle)
Xailin Wash
(20 x 5ml preservative free single dose unit)
Eye Drops - Sodium Hyaluronate
Artelac Rebalance
Artelac Splash
Blink Intensive Tears
Clinitas
Hy-Opti 0.1%
Hy-Opti 0.2%
Hyabak
HydraMed
Hylo-Care
Hylo-Forte
Hylo-Tear
February 2015
(10ml bottle)
(30 x 0.5ml single dose unit)
(60 x 0.5ml single dose unit)
(10ml bottle)
(20 x 0.4ml single dose unit)
(30 x 0.5ml single dose unit)
(10ml preservative free bottle)
(10ml preservative free bottle)
(10 ml bottle)
(10ml preservative free bottle)
(30 x 0.5ml preservative free single
dose unit)
(10ml preservative free bottle)
(10ml preservative free bottle)
(10ml preservative free bottle)
14
5.75
5.75
5.75
1.67
5.72
1.33
5.75
5.75
1.67
5.75
4.60
NEW
1.63
25.25
73.58
25.20
25.25
5.71
4.00
7.00
11.20
2.97
2.97
5.70
8.50
9.50
7.99
10.00
8.00
10.30
9.50
8.50
NEW
Part III
List of Appliances
Eye Products cont
Lubristil
(20 x 0.3ml preservative free single
dose unit)
(20 x 0.4ml preservative free single
dose unit)
(10ml bottle)
(10ml bottle)
(20 x 0.5ml single dose unit)
(10ml bottle)
(10ml bottle)
(10ml bottle)
(20 x 0.5ml single dose unit)
(20 x 0.3ml preservative free single
dose unit)
(20 x 0.45ml preservative free single
dose unit)
(10ml preservative free bottle)
(10ml preservative free bottle)
4.99
(20 x 0.3ml preservative free single dose unit)
6.22
(10ml preservative free bottle)
7.99
(10g tube)
(10g tube)
(10g tube)
(10g tube)
(10g tube)
(10g tube)
(10g tube)
2.96
2.80
2.80
1.49
2.80
2.10
3.25
Eye Ointment – Paraffin Based
VitA-POS
Xailin Night
(5g preservative free tube)
(5g preservative free tube)
2.75
2.49
Eye Ointment – Sodium Chloride
Sodium Chloride 5% (Alissa Healthcare)
(5g preservative free tube)
22.50
Lubristil Gel

Xailin HA
Lumecare Sodium Hyaluronate 0.15%
Ocusan
Optive Fusion
Oxyal
Rohto Dry Eye Relief
Vismed
Vismed Gel
Vismed Gel Multi
Vismed Multi
Eye Drops – Soybean Oil
Emustil
 Eye Drops – Zinc Hyaluronate
eyezin
Eye Gel – Carbomer
Artelac Nighttime Gel
Carbomer 0.2% (Blumont Healthcare Ltd)
Carbomer 0.2% (Medicom Healthcare)
Clinitas Carbomer Gel
EyeGel 0.2%
Lumecare Carbomer 0.2% Eye Gel
Xailin Gel
 to be deleted 1 April 2015
 to be deleted 1 May 2015
February 2015
15
6.49
7.13
3.97
5.31
7.49
4.15
4.10
4.75
5.10
5.98
7.95
6.81
NEW
Part III
List of Appliances
Eye Products cont
Eye Pad
No. 16 Eye Pad with Bandage BPC, sterile
0.68
Eye Shades
Plastic, semi-rigid, non-flammable, perforation along top for ventilation, to fit
either eye (individually packed in suitable container)
0.32
Finger Cots
Seamless latex
box of 10
per box
0.35
Medium & Large
Medium & Large
each
0.29
0.19
Finger Stalls
Plastic
Portia Clear – with adjustable elastic wristband
Portia Blue – with wrist tie
Gauzes
To be supplied in sealed packets* as received from manufacturer or wholesaler
Absorbent Cotton Gauze, Type 13 Light BP, sterile
90cm x 1m
1.13
(Syn. Absorbent Gauze)
90cm x 3m
2.36
90cm x 5m
3.68
90cm x 10m
7.05
Not sterilised
25m roll
16.15
(*i.e. an inner sealed paper wrapper, in a film wrapped carton). Where no quantity is stated by the
prescriber the 1m packet should be supplied.
Absorbent Cotton and Viscose Ribbon Gauze BP, Sterile
1.25cm x 5m
2.5cm x 5m
0.85
0.94
Cutimed Sorbact Swab
(Impregnated with dialkylcarbamoyl chloride)
4cm x 6cm
7cm x 9cm
1.63
2.72
Melladerm Plus Tulle
(Impregnated with melladerm plus honey gel)
10cm x 10cm
2.10
(*i.e. an inner sealed paper wrapper, in an outer paper wrapper)
Gauze Dressings (Impregnated)
Paraffin Gauze Dressing BP Sterile (Syn. Tulle Gras)
Sterile one piece pack consisting of a peelable outer wrap containing a single piece of impregnated
gauze, each piece separately enclosed between 2 pieces of film or paper.
Light Loading - 90-130g/m²
Paranet
10cm x 10cm
0.25
Normal loading - 175-220g/m²
Cuticell Classic
Jelonet
Neotulle
Paragauze
10cm x 10cm
10cm x 10cm
10cm x 10cm
10cm x 10cm
0.29
0.41
0.29
0.28
The labelling of each pack shall include: “Sterile”,”10cm x 10cm” and ”This pack shall not be issued
nor the contents used if the wrapper is broken”.
NOTE: The exact number of pieces (i.e. packs) ordered by the prescriber is to be dispensed.
February 2015
16
Part III
List of Appliances
Gauze Tissues
To be supplied in sealed packets* as received from the manufacturer or wholesaler.
Gauze and Cotton Tissue BP
(Absorbent Gauze Tissue, Gauze Tissue)
 i.e. sealed paper wrapper or heat-sealed stout plastic bag
500g
7.34
Gauze and Cotton Tissue (Drug Tariff)
*
i.e. sealed paper wrapper or heat-sealed stout plastic bag
To be supplied only where specifically ordered.
500g
5.36
Head Lice Device
Bug Buster Kit
4.80
(Kit containing 3 Bug Buster combs, 1 Nit Buster comb, 1 wide-tooth comb plus a protective cape.)
The Bug Buster Kit works in combination with ordinary shampoo and hair conditioner - no additional
medicated products are required.
Full Marks Solution
100ml
200ml
300ml
Linicin Lotion 15 mins
100ml
per bottle
3.47
6.36
8.67
Nitcomb-M2
5.49
each
2.12
Nitcomb-S1
1.13
Nitlotion
4.19
Nitty Gritty NitFree
Steel nit comb with microgrooved teeth
5.67
NYDA
50ml spray
100ml spray (2 x 50ml)
Portia Head Lice Comb
8.00
14.31
0.40
Hernia Support Garments
Orione Hernia Brief
February 2015
Size 2 (76-80cm)
Size 3 (81-85cm)
Size 4 (86-90cm)
Size 5 (91-95cm)
Size 6 (96-100cm)
Size 7 (101-105cm)
Size 8 (106-110cm)
Size 9 (111-115cm)
Size 10 (116-120cm)
17
each
36.50
36.50
36.50
36.50
36.50
36.50
36.50
36.50
36.50
Part III
List of Appliances
Hypodermic Equipment
A
(i)
Single Patient-Use Products
U100 Insulin Syringes with Needle - Sterile, Single-Use or Single Patient-Use.
Shall comply with the requirements of BS 7548:1992
Sterile: intended for single use or single patient-use for the injection of U100 insulin by diabetics in the
community.
NB: Intended for use immediately after filling, and not for containing insulin over extended periods of time.
The syringe may have permanently fixed needles, or detachable needles fitted ready for use.
Alternatively, syringes with a separate needle may be supplied.
The sterility of the fluid pathway and functional surfaces shall be protected by either end caps or by
suitable unit containers, all of which shall be tamper-evident.
Colour coding:- The colour orange is used to distinguish U100 Insulin syringes.
Instruction for disposal: These are given on the multiple (sales) packs and may be given on the unit or
multiple unit pack. (A leaflet containing guidance may be supplied at the time of issue.)
NOTE: Each scale graduation represents one unit on the 0.3ml and 0.5ml syringes and two units on the 1.0ml
syringe. The graduations on the syringes are clearly numbered at every 5 units on the 0.3ml and 0.5ml syringes
and at every 10 units on the 1.0ml syringe. When the size is not specified by the prescriber, the 0.5ml syringe
with needle should be supplied. If the patient is known to inject more than 50 units of Insulin per injection the
1.0ml syringe shall be supplied.
Needles 8mm long shall have a range of needle diameters as follows:
0.33mm (29g) and 0.3mm (30g).
Size
0.3ml syringe and needle
0.5ml syringe and needle
1.0ml syringe and needle
Per 10
1.47
1.42
1.41
Needles not less than 12mm long shall have a range of needle diameters as follows:
0.45mm (26g), 0.4mm (27g), 0.36mm (28g), 0.33mm (29g), and 0.3mm (30G)
0.5ml syringe and needle
1.0ml syringe and needle
1.53
1.54
Safety Needles 8mm long shall have a range of needle diameters as follows:
BD SafetyGlide insulin syringe
(Becton Dickinson)
0.3ml syringe and needle (0.25mm/31G)
0.5ml syringe and needle (0.3mm/30G)
13.20
13.20
Pack of 50
Kendall Magellan insulin safety syringe
(Covidien Commercial UK Ltd)
0.3ml syringe and needle (0.3mm/30G)
0.5ml syringe and needle (0.3mm/30G)
1.0ml syringe and needle (0.3mm/30G)
6.60
6.60
6.60
Safety Needles not less than 12mm long shall have a range of needle diameters as follows:
BD SafetyGlide insulin syringe
(Becton Dickinson)
0.5ml syringe and needle (0.33mm/29G)
1.0ml syringe and needle (0.33mm/29G)
Pack of 100
13.20
13.20
Pack of 50
Kendall Magellan insulin safety syringe
(Covidien Commercial UK Ltd)
0.3ml syringe and needle (0.33mm/29G)
0.5ml syringe and needle (0.33mm/29G)
1.0ml syringe and needle (0.33mm/29G)
6.60
6.60
6.60
TS-A Safety insulin syringe 1ml (0.33mm/29G)
(Minsmed )
February 2015
Pack of 100
18
1.30
Part III
List of Appliances
Hypodermic Equipment cont
(ii)
Hypodermic Needles - Sterile, Single-Use
For use with the re-usable glass syringes listed in this tariff. The sterility of the fluid pathway and
functional surfaces shall be protected by a suitable unit container, which shall be tamper-evident.
The needles shall be of length not less than 12mm and the following diameters may be supplied:
Size
0.5mm (25G), 0.45mm (26G) and 0.4mm (27G)
100
2.92
B
Reusable Pens
Cartridge Size
3.0ml
3.0ml
Dial Up Unit Dose
1 unit (1-21 units)
2 unit (2-42 units)
16.72
16.72
3.0ml
3.0ml
1 unit (1-21 units)
2 unit (2-42 units)
16.47
16.47
ClikSTAR (Sanofi) (formerly Sanofi-Aventis)
(Blue)
(Silver)
3.0ml
3.0ml
1 unit (1-80 units)
1 unit (1-80 units)
25.00
25.00
HumaPen Luxura HD
HumaPen Memoir (Lilly)
3.0ml
3.0ml
0.5 unit (1-30 units)
1 unit (1-60 units)
26.82
26.82
HumaPen Savvio (Lilly)
(Blue)
(Graphite)
(Green)
(Pink)
(Red)
(Silver)
3.0ml
3.0ml
3.0ml
3.0ml
3.0ml
3.0ml
1 unit (1-60 units)
1 unit (1-60 units)
1 unit (1-60 units)
1 unit (1-60 units)
1 unit (1-60 units)
1 unit (1-60 units)
26.82
26.82
26.82
26.82
26.82
26.82
NovoPen 3 (Novo Nordisk)
Demi
3.0ml
0.5 unit (1-35units)
25.95
NovoPen 4 (Novo Nordisk)
(Blue)
(Silver)
3.0ml
3.0ml
1 unit (1-60 units)
1 unit (1-60 units)
26.86
26.86
Novopen Echo (Novo Nordisk)
(Blue)
(Red)
3.0ml
3.0ml
0.5 unit (0.5-30units)
0.5 unit (0.5-30 units)
26.86
26.86
NovoPen Junior
(Green)
(Yellow)
3.0ml
3.0ml
0.5 unit (1-35 units)
0.5 unit (1-35 units)
25.51
25.51
Autopen Classic (Owen Mumford)
Autopen 24
February 2015
19
Part III
List of Appliances
Hypodermic Equipment cont
C
BD AutoShield Duo
5mm/30 gauge
Per 100
30.08
BD Micro-Fine+
5mm/31 gauge
8mm/31 gauge
9.69
7.90
BD Micro-Fine Ultra
4mm/32 gauge
9.69
Comfort Point
4mm/31 gauge
6mm/31 gauge
8mm/31 gauge
12mm/29 gauge
9.95
9.95
6.60
6.60
GlucoRx FinePoint
4mm/31 gauge
5mm/31 gauge
6mm/31 gauge
8mm/31 gauge
10mm/29 gauge
12mm/29 gauge
5.95
5.95
5.95
5.95
5.95
5.95
IME-FINE
6mm/31 gauge
8mm/31 gauge
11.20
8.20
Insupen
4mm/32 gauge
4mm/33 gauge
5mm/31 gauge
6mm/31 gauge
6mm/32 gauge
8mm/31 gauge
8mm/32 gauge
12mm/29 gauge
8.72
12.69
7.11
7.11
8.72
7.11
8.72
7.11
4mm/32 gauge
6mm/31 gauge
8mm/31 gauge
5.95
5.95
5.95
4mm/32 gauge
6mm/31 gauge
8mm/31 gauge
10mm/29 gauge
12mm/29 gauge
12.32
12.84
9.11
9.11
9.11
Mylife Clickfine AutoProtect
8mm/29 gauge
19.00
Mylife Penfine Classic
4mm/32 gauge
6mm/32 gauge
8mm/31 gauge
9.94
9.94
6.59
4mm/32.5 gauge
8mm/32.5 gauge
12.25
8.85
4mm/32 gauge
5mm/31 gauge
8mm/31 gauge
6.95
6.95
6.95
Needles for Pre-filled and Reusable Pen Injectors
Microdot Droplet
Mylife Clickfine
Nanopass
NeedleBay Fine Pen Needles
February 2015
20







Part III
List of Appliances
Hypodermic Equipment cont
C
6mm/31 gauge
8mm/30 gauge
12mm/28 gauge
Per 100
13.02
9.24
9.40
NovoFine Autocover
8mm/30 gauge
22.28
NovoTwist
5mm/32 guage
12.99
4mm/31 gauge
6mm/31 gauge
8mm/31 gauge
10mm/30 gauge
12mm/29 gauge
5.95
5.95
5.95
5.95
5.95
4mm/32 gauge
5mm/31 gauge
6mm/31 gauge
8mm/31 gauge
5.95
5.95
5.95
5.95
Unifine Pentips
4mm/32 gauge
5mm/31 gauge
6mm/31 gauge
8mm/31 gauge
12mm/29 gauge
11.75
12.00
11.75
8.25
8.25
Unifine Pentips Plus
4mm/32 gauge
5mm/31 gauge
6mm/31 gauge
8mm/31 gauge
12mm/29 gauge
12.74
12.74
12.74
8.95
8.95
Needles for Pre-filled and Reusable Pen Injectors (cont)
NovoFine
Omnican Fine
TriCare
D
Lancets - Sterile, Single-Use
AgaMatrix Ultra-Thin Lancets
(AgaMatrix Europe Ltd)
0.35mm/28gauge
0.20mm/33gauge
200
200
7.17
7.17
Apollo Pressure-Activated SafetyLancets
(Apollo Medical Technologies Ltd)
1.8mm/26 gauge
1.8mm/28 gauge
2.4mm/21 gauge
2.4mm/23 gauge
100
100
100
100
5.99
5.99
5.99
5.99
Apollo Twist
(Apollo Medical Technologies Ltd)
0.36mm/28 gauge
200
4.50
BD Micro-Fine +
(Becton Dickinson)
0.20mm/33 gauge
0.30mm/30 gauge
100
200
3.16
6.13
BGStar Ultra-Thin Lancets
(Sanofi)
0.20mm/33 gauge
100
3.65
CareSens
(Spirit Healthcare Ltd)
0.31mm/30 gauge
0.36mm/28 gauge
100
100
2.95
2.95
Dario
(Farla Medical Ltd)
0.31mm/30 gauge
100
3.45
February 2015
21
Part III
List of Appliances
Hypodermic Equipment cont
D
Lancets - Sterile, Single-Use (cont)
FastClix
0.3mm/30 gauge
(Roche Diabetes Care Ltd (formerly Roche Diagnostics))
204
9.83
FreeStyle
(Abbott Labs Ltd)
0.5mm/28 gauge
200
7.33
GlucoDock Lancets
(Medisana Healthcare UK Ltd)
0.35mm/28 gauge
100
3.60
Glucoject Lancets PLUS
(A. Menarani Diagnostics)
0.20mm/33 gauge
100
200
3.71
7.19
Glucoject No-dol Lancets
(A. Menarani Diagnostics)
0.315mm/30 gauge
100
200
3.71
7.19
GlucoRx Lancets
(DiME)
0.31mm/30 gauge
200
5.50
Greenlan Lancets
(Neon Diagnostics Ltd)
0.35mm/28 gauge
100
200
3.00
6.00
iCare Advanced
(iCare Medical Ltd)
0.38mm/30 gauge
100
200
2.85
4.45
IME-DC
(Arctic Medical Ltd)
0.3mm/30 gauge
100
3.00
MediSafe Solo Lancets
(Cambridge Sensors Ltd)
0.50mm/29 gauge
200
10.75
MediTouch
(Medisana Healthcare (UK) Ltd)
0.34mm/28 gauge
100
3.60
Mendor Discreet (Merck Serono Ltd)
0.32mm/28 gauge
100
3.61
Microdot
(Cambridge Sensors Ltd)
0.31mm/30 gauge
100
200
3.00
6.00
Microlet
(Bayer Diagnostics)
0.5mm/28 gauge
100
200
3.90
7.44
Milward Steri-Let
(Entaco)
0.66mm/23 gauge
100
200
100
200
3.00
5.70
3.00
5.70
Multiclix
0.3mm/30 gauge
(Roche Diabetes Care Ltd (formerly Roche Diagnostics))
204
9.79
Mylife Lancets
(Ypsomed Ltd)
200
5.50
0.36mm/28 gauge
February 2015
0.3mm/30 gauge
22
Part III
List of Appliances
Hypodermic Equipment cont
D
Lancets - Sterile, Single-Use (cont)
Mylife Multicolour
(Ypsomed Ltd)
0.3mm/30 gauge
200
5.50
Mylife Safety lancets
(Ypsomed Ltd)
0.36mm/28 gauge
200
12.00
Omnican Lance Soft
(B.Braun Medical UK Ltd)
0.30mm/30 gauge
200
5.45
One Touch Comfort
(LifeScan UK)
0.20mm/33 gauge
200
7.63
One Touch Delica
(LifeScan UK)
0.32mm/30 gauge
200
7.63
One Touch UltraSoft
(LifeScan UK)
0.4mm/28 gauge
100
3.81
Sarstedt Safety Lancets
(Sarstedt Ltd)
1.6mm/28 gauge
1.8mm/21 gauge
1.8mm/18 gauge
200
200
200
10.92
10.92
10.92
Softclix
0.4mm/28 gauge
(Roche Diabetes Care Ltd (formerly Roche Diagnostics))
200
7.82
Softclix XL
(Roche Diagnostics Ltd)
0.8mm/21 gauge
50
1.96
Sterilance Lite II Safety Lancets
(Spirit Healthcare Ltd)
1.8mm/18 gauge
1.8mm/21 gauge
1.8mm/26 gauge
1.8mm/28 gauge
2.4mm/21 gauge
2.4mm/26 gauge
100
100
100
100
100
100
5.70
5.70
5.70
5.70
5.70
5.70
SylkFeel Ultra-Thin Lancets
(Sanofi)
0.20mm/33 gauge
100
3.65
Thin Lancets
(Abbott Labs Ltd)
0.36mm/28 gauge
200
7.56
TRUEplus Lancets
(Nipro Diagnostics)
0.32mm/30gauge
0.195mm/33gauge
100
100
2.90
2.90
Unilet ComforTouch
(Owen Mumford Ltd)
0.375mm/28 gauge
100
200
3.71
7.03
Unilet Eco
(Owen Mumford Ltd)
0.375mm/28 gauge
100
200
2.97
5.55
Unilet General Purpose Superlite
(Owen Mumford Ltd)
0.66mm/23 gauge
100
200
3.78
7.16
February 2015
23
Part III
List of Appliances
Hypodermic Equipment cont
D
Lancets - Sterile, Single-Use (cont)
Unistik 3 Comfort
(Owen Mumford Ltd)
1.8mm/28 gauge
50
100
200
3.24
6.31
12.34
Unistik 3 Extra
(Owen Mumford Ltd)
2.0mm/21 gauge
100
200
6.31
12.34
Unistik 3 Gentle
(Owen Mumford Ltd)
1.5mm/30 gauge
50
100
200
3.24
6.00
12.00
Unistik 3 Normal
(Owen Mumford Ltd)
1.8mm/23 gauge
50
100
200
3.24
6.31
12.34
Vitrex Gentle
(Vitrex Medical Ltd)
0.36mm/28 gauge
100
200
3.19
6.13
Vitrex Soft
(Vitrex Medical Ltd)
0.65mm/23 gauge
100
200
3.00
5.70
Disposal: Please see guidance in paragraph 5 of the Appendix to Part II
E
Accessories
Needle Clipping (Chopping) Device
1.43
Consisting of a clipper to remove the needle from its hub, and incorporating a suitable receptacle from
which the cut-off needles cannot be retrieved. Sufficiently robust to accommodate needles of
diameter 0.45mm (26G) or finer; length: 16mm or shorter. Not generally suitable for use with lancets.
Designed to hold approximately 1,200 such needles.
Sharpsafe
1 litre
0.85
Sharpsguard
F
Needle-free Insulin Delivery Systems
●
Injex Starter Set
1 litre
0.85
each
(60500)
149.36
(Set includes 1 needle–free delivery system, reset box, transporter, nine disposable 10ml
vial adaptors, 165 ampoules)
●
●
●
Injex Four-Monthly Refill Pack
(Pack contains 6 disposable 10ml vial adaptors,100 ampoules)
Injex Ampoule Pack
(Contains 50 ampoules)
Injex 10ml Vial Adaptor Pack
(Contains 20 10ml vial adaptors)
● Please refer to manufacturer for availability
February 2015
24
(60504)
24.47
(60501)
12.28
(60502)
12.23
Part III
List of Appliances
Hypodermic Equipment cont
F
Needle-free Insulin Delivery Systems - cont
InsuJet Starter Set
012003GBSP-012007GBSP
143.60
(Set includes 1 InsuJet pen, 1 nozzle cap, 1 nozzle & piston, 1 vial (10ml) adaptor, 1
cartridge (3ml) adaptor, 1 cartridge cap removal key)
InsuJet Nozzle Pack
(Pack contains 15 pieces)
InsuJet 3ml Cartridge Adaptor Pack
(Pack contains 15 pieces)
InsuJet 10ml Vial Adaptor Pack
(Pack contains 15 pieces)
012070GB15
28.40
012071GB1503
21.70
01207GB1510
21.70
G Subcutaneous Drug Delivery Accessories - Sterile
Neria (Unomedical Ltd)
60cm tubing
60cm tubing
110cm tubing
110cm tubing
110cm tubing
110cm tubing
110cm tubing
110cm tubing
Neria Multi (Unomedical Ltd)
100cm tubing
100cm tubing
100cm tubing
100cm tubing
100cm tubing
100cm tubing
100cm tubing
100cm tubing
Neria Soft 90 (Unomedical Ltd)
60cm tubing
60cm tubing
110cm tubing
110cm tubing
Neria Soft (Unomedical Ltd)
60cm tubing
60cm tubing
60cm tubing
110cm tubing
110cm tubing
110cm tubing
February 2015
8mm/29 gauge
10mm/29 gauge
6mm/27 gauge
6mm/29 gauge
8mm/27 gauge
8mm/29 gauge
10mm/27 gauge
10mm/29 gauge
78-060-2938
78-060-2931
78-110-2736
78-110-2936
78-110-2738
78-110-2938
78-110-2731
78-110-2931
2 x 8mm/27 gauge
2 x 10mm/27 gauge
3 x 8mm/27 gauge
3 x 10mm/27 gauge
3 x 12mm/27 gauge
4 x 8mm/27 gauge
4 x 10mm/27 gauge
4 x 12mm/27 gauge
721060-2738
721060-2731
721060-3738
721060-3731
721060-3737
721060-4738
721060-4731
721060-4737
6mm/22 gauge
9mm/22 gauge
6mm/22 gauge
9mm/22 gauge
722060-5226
722060-5229
722110-5226
722110-5229
13mm/24 gauge
17mm/24 gauge
connecting tube
13mm/24 gauge
17mm/24 gauge
connecting tube
79-060-2522
79-060-2622
76-060-2652
79-110-2522
79-110-2622
76-110-2652
25
pack of 10
46.33
46.33
46.33
46.33
46.33
46.33
46.33
46.33
pack of 10
89.76
89.76
123.04
123.04
123.04
155.31
155.31
155.31
each
8.60
8.60
8.60
8.60
each
8.60
8.60
2.20
8.60
8.60
2.20
Part III
List of Appliances
Indwelling Pleural Catheter Drainage Systems
Rocket IPC
Dressing Pack and Bottle
Pre-Evacuated Bottle
(R54400)
(R54410)
25.00
17.50
20 x 4ml
60 x 4ml
12.98
27.00
20 x 4ml
60 x 4ml
12.98
27.00
60 x 4ml
27.00
Inhalation Solutions
Sodium Chloride 3% Solution – Sterile
MucoClear 3%
Sodium Chloride 6% Solution – Sterile
MucoClear 6%
Sodium Chloride 7% Solution – Sterile
Nebusal 7%
Inspiratory Muscle Training Devices
Pressure Threshold Device
POWERbreathe Medic
Threshold IMT
Resistance Breathing Device
Ultrabreathe
17.90
11.50
10.95
Insufflators Plastics - for inhalation of fine powders
Cyclohaler
1.40
Irrigation Solutions
Octenilin
(Schulke & Mayr UK Ltd)
Bottle
350ml
4.60
Pod
Bottle
24 x 40ml
350ml
14.12
4.75
Sodium Chloride 0.9% Irrigation Solution – Sterile
Alissa
Pod
25 x 20ml
7.36
Clinipod
Pod
25 x 20ml
4.95
Crest Medical Ltd
Pod
25 x 20ml
4.99
Bellows pack
1x120ml
1.53
1x1000ml
0.97
Prontosan
(B Braun Medical Ltd)
Flowfusor
(Fresenius Kabi)
Fresenius Sodium Chloride 0.9% for irrigation
(Fresenius Kabi)
Pour Bottle
February 2015
26
Part III
List of Appliances
Irrigation Solutions cont
Generics UK
Pod
25 x 25ml
5.50
Irriclens
(Conva Tec)
Aerosol
1 x 240ml
3.49
Pod
25 x 20ml
5.84
ISO-POD
(St Georges Medical Ltd)
Pod
25 x 20ml
4.95
Normasol
(Molnlycke Health Care)
Sachet
25 x 25ml
10 x 100ml
6.42
7.80
Pod
25 x 20ml
7.91
Pour Bottle
1 x 150ml
0.99
100ml
240ml
2.06
3.13
Irripod
(CD Medical Ltd)
Sal-e Pods (Ennogen Healthcare Ltd)
Sterac
Stericlens
Aerosol
Steripod
(Molnlycke Health Care)
Pod
25 x 20ml
7.90
Sterowash
(Steroplast Ltd)
Pod
25 x 20ml
5.40
Fresenius Water for Irrigation
(Fresenius Kabi)
Pour Bottle
1 x 1000ml
0.97
Sterac
Pour Bottle
1 x 150ml
0.99
Water for Irrigation – Sterile
Note: The exact number of containers (i.e. aerosols, bellows packs, bottles, cans, pods, pour
bottles or sachets) ordered by the prescriber is to be dispensed.
Jaw Rehabilitation Device
TheraBite
Adult, Edentulous, Paediatric
each
221.37
pack of 4
10.34
22.5cm x 45cm, 7mm thick
Pack of 4
19.73
Device, initial Bite Pads and Accessories
Bite Pads
Adult, Paediatric
Latex Foam, Adhesive
Specification 19
Cervical Collar – now listed in Part III – Appliances
February 2015
27
Part III
List of Appliances
Leg Ulcer Wrap
4UlcerCare
28-35cm
35-43cm
43-51cm
51-61cm
61cm+
Each
13.80
13.80
13.80
13.80
13.80
Lint
To be supplied in sealed packets (film wrapped cartons) as received from the manufacturer or
wholesaler.
Absorbent Lint BPC
25g
0.94
(Syn. Absorbent Cotton Lint;
100g
2.87
Cotton Lint; Plain Lint; White Lint)
500g
12.06
Where no quantity is stated on the prescription form the 25g pack is to be supplied.
Low Friction Garments
Aderma Dermal Pad
Sacrum/Ankle Wrap
Heel
Strip
Devon Positioning Products
Foot and Heel Protector
Utility Pad
KerraPro
Heel
Sacrum/Ankle
Sheet
Strip
Undergarment
February 2015
51x30x5cm
per pair
4.99
7.99
10x10x0.3cm
10x10x1.2cm
50x2.5x0.3cm
30x5x0.3cm
each
14.83
16.69
4.20
12.64
5.26
6.32
XS,S,M,L,XL
XS,S,M,L,XL
XS,S,M,L,XL
XS,S,M,L,XL
XS,S,M,L,XL
35.14
35.14
35.14
35.14
35.14
Standard
Extra Large
Sheet
Parafricta
Bootee
10x10x0.3cm
10x10x1.2cm
20x20x0.3cm
50x2.5x0.3cm
30x5.0x0.3cm
each
16.87
15.02
17.12
4.30
12.89
17.16
5.38
6.45
Velcro Closure
Slip On
Velcro Closure
Brief Slip On
Boxer Slip On
28
Part III
List of Appliances
Lubricant Gels
Aquagel Lubricating Jelly (sterile until opened)
Cathejell Lidocaine C
Cathejell Mono
Elite Lubricating Jelly
Hydro-Caine Gel
CJL 08501
CJL 12501
CJM 08501
CJM 12501
HYD-006
HYD-011
KY Jelly (sterile until opened)
OptiLube Sterile Lubricating Jelly
1120
1121
1122
1125
1126
OptiLube Active Sterile Lubricating Jelly
1160
1161
Sutherland Lubricating Jelly (sterile until opened)
5g
42g
82g
8.5g
12.5g
8.5g
12.5g
50ml
6ml
11ml
82g
5g
42g
82g
6ml
11ml
6ml
11ml
5g
42g
82g
sachet
tube
tube
0.19
1.10
1.83
1.20
1.25
0.80
0.85
2.25
1.10
1.15
2.33
0.15
1.00
1.65
0.90
0.95
1.08
1.13
0.11
1.26
1.97
pump
syringe
syringe
tube
sachet
tube
tube
syringe
syringe
syringe
syringe
sachet
tube
tube
Micro-Enema – Sodium Citrate
Relaxit
Tube
12 x 5ml
5.21
Nasal Products
Nasal Aspirator
NoseFrida hygiene filters
NoseFrida nasal aspirator
Snufflebabe nasal aspirator (formerly Baby nose-clear nasal aspirator (4little1))
20
0.71
3.48
4.32
Dropper Bottle
10ml
14.95
Dropper Bottle
Dropper Bottle
Dropper Bottle
Dropper Bottle
Dropper Bottle
Dropper Bottle
10ml
10ml
10ml
10ml
10ml
10ml
0.99
0.99
0.95
0.99
0.99
0.99
500mg (200 dose)
4.32
Nasal Drops – Glucose in Glycerol
Glycerdex Nose Drops
Nasal Drops - Sodium Chloride 0.9%
Almus Pharmaceuticals
Mandanol
Orbis Consumer Products Ltd
RX Farma
Sandoz
Tubilux Pharma (Tubilux Brand)
Nasal Powder
Care Allergy Defence
February 2015
Powder Spray
29
Part III
List of Appliances
Nasal Spray
Aqua Maris Daily
Aqua Maris Junior
Aqua Maris Strong
Aqua Maris Baby
GeloSitin
Nozoril
Sterimar
Isotonic
Hypertonic
Sterimar Baby
Spray
Spray
Spray
Drops
Spray
Spray
30ml
30ml
30ml
15ml
15ml
10ml
2.49
2.49
2.77
2.39
5.25
3.99
Spray
Spray
Spray
50ml
50ml
50ml
2.49
2.89
2.49
Nipple Shields, Plastic
Semi-rigid polypropylene base with latex teat (each in carton)
(Not to be confused with Breast Shield)
0.66
Oral Film Forming Agents
Caphosol
( 1 dose = 1 x Caphosol A (15ml) + 1 x Caphosol B
(15ml)
Episil
Oral Spray
Gelclair
GeloRevoice
Lozenges
Gengigel
Gel
Mouthrinse
MuGard
30 doses
120 doses
34.28
130.70
10ml
21 x 15ml sachets
20 lozenges
20ml Tube
150ml bottle
250ml bottle
49.21
33.05
5.00
3.70
4.55
20.00
Oscillating Positive Expiratory Pressure Device
Acapella
Flutter
February 2015
40.50
40.50
30
Part III
List of Appliances
Peak Flow Meters
Syn. P.F.M
(Non-powered; hand-held)
Portable meters intended for single-patient use.
The standard range is suitable for use by both adults and children.
The low range model is for adults or children with severely restricted airflow.
The Peak Flow Meters standard range will conform to the ISO standard EN ISO 23747:2007.
The Peak Flow Meters low range will be CE marked and comply with EN ISO 23747:2007 in
all aspects except for a reduced measurement range.
Manufacturer
Standard Range EN ISO 23747:2007
Clement Clarke
Clement Clarke AirZone
Fyne Dynamics Pinnacle
Medicareplus International Ltd
Micro Medical
nSpire PiKo-1 Electronic Peak Flow/FEV1 Meter
nSpire Pocket Peak Flow Meter
Philips Respironics PersonalBest
Vitalograph
Vitalograph Child
Vitalograph myPEF
3103388
3130160
72000EU
60482
MPE 8200EU
346005- EU
208(EU)/F
1022973
43602
43703
43950
Low Range CE marked (must comply with the EN ISO 23747:2007 except for scale range)
Clement Clarke
3104708
Medicareplus International Ltd
60536
nSpire Pocket Peak Flow Meter
209(EU)/F
NB
7.08
4.69
6.50
4.50
6.50
9.50
6.53
6.86
4.83
4.83
7.08
7.14
6.50
6.53
1. "Low range" to be supplied only where specifically ordered.
2. Where the brand or manufacturer is not stated by the prescriber and has not been
endorsed, the basic price must not exceed £4.50(Standard Range) and £6.50(Low Range).
3. Replacement recording charts (FP1010) are given by the prescribing Doctor; they are also
available from pharmacists.
Replacement Mouthpiece/Adaptor (Plastics) for above
(Not interchangeable between brands or manufacturers)
Replacement mouthpiece - suitable for both standard and low range models for use by adults or
children
Clement Clarke
0.38
Micro Medical
0.38
nSpire
0.38
Pelvic Toning Devices
each
13.95
15.00
15.00
Aquaflex
Kegel8
PelvicToner
Perineal Massage Appliances
Elastolabo gel
February 2015
40ml
31
14.58
Part III
List of Appliances
Pessaries
Ring
Polythene
50-80mm(rising in 3 mm), 85-100mm(rising in 5 mm) OR 110mm
7.5mm thick
each
2.06
1.25cm thick
2.23
Size 0, 44mm (Outer Diameter)
Size 1, 51mm (Outer Diameter)
Size 2, 57mm (Outer Diameter)
Size 3, 64mm (Outer Diameter)
Size 4, 70mm (Outer Diameter)
Size 5, 76mm (Outer Diameter)
Size 6, 83mm (Outer Diameter)
Size 7, 89mm (Outer Diameter)
Size 8, 95mm (Outer Diameter)
Size 9, 102mm (Outer Diameter)
Size 0, 44mm (Outer Diameter)
Size 1, 51mm (Outer Diameter)
Size 2, 57mm (Outer Diameter)
Size 3, 64mm (Outer Diameter)
Size 4, 70mm (Outer Diameter)
Size 5, 76mm (Outer Diameter)
Size 6, 83mm (Outer Diameter)
Size 7, 89mm (Outer Diameter)
Size 8, 95mm (Outer Diameter)
Size 9, 102mm (Outer Diameter)
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
Size 0, 38mm (Outer Diameter)
Size 1, 45mm (Outer Diameter)
Size 2, 51mm (Outer Diameter)
Size 3, 57mm (Outer Diameter)
Size 4, 64mm (Outer Diameter)
Size 5, 70mm (Outer Diameter)
Size 6, 76mm (Outer Diameter)
Size 7, 83mm (Outer Diameter)
Size 8, 89mm (Outer Diameter)
Size 0, 38mm (Outer Diameter)
Size 1, 45mm (Outer Diameter)
Size 2, 51mm (Outer Diameter)
Size 3, 57mm (Outer Diameter)
Size 4, 64mm (Outer Diameter)
Size 5, 70mm (Outer Diameter)
Size 6, 76mm (Outer Diameter)
Size 7, 83mm (Outer Diameter)
Size 8, 89mm (Outer Diameter)
21.50
21.50
21.50
21.50
21.50
21.50
21.50
21.50
21.50
21.50
21.50
21.50
21.50
21.50
21.50
21.50
21.50
21.50
PVC
50-80mm(rising in 3 mm), 85-100mm(rising in 5 mm) OR 110mm
Bioteque America (R&J Medical Ltd)
Ring
Silicone
With Support
Without Support
Gellhorn
Silicone
Standard Stem
Short Stem
February 2015
32
Part III
List of Appliances
Pessaries cont.
GBUK vaginal pessary (GBUK Healthcare)
Ring
Silicone
Without Support
Gellhorn
Silicone
Size 0, 44mm (Outer Diameter)
Size 1, 51mm (Outer Diameter)
Size 2, 57mm (Outer Diameter)
Size 3, 64mm (Outer Diameter)
Size 4, 70mm (Outer Diameter)
Size 5, 76mm (Outer Diameter)
Size 6, 83mm (Outer Diameter)
Size 7, 89mm (Outer Diameter)
Size 8, 95mm (Outer Diameter)
19.00
19.00
19.00
19.00
19.00
19.00
19.00
19.00
19.00
Size 0, 38mm (Outer Diameter)
Size 1, 45mm (Outer Diameter)
Size 2, 51mm (Outer Diameter)
Size 3, 57mm (Outer Diameter)
Size 4, 64mm (Outer Diameter)
Size 5, 70mm (Outer Diameter)
Size 6, 76mm (Outer Diameter)
Size 7, 83mm (Outer Diameter)
Size 8, 89mm (Outer Diameter)
Size 0, 38mm (Outer Diameter)
Size 1, 45mm (Outer Diameter)
Size 2, 51mm (Outer Diameter)
Size 3, 57mm (Outer Diameter)
Size 4, 64mm (Outer Diameter)
Size 5, 70mm (Outer Diameter)
Size 6, 76mm (Outer Diameter)
Size 7, 83mm (Outer Diameter)
Size 8, 89mm (Outer Diameter)
20.49
20.49
20.49
20.49
20.49
20.49
20.49
20.49
20.49
20.49
20.49
20.49
20.49
20.49
20.49
20.49
20.49
20.49
Size 0, 44mm (Outer Diameter)
Size 1, 51mm (Outer Diameter)
Size 2, 57mm (Outer Diameter)
Size 3, 64mm (Outer Diameter)
Size 4, 70mm (Outer Diameter)
Size 5, 76mm (Outer Diameter)
Size 6, 83mm (Outer Diameter)
Size 7, 89mm (Outer Diameter)
Size 8, 95mm (Outer Diameter)
Size 9, 102mm (Outer Diameter)
Size 10, 108mm (Outer Diameter)
Size 11, 114mm (Outer Diameter)
Size 12, 121mm (Outer Diameter)
Size 13, 127mm (Outer Diameter)
20.80
20.80
20.80
20.80
20.80
20.80
20.80
20.80
20.80
20.80
20.80
20.80
20.80
20.80
Standard Stem
Short Stem
Milex (Mediplus Ltd)
Ring
Silicone
Without Support/Folding
February 2015
33
Part III
List of Appliances
Pessaries cont.
Silicone
With Support/Folding
Gellhorn
Silicone
Flexible
Size 0, 44mm (Outer Diameter)
Size 1, 51mm (Outer Diameter)
Size 2, 57mm (Outer Diameter)
Size 3, 64mm (Outer Diameter)
Size 4, 70mm (Outer Diameter)
Size 5, 76mm (Outer Diameter)
Size 6, 83mm (Outer Diameter)
Size 7, 89mm (Outer Diameter)
Size 8, 95mm (Outer Diameter)
Size 9, 102mm (Outer Diameter)
Size 10, 108mm (Outer Diameter)
Size 11, 114mm (Outer Diameter)
Size 12, 121mm (Outer Diameter)
Size 13, 127mm (Outer Diameter)
20.80
20.80
20.80
20.80
20.80
20.80
20.80
20.80
20.80
20.80
20.80
20.80
20.80
20.80
38mm (Outer Diameter)
44mm (Outer Diameter)
51mm (Outer Diameter)
57mm (Outer Diameter)
64mm (Outer Diameter)
70mm (Outer Diameter)
76mm (Outer Diameter)
83mm (Outer Diameter)
89mm (Outer Diameter)
95mm (Outer Diameter)
38mm (Outer Diameter)
44mm (Outer Diameter)
51mm (Outer Diameter)
57mm (Outer Diameter)
64mm (Outer Diameter)
70mm (Outer Diameter)
76mm (Outer Diameter)
83mm (Outer Diameter)
89mm (Outer Diameter)
95mm (Outer Diameter)
22.40
22.40
22.40
22.40
22.40
22.40
22.40
22.40
22.40
22.40
22.40
22.40
22.40
22.40
22.40
22.40
22.40
22.40
22.40
22.40
Short Stem
February 2015
34
Part III
List of Appliances
Physical Debridement Device
Physical Debridement Accessories
VersaJet Exact Handset 45/8mm
VersaJet Exact Handset 45/14mm
VersaJet II Exact Handset 45/8mm
VersaJet II Exact Handset 45/14mm
Physical Debridement Pad
DebriSoft
UCS Debridement
50637
50636
6680042
6680041
256.54
256.54
256.54
256.54
10cm x 10cm
6.35
3.25
Plantar Pressure Offloading Device
BeneFoot Medical Shoe
Original Post Op
(male)
(female)
(paediatric)
High Top
(male)
(female)
(paediatric)
POMS – POMXL
POWS – POWL
POPD
S, M, L, XL
S, M, L
One Size
each
12.99
12.99
12.99
POHTMS – POHTMXL
POHTWS – POHTWL
POHTPD
S, M, L, XL
S, M, L
One Size
16.99
16.99
16.99
Kerraped
All Purpose Boot
Kerraped Plantar Ulcer Shoe System
Single Boot + PegAssist Insole
S, M, L, XL
PegAssist Insole (replacement)
S, M, L, XL
Liqua Care
Diabetic FlowGel
Orthotics
Small, Medium, Large, Extra Large
17.75
KPUC002-KPUC005
56.49
KPUI002-KPUI005
25.99
9-3536
9-3738
9-3940
9-4142
9-4344
9-4546
Size 35-36
Size 37-38
Size 39-40
Size 41-42
Size 43-44
Size 45-46
Per pair
17.45
17.45
17.45
17.45
17.45
17.45
Plasters
Belladonna Adhesive Plaster BP
Medium
Large
(Syn. Belladonna Self-Adhesive Plaster; Belladonna Plaster)
February 2015
35
19cm x 12.5cm
28cm x 17.5cm
Each
1.46
2.54



Part III
List of Appliances
Potassium Hydroxide Solution
Molutrex (5%)
MolluDab (5%)
10ml
2ml
9.99
13.50
5g
25g
4.25
16.25
Small, Medium or Large
pack of 30
2.43
Small, Medium or Large
pack of 100
3.31
Prosthetic Adhesives
Edge Adhesive
Protectives
Hand
EMA Film Gloves - Disposable
(Dispos-A-Gloves Non-Sterile)
Nitrile Gloves
Finite P Indigo AF
Small, Medium, Large
Nitrile-Pro
Small, Medium, Large, Extra Large
Premier Prestige Nitrile Blue
Small, Medium, Large, Extra Large
Vitrex
Small, Medium, Large
Gloves - Polythene, 100 gauge
(Polythene Occlusive, Disposable For use as occlusives with medicated creams)
To be supplied in sealed packets as received from the manufacturer or wholesaler.
"The sizes given are lay-flat width x length."
Limb
LimbO Waterproof Protector
Adult 1/2 leg
MP76
MP76S
MP80
MP80S
MP180
MP180S
Adult elbow
MP65
MP75
Seal-Tight Wound Care Protector
CV27105
CV27103
CV27106
February 2015
Slim build
Slim build, short leg
Normal build
Normal build, short leg
Large build
Large build, short leg
Slim to medium build
Medium to large build
Adult foot/ankle
Adult short leg
Adult wide short leg
36
pack of 100
7.00
Pack of 200
8.50
pack of 150
6.75
pack of 50
3.89
pack of 25
0.60
each
10.56
10.56
10.56
10.56
10.56
10.56
12.95
12.95
each
10.50
10.50
10.50
Part III
List of Appliances
Silk Garments
size
DermaSilk
Infant Hat
0-3 months
3-12 months
12-24 months
One Size
Infant
Child
Teen size
Adult size
XS - S
M-L
XL - XXL
0-3 months
3-6 months
6-9 months
9-12 months
12-18 months
18-24 months
24-36 months
3-4 years
Adult (Male) XS – S
M–L
XL – XXL
3-6
7-10 years
3-6 years
7-10 years
Adult (Female) XS – S
M–L
XL – XXL
XS – S
M–L
XL – XXL
3-4 years
5-6 years
7-8 years
10-12 years
Adult Small – XXL
Adult (Male) Small – XXL
Adult (Female) Small – XXL
Eye Mask
Facial Mask
Soft Cup Bra
Body Suit
Boxer Shorts
Boy’s Briefs
Girl’s Briefs
Ladies Briefs (formerly Briefs)
Adult Female Mini Shorts
Shirt Roll Neck
Shirt Round Neck
Tubular Sleeves
33cm long
50cm long
Graduated 70cm long
0-3 months
3-6 months
6-9 months
9-12 months
12-18 months
18-24 months
24-36 months
Leggings
February 2015
37
each
16.95
16.95
16.95
10.06
16.29
16.29
20.78
20.78
37.95
37.95
37.95
37.88
37.97
39.05
40.06
40.14
41.15
41.23
42.31
41.36
41.36
41.36
21.56
21.56
21.56
21.56
30.77
30.77
30.77
32.95
32.95
32.95
46.78
49.91
51.99
54.07
76.90
76.90
76.90
Per Pair
27.10
33.45
41.30
27.05
27.10
28.19
29.22
29.28
30.31
30.36
Part III
List of Appliances
Silk Garments Cont
DermaSilk Leggings cont.
Size
3-4 years
Adult (Male) Small – XXL
Adult (Female) Small – XXL
Small child
Medium child
Small adult
Medium Adult
Large Adult
Extra Large Adult
Child 3-4 years
Child 5-9 years
Adult Small
Adult Medium
Adult Large
Adult X Large
Adult XX Large
Gloves
Fingerless Gloves
Pyjamas
3-4 years
5-6 years
7-8 years
10-12 years
Adult 5 - 6 1/2
Adult 7 - 8 1/2
Adult 9 - 10 ½
Adult 11 – 13
Comfort Socks
Knee-length Undersocks
(formerly Heel-Less Undersocks)
Thigh Length Undersock
Standard Length
Longer Length
Standard Length
Longer Length
Child 3 – 8
Child 9 – 1
Child 2 – 5
Adult 5 ½ - 6 ½
Adult 7 – 8 ½
Adult 9 – 10 ½
Adult 11 – 13
Undersocks
Size
One Size
Infant
Child
Teenager
Adult
0-3 months
0-6 months
3-6 months
6-9 months
DreamSkin (formerly DreamSkin Silk)
Eye Mask
Head Mask
Body Suit
February 2015
38
per pair
31.45
77.81
77.81
14.67
14.67
20.59
20.59
20.59
20.54
14.50
14.50
20.35
20.35
20.35
20.35
20.35
Per Set
70.56
74.90
78.16
81.42
18.30
18.30
18.30
18.30
Per 2 Pairs
24.07
24.07
34.50
34.50
18.30
18.30
18.30
18.30
18.30
18.30
18.30
each
10.06
15.48
15.48
20.19
20.19
35.15
36.06
35.65
37.09
Part III
List of Appliances
Silk Garments Cont
DreamSkin cont (formerly DreamSkin Silk)
Size
9-12 months
12-18 months
18-24 months
24-36 months
3-4 years
5-6 years
7-8 years
9-10 years
11-12 years
Adult (Male) Small – XXL
Adult (Female) Small – XXL
3-4 years
5-6 years
7-8 years
9-10 years
11-12 years
Adult (Male) Small – XXL
Adult (Female) Small – XXL
3-4 years
5-6 years
7-8 years
9-10 years
11-12 years
Adult (Male) Small – XXL
Adult (Female) Small – XXL
Shirt Polo Neck
(Available in boys & girls sizes)
Shirt Round Neck
(Available in boys & girls sizes)
Briefs and Fitted Boxers
Tubular Sleeves
33cm long
50cm long
0-3 months
0-6 months
3-6 months
6-9 months
9-12 months
12-18 months
18-24 months
24-36 months
3-4 years
3-4 years
5-6 years
7-8 years
9-10 years
11-12 years
Adult (Male) Small –XXL
Adult (Female) Small – XXL
Small Child
Medium Child
Small Adult
Medium Adult
Large Adult
Extra Large Adult
Baby Leggings with foldaway feet
(formerly Leggings)
Leggings (Footless)
(Available in boys & girls sizes)
Gloves
February 2015
39
each
37.63
38.12
38.64
39.16
45.46
48.49
50.51
51.53
52.54
74.72
74.72
45.47
47.49
49.51
50.52
51.54
74.72
74.72
21.19
21.19
21.19
21.19
21.19
33.33
31.31
Per pair
26.13
32.50
24.95
25.45
25.45
26.77
27.29
27.81
28.32
28.84
29.87
29.87
31.35
31.85
32.36
32.86
75.60
75.60
14.14
14.14
19.85
19.85
19.85
19.85
Part III
List of Appliances
Silk Garments Cont
Pyjamas
(Available in boys & girls sizes)
3-4 years
5-6 years
7-8 years
9-10 years
11-12 years
Liner Socks
Child 3 – 5 ½
Child 6 – 8 ½
Child 9 – 12
Child 12 ½ - 3 ½
Child 4 – 5 ½
Adult (Female) 4 – 5 ½
Adult (Female) 6 – 8 ½
Adult (Male) 6 – 8 ½
Adult (Male) 9 – 11
One Size
Heel-Less Undersocks
Size
6 months-5 years
5-14 years
6-24 months
2-5 years
5-8 years
8-11 years
11-14 years
Adult Small
Adult Medium
Adult Large
6-24 months
2-5 years
5-8 years
8-11 years
11-14 years
Adult Small
Adult Medium
Adult Large
Premature
0-3 months
3-6 months
6-12 months
6-24 months
2-5 years
5-8 years
8-11 years
11-14 years
Adult Small
Adult Medium
Adult Large
Skinnies Silk
Clavas
Leggings
Tops
Baby Grow
Shorts
February 2015
40
Per set
67.01
71.14
74.23
75.81
77.33
Per 2 pairs
17.78
17.78
17.78
17.78
17.78
17.78
17.78
17.78
17.78
23.39
each
14.80
14.80
25.28
28.39
29.90
32.70
35.90
69.99
71.99
73.72
44.46
47.49
49.51
51.54
52.54
69.99
71.99
73.72
35.81
35.81
35.81
37.87
19.99
19.99
19.99
19.99
21.99
37.99
38.49
38.99
Part III
List of Appliances
Silk Garments Cont
Size
Child 6-24 months
Child 2-5 years
Child 5-8 years
Child 8-11 years
Child 11-14 years
Adult Small
Adult Medium
Adult Large
6-24 months
2-5 years
5-8 years
8-11 years
11-14 years
Adult Small
Adult Medium
Adult Large
0-24 months
2-8 years
8-14 years
6months-8 years
8-14 years
Child Small
Child Medium
Child Large
Adult Small
Adult Medium
Adult Large
Child Small
Child Medium
Child Large
Adult Small
Adult Medium
Adult Large
Adult XL
Skinnies Silk cont
Vests Sleeveless
Short Sleeve Vests
Mittens
Socks
Gloves
Knee Length Sock
February 2015
41
Per Pair
42.29
42.79
43.29
43.79
44.11
67.49
68.99
69.99
43.39
44.49
44.99
45.11
45.49
68.99
70.99
72.99
13.49
13.49
13.49
16.75
16.75
13.22
13.49
13.99
17.98
18.19
18.96
22.39
22.39
22.39
22.39
22.39
22.39
22.39
Part III
List of Appliances
Sodium Hyalauronate Injection
SportVis
1 injection
2 injections
each
69.50
139.00
Spacer/Holding Chamber Device
A2A Spacer
A2A Spacer with small or medium mask
Able Spacer
Able Spacer with either Small (infant), Medium (child) mask
Aerochamber Plus
Aerochamber Plus with adult, child or infant face mask
Compact Space Chamber Plus (see Space Chamber Plus Compact)
Fisio Chamber Vision
Fisio Chamber Vision with infant mask (0-3 years)
Fisio Chamber Vision with paediatric mask (3-6 years)
Fisio Chamber Vision with large mask (6 years-adult)
Flo-Tone MDI (regular fit)
Flo-Tone MDI (circular fit)
Free Breath Spacer
Free Breath Spacer with removable adult, child or infant face mask
OptiChamber
OptiChamber Diamond
OptiChamber Diamond with small LiteTouch Mask (0-18 months)
OptiChamber Diamond with medium LiteTouch Mask (1-5 years)
OptiChamber Diamond with large LiteTouch Mask (5 years - adult)
Pocket Chamber
Pocket Chamber with infant, child, teenager or adult mask
Space Chamber Plus
Space Chamber Plus with small, medium or large mask
Space Chamber Plus Compact (formerly Space chamber Plus)
Space Chamber Plus Compact with small, medium or large mask
Volumatic
Volumatic with paediatric mask
Vortex
Vortex with child mask (age 0-2 years)
Vortex with child mask (age 2+ years)
each
4.15
6.68
4.39
7.16
4.79
7.99
4.40
7.35
7.35
7.35
pack of 2
2.90
2.90
each
4.50
7.20
4.28
4.49
7.49
7.49
7.49
4.18
9.75
4.26
6.98
4.26
6.98
2.91
2.91
6.28
7.99
7.99
Spinal Alignment Cushion
Rophi Cushion
February 2015
18cm x 18cm x 9cm
42
each
12.00
Part III
List of Appliances
Stockinette
To be supplied in sealed packets as received from the manufacturer or wholesaler.
Cotton Stockinette, Bleached BP
2.5cm x 1m
0.38
(Syn. Cotton Stockinette)
5cm x 1m
0.60
7.5cm x 1m
0.71
10cm x 6m
4.88
NB: 1m in length for use as a basic for Plaster of Paris or other bandages. 6m length for use use as a
compression bandage.
Cotton Impregnated with Antimicrobial Agents - Garments
skintoskin
born Kit
Summer
Winter
Babygrow
0-3 months
3-6 months
6-9 months
9-12 months
12-18 months
18-24 months
Body Suit (winter)
T-Shirt (long sleeve)
T-Shirt (short sleeve)
Leggings (footless)
Leggings (footless)(available as female and male)
Leggings with feet
February 2015
43
0-3 months
3-6 months
6-9 months
9-12 months
12-18 months
18-24 months
2-3 years
4-5 years
6-7 years
8-10 years
11-13 years
Adult Small – XL
2-3 years
4-5 years
6-7 years
8-10 years
11-13 years
Adult Small – XL
2-3 years
4-5 years
6-7 years
8-10 years
11-13 years
Adult Small – XL
0-3 months
3-6 months
6-9 months
9-12 months
12-18 months
18-24 months
Pack of 1 set
34.00
39.00
Pack of 1
16.95
16.95
16.95
16.95
16.95
16.95
Pack of 2
32.00
32.00
32.00
32.00
32.00
32.00
33.00
33.00
33.00
38.00
38.00
44.00
32.00
32.00
32.00
37.00
37.00
43.00
36.00
36.00
36.00
39.00
39.00
48.00
28.00
28.00
28.00
28.00
28.00
28.00
Part III
List of Appliances
Cotton Impregnated with Antimicrobial Agents - Garments cont
Skintoskin cont
Boxer (female)
Boxer (male)
Socks
Elasticated Nylon/Elastane Stockinette - Garments
Skinnies WEB
Skull Cap
Clava
Round Top Long Sleeve
Round Top Short Sleeve
High Top Long Sleeve
High Top Short Sleeve
Wrap Top Long Sleeve
Wrap Top Short Sleeve
Wrap Top Sleeveless
Single Arm Top
February 2015
Child 22-24
Child 25-27
Child 28-30
Child 31-33
Child 34-36
Child 36-38
Child 37-39
Adult 39-41
Adult 42-45
Pack of 2
22.00
22.00
22.00
26.00
26.00
26.00
23.00
23.00
23.00
27.00
27.00
27.00
Pack of 3 pair
18.00
18.00
18.00
22.00
22.00
22.00
22.00
22.00
22.00
0-5 years
5-11 years
11-14 years
S,M,L
0-5 years
5-11 years
11-14 years
S,M,L
0-24 months
2-7 years
7-11 years
11-14 years
XS,S,M,L,XL
0-24 months
2-7 years
7-11 years
11-14 years
XS,S,M,L,XL
0-24 months
2-7 years
7-11 years
11-14 years
XS,S,M,L,XL
0-24 months
2-7 years
7-11 years
11-14 years
XS,S,M,L,XL
XS,S,M,L,XL
XS,S,M,L,XL
XS,S,M,L,XL
XS,S,M,L,XL
each
35.00
35.00
35.00
40.50
35.00
35.00
35.00
40.50
85.00
85.00
85.00
85.00
99.00
75.00
75.00
75.00
75.00
90.00
90.00
90.00
90.00
90.00
105.75
80.00
80.00
80.00
80.00
96.75
148.50
135.00
121.50
72.00
2-3 years
4-5 years
6-7 years
8-10 years
11-13 years
Adult Small – XL
2-3 years
4-5 years
6-7 years
8-10 years
11-13 years
Adult Small – XL
44
Part III
List of Appliances
Arm Tube
0-5 years
5-11 years
11-14 years
S,M,L
0-5 years
5-11 years
11-14 years
S,M,L
0-5 years
5-11 years
11-14 years
S,M,L
0-5 years
5-11 years
11-14 years
S,M,L
Lower Leg Tube
Upper Leg Tube
Waist Tube
Leggings
0-24 months
2-7 years
7-11 years
11-14 years
XS,S,M,L,XL
XS,S,M,L,XL
XS,S,M,L,XL
0-24 months
2-7 years
7-11 years
11-14 years
XS,S,M,L,XL
XS,S,M,L,XL
XS,S,M,L,XL
0-5 years
5-11 years
11-14 years
S,M,L
0-5 years
5-11 years
11-14 years
S,M,L
0-5 years
5-11 years
11-14 years
S,M,L
S,M,L
S,M,L
Crotchless Leggings
Single Leg Leggings
Shorts
Crotchless Shorts
Single Leg Shorts
Socks
Gloves Full 5 Digit
Gloves Half 5 Digit
Gloves 2 Digit
Mitten
February 2015
45
45.00
45.00
45.00
51.75
45.00
45.00
45.00
51.75
45.00
45.00
45.00
51.75
45.00
45.00
45.00
51.75
Per pair
75.00
75.00
75.00
75.00
83.25
83.25
72.00
50.00
50.00
50.00
50.00
58.50
58.50
58.50
35.00
35.00
35.00
40.50
45.00
45.00
45.00
51.75
40.00
40.00
40.00
45.00
40.50
40.50
Part III
List of Appliances
Stockinette cont.
Elasticated Surgical Tubular Stockinette Foam Padded
Tubipad
Heel, Elbow, Knee
Small 'P4'
Medium 'P4X
Large 'P5'
Sacral
Medium 'P9'
Large 'P9
6.5cm x 60cm
7.5cm x 60cm
10cm x 60cm
28cm x 27cm
35cm x 27cm
Elasticated Tubular Bandage BP
(Elasticated Surgical Tubular Stockinette, ESTS, Elasticated Stockinette)
Size
4.5cm
6.25cm
6.75cm
A
B
C
Ref.
0.5m
1m
0.5m
1m
0.5m
1m
Quantity
CLINIgrip
0.61
1.10
0.61
1.10
0.65
1.17
Comfigrip
0.61
1.10
0.65
1.17
Eesiban ESTS
0.87
1.57
0.95
1.66
easiGRIP
0.62
1.11
0.66
1.18
Tubigrip
0.99
1.78
1.07
1.88
Size
Ref.
Quantity
CLINIgrip
Comfigrip
Eesiban ESTS
easiGRIP
Tubigrip
8.75cm
E
0.5m
1m
0.74
1.26
0.74
1.26
1.05
1.80
0.75
1.28
1.18
2.04
10cm
F
0.5m
1m
0.74
1.26
0.74
1.26
1.05
1.80
0.75
1.28
1.18
2.04
12cm
G
0.5m
1m
0.77
1.47
0.77
1.47
1.09
2.09
0.78
1.49
1.23
2.35
3.00
3.23
3.46
15.28
15.28
7.5
D
0.5m
0.66
0.66
0.95
0.67
1.07
1m
1.19
1.19
1.66
1.20
1.88
17.5
J
0.5m
0.92
-
1m
1.59
-
NB: 1 Where no quantity is stated by the prescriber the 0.5 metre length should be supplied.
2 Where the size is not stated by the prescriber, the size supplied should be endorsed.
3 Where the brand is not stated by the prescriber the basic price of this stockinette must not
exceed:
Size and Quantity
4.5cm x 0.5m
4.5cm x 1.0m
6.25cm x 0.5m
6.25cm x 1.0m
6.75cm x 0.5m
6.75cm x 1.0m
February 2015
each
0.61
1.10
0.61
1.10
0.65
1.17
each
7.5cm x 0.5m
7.5cm x 1.0m
8.75cm x 0.5m
8.75cm x 1.0m
10.00cm x 0.5m
10.00cm x 1.0m
46
0.66
1.19
0.74
1.26
0.74
1.26
each
12.00cm x 0.5m
12.00cm x 1.0m
17.50cm x 0.5m
17.50cm x 1.0m
0.77
1.47
0.92
1.59
Part III
List of Appliances
Stockinette cont.
Elasticated Viscose Stockinette – Bandage
(Lightweight Elasticated Viscose Tubular Bandage)
A lightweight, plain-knitted elasticated tubular fabric for dressing retention: washable for re-use
Acti-Fast
2-way
stretch
CliniFast
Comfi
fast
Comfifast
Multi
Stretch
Coverflex
Easifast
Fortuna
Fast
Tubifast
2-way
stretch
Small Limb
3.5cm (Red
Line)
1m
0.56
0.56
0.56
0.72
0.81
0.65
0.85
0.92
Medium
Limb
5.0cm
(Green Line)
1m
0.58
0.58
0.58
0.78
0.85
0.69
0.89
0.99
3m
1.62
2.81
1.62
2.81
1.62
2.81
2.23
3.82
2.49
4.29
1.95
3.40
2.13
3.05
2.82
4.83
Large Limb
7.5cm
(Blue Line)
1m
0.77
2.13
3.74
0.77
2.13
3.74
0.77
2.13
3.74
1.05
2.93
5.12
1.19
2.82
5.59
0.94
2.60
4.50
1.23
2.68
3.75
1.32
3.72
6.48
Trunk (Child)
10.75cm
(Yellow
Line)
1m
5m
1.20
3.49
6.04
1.20
3.49
6.04
1.20
3.49
6.04
1.67
4.78
8.21
1.86
5.37
9.44
1.50
4.25
7.20
1.75
3.75
6.04
2.11
6.05
10.39
Trunk (Adult)
17.5cm
(Beige Line)
1m
1.83
1.83
1.83
2.49
2.49
1.90
2.28
Trunk (Lrg
Adult) 20cm
(Purple
Line)
1m
3.20
3.42
5m
16.15
16.76
February 2015
5m
3m
5m
3m
47
Part III
List of Appliances
Stockinette cont.
Elasticated Viscose Stockinette -Garments
CliniFast
Comfifast
Easy Wrap
Skinnies
Tubifast 2way stretch
each
Body Suit
Clava
Vest Long
Sleeve
Vest Short
Sleeve
Vest
Sleeveless
Cycle
Shorts
February 2015
Premature
Up to 3 months
3-6 months
6-12 months
6 months - 5 years
5 - 14 years
6 - 24 months
2 - 5 years
5 - 8 years
8 - 11 years
11 - 14 years
Small Adult
Medium adult
Large Adult
6-24 months
2-5 years
5-8 years
8-11 years
11-14 years
Small Adult
Medium Adult
Large Adult
6 – 24 months
2 - 5 years
5 - 8 years
8 - 11 years
11 - 14 years
Small Adult
Medium adult
Large Adult
-
-
5.85
6.75
7.13
9.50
10.69
11.88
11.88
12.75
14.54
16.58
5.85
6.75
7.13
9.50
10.69
11.88
11.88
12.75
14.54
16.58
12.50
14.25
16.25
-
Small Adult
12.50
per pair
-
Medium Adult
Large Adult
14.25
16.25
-
48
16.18
16.18
16.18
18.21
6.74
7.73
10.48
13.74
15.52
17.20
17.20
21.27
23.20
25.13
10.38
13.63
15.36
17.09
17.09
21.16
23.10
25.03
10.38
13.63
15.42
17.09
17.09
21.16
23.10
25.03
11.36
15.14
17.04
18.93
18.93
-
-
-
-
-
-
Part III
List of Appliances
Stockinette
Elasticated Viscose Stockinette –Garments cont
CliniFast
Gloves
Knee
Length
Shorts
Knee Sock
Leggings
Mittens
Socks
Tights
February 2015
Extra Small Child
Small Child
Medium Child
Large Child
Large Child, Small
Adult
Small Adult
Small/Medium Adult
Med./Large Child
Med. Adult
Medium/Large Adult
Large Adult
6-24 months
2-5 years
5 - 8 years
8 - 11 years
11 - 14 years
Small Adult
Medium adult
Large Adult
Small Child 0-1
Medium Child 1-2
Large Child 2-4
Small Adult 4-6
Medium Adult 6-8
Large Adult 8-11
X Large Adult 11+
6 – 24 months
2 - 5 years
5 - 8 years
8 - 11 years
11 - 14 years
Small Adult
Medium adult
Large Adult
Up to 24 months
2 - 8 years
8 - 14 years
One Size
Up to 8 years
6m – 8 years
8 - 14 years
6-24 months
Comfifast
Easy Wrap
Skinnies
Tubifast 2way stretch
4.99
4.99
4.99
per pair
-
5.29
5.34
5.34
-
5.69
5.69
-
4.99
-
5.29
5.34
5.69
-
4.99
9.50
10.69
11.88
11.88
12.75
14.54
16.58
2.97
2.97
2.97
2.97
2.97
7.13
9.50
10.69
11.88
11.88
12.75
14.54
16.58
2.97
2.97
2.97
2.97
2.97
7.13
5.34
10.38
13.63
15.42
17.09
17.09
21.16
23.10
25.03
13.94
13.94
13.94
13.94
13.94
13.94
13.94
10.48
13.74
15.52
17.20
17.20
21.27
23.20
25.13
3.87
3.87
3.87
4.27
4.27
-
5.69
15.14
17.04
18.93
18.93
4.79
11.36
49
Part III
List of Appliances
Stockinette
Ribbed Cotton Surgical Tubular Stockinette
Eesiban
Arm/Leg (child); arm (adult)
Arm (OS adult); leg (adult)
Leg (OS adult)
Trunk (child)
Trunk (adult)
Trunk (OS adult)
5cm x 5m
7.5cm x 5m
10cm x 5m
15cm x 5m
20cm x 5m
25cm x 5m
each
2.55
3.36
4.44
6.40
7.39
8.83
Ribbed Stockinette (Molnlycke)
Arm/Leg (child); arm (adult)
Arm (OS adult); leg (adult)
Leg (OS adult)
Trunk (child)
Trunk (adult)
Trunk (OS adult)
5cm x 5m
7.5cm x 5m
10cm x 5m
15cm x 5m
20cm x 5m
25cm x 5m
2.48
3.28
4.36
6.27
7.19
8.67
NB:
One 5m length of the relevant width is sufficient to provide two sets of dressing for a pair of limbs or a
trunk.
Two full suits for an OS adult are provided from one pack each of the 7.5cm, 10cm and 25cm widths.
Two full suits for a standard sized adult are provided from one pack each of the 5cm, 7.5cm and 20cm
widths.
Two full suits for a young child are provided from one pack each of the 5 cm and 15 cm width.
Stoma Appliances
(Colostomy, Ileostomy)
All products - Manufaturer’s list price as stated in the England & Wales Drug Tariff Price
NB:
Where the prescriber has not specified the type of appliance or part thereof or
accessory, the Chemist or Appliance Contractor must endorse the prescription stating the type
supplied and submit the invoice to the BSO.
February 2015
50
Part III
List of Appliances
Surgical Adhesive Tapes
To be supplied on spools, suitably protected, or in tins or cartons as received from the manufacturer or
wholesaler.
Elastic Adhesive Tape BP
(Syn. Elastic Surgical Adhesive Tape)
2.5cm x 4.5m
stretched
1.79
2.5cm x 3m
2.5cm x 5m
5cm x 5m
7.5cm x 5m
1.42
2.12
2.69
3.92
2.5cm x 5m
5cm x 5m
1.77
3.37
Permeable, Apertured Non-Woven Synthetic Adhesive Tape BP 1988
(Syn: Permeable Non-Woven Surgical Synthetic Adhesive Tape)
Chemifix
2.5cm x 5m
5cm x 5m
10cm x 5m
2.5cm x 10m
5cm x 10m
10cm x 10m
Hygiofix
2.5cm x 10m
5cm x 10m
7.5cm x 10m
10cm x 10m
15cm x 10m
20cm x 10m
Hypafix
5cm x5m
10cm x 5m
2.5cm x10m
5cm x 10m
10cm x 10m
15cm x 10m
20cm x 10m
30cm x 10m
Mefix
2.5cm x 5m
5cm x 5m
10cm x 5m
15cm x 5m
20cm x 5m
30cm x 5m
Omnifix
5cm x 10m
10cm x 10m
15cm x 10m
Primafix
5cm x 10m
10cm x 10m
15cm x 10m
20cm x 10m
0.90
1.25
2.10
1.00
1.40
2.10
1.10
1.90
2.55
2.85
4.55
6.25
1.43
2.40
1.67
2.65
4.63
6.86
9.10
13.15
1.02
1.81
2.89
3.94
5.04
7.24
2.38
4.02
5.93
1.58
2.32
3.43
4.22
Impermeable Plastic Adhesive Tape BP
(Syn. Impermeable Plastic
Surgical Adhesive Tape)
Impermeable Plastic Synthetic Adhesive Tape BP 1988
(Syn. Impermeable Plastic Surgical Synthetic Adhesive Tape)
Blenderm
February 2015
51
Part III
List of Appliances
Surgical Adhesive Tapes cont
Permeable Non-Woven Synthetic Adhesive Tape BP 1988
(Syn. Permeable Non-Woven Surgical Synthetic Adhesive Tape)
Size
Quantity
Chemipore
Clinipore
Leukofix
Leukopore
Mediplast
Micropore
Scanpor
Transpore
1.25 cm
5m
10m
(p)
(p)
0.27
0.35
0.55
0.49
0.30
0.62
0.42
0.55
0.52
-
2.5 cm
5m
10m
(p)
(p)
0.45
0.70
0.59
0.73
0.89
0.76
0.50
0.92
0.68
0.92
0.84
-
5 cm
5m
(p)
0.95
0.99
1.55
1.34
1.62
1.18
1.4
10m
(p)
1.75
-
5m
(p)
-
7.5 cm
10m
(p)
2.56
-
Where no brand is stated by the prescriber, the basic price of the tape supplied must not exceed:
1.25cm x 5m
0.27
2.5cm x 5m
0.45
5cm x 5m
0.95
Soft Silicone Fixation Tape
3M Kind Removal Silicone Tape (no liner)
2.5cm x 5m
5cm x 5m
3.58
6.48
Insil
2cm x 3m
4cm x 1.5m
2cm x 3m
4cm x 1.5m
2.5cm x 5m
5cm x 5m
2cm x 3m
4cm x 1.5m
5.77
5.77
6.93
6.93
10.20
19.13
5.60
5.60
1.25cm x 5m
2.5cm x 5m
5cm x 5m
7.5cm x 5m
Strappal
2.5cm x 5m
5cm x 5m
7.5cm x 5m
Zinc Oxide Adhesive Tape BP
1.25cm x 5m
(Syn. Zinc Oxide Surgical Adhesive Tape)
2.5cm x 5m
5cm x 5m
7.5cm x 5m
Where no size or quantity is stated by the prescriber 2.5cm x 1m should be supplied.
0.82
1.19
1.99
2.99
1.37
2.32
3.49
1.00
1.45
2.45
3.68
Mepitac
OpSite Flexifix Gentle
Siltape
Zinc Oxide Adhesive Tape
(Zinc Oxide Surgical Adhesive Tape)
Mediplast – zinc oxide plaster
February 2015
52


Part III
List of Appliances
Surgical Sutures*
Code No
Metric Gauge
Length
Needle
Absorbable Sutures
Sterile Synthetic
B Braun Medical Ltd
Poliglecaprone absorbable suture composed of a copolymer of glycolide and caprolactone
Pack of 36
Monosyn suture
C0023285
2.0
70cm
60mm straight cutting needle (undyed)
78.43
Polyglycolic acid absorbable suture coated with glyconate which gives rapid strength loss and
absorption profile.
Safil suture
C1048150
1.5
70cm
18mm 3/8 curved round bodied needle
67.00
(violet)
Polyglycolic acid absorbable suture coated with glyconate which gives rapid strength loss and
absorption profile (and accelerated degradtion)
Safil Quick suture
C1046610
1.0
45cm
11mm 3/8 curved reverse cutting needle
with micro point (undyed)
C1046420
1.5
70cm
19mm 3/8 curved reverse cutting needle
(undyed)
C1046530
2.0
70cm
19mm 3/8 curved rverse cutting needle
with micro point (undyed)
C1046651
3.0
90cm
37mm ½ circle tapercut needle (undyed)
C1046213
1.5
70cm
16mm 3/8 curved reverse cutting needle
(undyed)
C1046657
2.0
70cm
24mm 3/8 curved reverse cutting needle
with micro point (undyed)
123.80
112.32
103.77
105.28
99.38
104.45
Ethicon Monocryl Poliglecaprone absorbable sutures composed of copolymer of
glycolide ε-caprolactone:
W3207
2.0
45cm
19mm P needle reverse cutting (undyed)
W3205
1.5
45cm
16mm P needle reverse cutting (undyed)
Pack of 12
Ethicon PDS ll-polyester polydioxanone absorbable sutures
W9873T
1.5
45cm
16mm P needle reverse cutting (clear)
pack of 24
95.86
Ethicon Vicryl - Polyglactin 910 absorbable sutures composed of copolymer of
glycolide and lactide
W9074
1.5
45cm
16mm Curved Round Bodied
pack of 12
W9515T
W9516T
1.5
2.0
45cm
45cm
19mm P needle reverse cutting (undyed)
19mm P needle reverse cutting (undyed)
Ethicon Vicryl Plus-polyglactin 910 absorbable sutures composed of copolymer
of glycolide and lactide which contain Irgacare MP (Triclosan)
VCP683H
2.0
45cm
24mm P needle reverse cutting (undyed)
VCP497H
2.0
45cm
19mm P needle reverse cutting (undyed)
February 2015
53
41.86
43.19
24.97
pack of 24
75.58
73.77
pack of 36
133.72
141.65
Part III
List of Appliances
Surgical Sutures* cont
Ethicon Vicryl Rapide - polyglactin 910 absorbable sutures composed of
copolymer of glycolide and lactide which have been specially treated to give rapid
strength loss and absorption profiles:
W9915
1.0
45cm
12mm P Needle Curved Reverse cutting
W9922
1.5
75cm
19mm P Needle Curved Reverse Cutting
W9918
1.5
75cm
16mm P Needle Curved Cutting
W9932
2.0
75cm
26mm P Needle Curved Reverse Cutting
W9923
2.0
75cm
19mm P Needle Curved Reverse Cutting
Pack of 12
45.87
41.62
36.83
38.70
38.46
Non-Absorbable Sutures
Ethicon
Code No
Sterile Synthetic
B Braun Medical Ltd
Metric
Gauge
Length
Polyamide suture, monofilament
Dafilon suture
C0936227
1.0
45cm
C0936146
0.7
45cm
C0933201
1.5
45cm
C0932353
2.0
45cm
Polyamide suture, monofilament
Premilene suture
C0090655
1.5
45cm
Needle
Pack of 36
19mm 3/8 curved reverse cutting needle
with micro point (blue)
16mm 3/8 curved reverse cutting needle
micro point (blue)
19mm 3/8 curved reverse cutting needle
(blue)
24mm 3/8 curved reverse cutting needle
(blue)
55.09
24mm 3/8 curved reverse cutting needle
with micro point (blue)
63.57
53.87
37.11
38.36
Ethicon
Sterile Polyamide Synthetic Suture
W1618T
1.0
45cm
19mm P needle curved reverse cutting
Pack of 24
40.83
Sterile Polyamide 6 Suture, Monofilament
W319
1.5
45cm (blue)
W320
2
45cm (blue)
19mm Curved reverse cutting
26mm Curved reverse cutting
W1615T
W1621T
16mm P needle curved cutting
16mm P needle reverse cutting
Pack of 12
13.75
14.21
Pack of 24
39.92
45.33
26mm P needle curved cutting
47.11
0.7
2.0
45cm (black)
45cm (blue)
Sterile Polypropylene Suture, Monofilament
W8020T
1.5
45cm (blue)
February 2015
54
Part III
List of Appliances
Skin Adhesive, Sterile
Dermabond Propen*
0.5ml Pen
19.08
0.5ml
5.36
Indermil*
0.5g
6.50
Histoacryl*
0.2g
0.5g
0.2g
0.5g
6.41
6.50
6.20
6.72
Liquiband Flow Control Tissue Adhesive*
0.5g
5.50
Liquiband Tissue Adhesive*
0.5g
5.50
3 strips per envelope
Pack of 10
Envelopes
6.28
3 strips per envelope
Pack of 50
Envelopes
23.95
3 strips per envelope
Pack of 12
Envelopes
8.77
Derma+Flex*
Histoacryl L*
Skin Closure Strips, Sterile
*Leukostrip
Code No 2952
*Omnistrip
Code No. 540683
*Steri-strip
Code No GP 41
6.4m x 76mm
6mm x 76mm
6mm x 75mm
* To be supplied on stock orders only
Swabs
Packet
Alcohol Impregnated Swabs
Medicareplus Skin Prep Wipes
3cm sq
100 sachets per pkt
1.60
3cm sq
100 sachets per pkt
1.80
7.5cm sq
5 pads per pkt
0.41
Gauze Swab Type 13 Light BP, Non Sterile
Swabs of folded 8-ply undyed gauze
10cm sq.
100 pads per pkt
1.43
Filmated Gauze Swab BP1988 Non Sterile
A thin layer of Absorbent Cotton enclosed within
Absorbent Cotton Gauze Type 13 LightBP 1988 8-ply
10cm sq.
100 pads per pkt
3.84
Sterets Skin Cleansing Swab
Gauze Swabs
Gauze Swab Type 13 Light BP, Sterile
Sterile swabs of folded 8-ply undyed gauze
February 2015
55
Part III
List of Appliances
Swabs - cont
Non-Woven Fabric Swabs
The labelling of each pack shall include: The Title, "Drug Tariff specification" and number.
Non-Woven Fabric Swab, Sterile
Specification 28 (5 pads per pkt)
Non-Woven Fabric Swab, Non Sterile
Specification 28 (100 pads per pkt)
Swabs of folded 4-ply non-woven fabric.
7.5cm square
0.27
10cm square
0.83
These swabs are an alternative to gauze swabs Type 13 light BP, for general swabbing and cleansing purposes
Filmated Non-Woven Fabric Swab, Non-Sterile,
Specification 29 (100 pads per pkt)
10cm square
3.78
Swabs of folded 8-ply non-woven viscose fabric containing a film of viscose fibres to increase absorbency.
These swabs are an alternative to Filmated Gauze Swabs BP for general swabbing and cleansing purposes
Sterile swabs of folded 4-ply non-woven fabric.
These swabs are an alternative to Gauze Swabs Type 13 Light BP 1988 Sterile
(Supplied in packets of 20)
NB:
Sterile Swabs - These sterile dressings are to be supplied in packs of 5 swabs 7.5cm square in a sealed
pack as received from the manufacturer, supplier or wholesaler. They should not be confused with the
non sterile 10cm size in packets of 100 swabs used for general swabbing purposes.
The exact number of sterile swabs ordered are to be supplied except for orders not in multiples of 5. A
packet to be used for each sterile dressing operation; unused swabs to be discarded as unsterile.
Synovial Fluid
Arthrum H
Crespine Gel
Durolane
Euflexxa
Fermathron
Monovisc
Orthovisc
Ostenil
Ostenil Plus
RenehaVis
Suplasyn
Synocrom
Synocrom Mini
Synolis
Synopsis
Synvisc
(Hylan G-F20)
Synvisc ONE
(Hylan G-F20)
February 2015
Box containing 3 pre-filled 2ml syringes
Box containing 1 pre-filled 2ml syringe
Box containing 1 pre-filled 3ml syringe
Box containing 3 pre-filled 2ml syringes (1 treatment)
Box containing 1 pre-filled 20mg/2ml syringe
Box containing 1 pre-filled 4ml syringe
Box containing 1 pre-filled 2ml syringe
Box containing 1 pre-filled 20mg/2ml syringe
Box containing 1 pre-filled 40mg/2ml syringe
Box Containing 1 pre-filled dual chambered 1.4ml syringe
Box containing 1 pre-filled 20mg/2ml syringe
Box containing 1 vial 20mg/2ml
Box containing 1 pre-filled 20mg/2ml syringe
Box containing 1 pre-filled 10mg/1ml syringe
Box containing 1 pre-filled 2ml syringe
Box containing 3 pre-filled 2ml syringe (1 treatment)
Box containing 1 pre-filled 40mg/2ml syringe
Box containing 3 pre-filled 2ml syringes
(1 treatment)
Box containing 1 pre-filled 6ml syringe
56
175.00
131.68
199.17
195.00
39.00
160.00
65.00
33.96
80.00
112.00
35.50
35.50
30.00
22.50
75.00
205.00
88.00
205.00
205.00
Part III
List of Appliances
Syringes
Bladder/Irrigating
100ml
4.54
Polypropylene with catheter nozzle graduated from 0 to 100ml in 5ml graduation marks, clearly
numbered in multiples of 10.
Ear
Portia Rubber Ear Syringe
Plastics-plasticised PVC polymer, moulded in one piece, fine pointed.
60ml
2.18
Enema Higginson's
6.64
Plastic - plasticised PVC polymer, with inverted flutter valve moulded in the tube, or with metal valve,
(duralumin or pewter), inserted in the tube; full length tubes; polypropylene rectal pipe; PVC polymer
or rubber vaginal pipe; PVC polymer shield.
Spare Vaginal Pipes
Plastics or rubber, straight
15cm
0.53
150ml
150ml
150ml
5.85
5.85
5.85
Topical Skin Coolants
Magicool Plus itchy skin spray
Magicool Plus prickly heat spray
Magicool Plus sunburn spray
Trusses
Prescribing
Before the prescription can be dispensed the following details must be given by the prescriber :(i)
Single, or double, and the side, if single
(ii)
Position e.g.
Inguinal, Scrotal
(iii)
Type e.g.
Spring Truss, Elastic Band Truss.
Spring Truss
Spring Trusses shall conform to the British Standard 2930: 1970 for Surgical Spring Trusses
Inguinal
Single
Double
Single
Double
Single
Double
Single
Double
extra
Inguinal Rat-tail
Femoral
Scrotal
Double Inguinal/Scrotal
Back Pad-fixed or sliding (if ordered)
Slotted, polished Spring Ends (if ordered)
Single extra
Double extra
"Special" Trusses
Single extra
Double extra
NOTE: Requirement for a "Special" Truss should normally be confirmed by the prescriber.
Replacements and repairs:
Understrap for Inguinal or Femoral Trusses
February 2015
Each
33.70
47.02
41.49
62.01
37.23
57.59
41.49
62.01
59.63
9.56
4.86
9.79
10.74
21.19
2.95
57
Part III
List of Appliances
Trusses cont
Elastic Band Truss
Elastic Band Trusses shall conform to the British Standard 3271: 1970 for Surgical Elastic Band Trusses.
Inguinal
Single
Double
22.89
38.12
Scrotal
Single
Double
23.82
38.80
Single belt
Double belt where specified by the prescriber
25.98
35.38
Umbilical
"Special" Trusses
Single extra
Double extra
NOTE: Requirement for a "Special" Truss should normally be confirmed by the prescriber.
6.73
9.75
Urinals, Portable
invoice price
Invoice to be attached to prescription
For day or night use Rubber or Plastic Bags
NOTE: Not to be confused with plastic night drainage bags (See Suprapubic Belts)
Spare Plastic Bags:
invoice price
Replacement of other parts if necessary:
invoice price
Ultrasound Therapy System Accessories
MIST
Single use applicator kit containing: single use applicator, 100ml bottle of saline, absorbent
Pad 17cm x 24cm and 2 germicidal wipes
February 2015
58
35.54
Part III
List of Appliances
Vacuum Pumps And Constrictor Rings For Erectile Dysfunction
The following products may be ordered on a prescription form (i.e. prescribed on the Health Service)
only if the patient is a person of a description mentioned in column 1 of the prescribing restrictions
note below, and for the purpose specified in column 2 of that note, and if the prescriber endorses the
face of the prescription form with “S11”.
Vacuum Pumps
Euro Surgical Ltd
Pos-T-Vac
Farnhurst Medical Ltd
Elite
Elite Plus with gauge
Elite Plus 2 with limiter
FTP Medical
VED Axis
Genesis Medical Ltd
Accord
Impulse with limiter
Revive with limiter
AVP1000 Battery Operated
MVP 700 Manual
127.00
98.00
ES101
EG105
EL108
135.00
160.00
160.00
FTP-VED-AXIS
159.00
0103 Manual
0102 Manual
0101 Battery Operated
119.00
119.00
149.00
Healthcare 2000 Ltd
E.I.D. Erection Inducer Device
149.00
iMEDicare Ltd
SomaCorrect
SomaCorrect Xtra
SomaErect Response II
SomaErect Response II - XL
SomaErect Touch II
15080
15111
15019
15888
15013
159.00
179.00
160.81
160.81
169.00
Mediplus Ltd
Osbon ErecAid Classic
Osbon ErecAid Esteem
XX-02
XX-50
105.96
191.58
Mediwatch UK Ltd
ErectEase
S0001
94.00
Owen Mumford Ltd
Rapport Classic
Rapport Premier
SM2000
SM2200
116.00
176.93
VaxAid Ltd
VaxAid Hydropump V30
VX30PR
89.50
001 Manual
95.00
Vetco UK
(Vetex Pump System)
February 2015
59
Part III
List of Appliances
Vacuum Pumps And Constrictor Rings For Erectile Dysfunction cont
Constrictor Rings - to maintain an erection
Euro Surgical Ltd
Constrictor Ring
9.68
Farnhurst Medical Ltd
Constriction Rings (pack of 5 rings)
Sizes 1-5
Size 1
Size 2
Size 3
Size 4
Size 5
Applicator and cone set with 5 different sized rings
FTP Medical
VED Axis
Constriction Ring
Size 4
Size 6
Firma Band
Sensation Seal
Size 2
Size 3
ECR01
ECR01/1
ECR01/2
ECR01/3
ECR01/4
ECR01/5
ECA02
20.00
20.00
20.00
20.00
20.00
20.00
24.00
FTP-44003-4-001
FTP-44003-6-001
FTP-001-0-FB
FTP-001-2-SS
FTP-001-3-SS
10.42
10.42
13.33
10.00
10.00
Genesis Medical Ltd
Asset
(Set of 5 different rings, loading cone and holding cylinder for maintaining an erection)
0105
24.00
Genesis Constriction Ring
(Single ring for use with erection assistance devices
0110B, 0110C, 0110D, 0110E, 0110F) sizes B, C, D, E, F
7.00
Genesis 3H (Single ring for use with erection assistance devices
013H-3, 013H-4, 013H-5, 013H-6, 013H-7, 013H-8, 013H-9) sizes 3,4,5,6,7,8,9
7.00
Healthcare 2000 Ltd
Confidence Rings
Starter pack of 2 Rings (1 x Regular, 1 x Firm)
Firm x 2 Rings (Pink)
Regular x 2 Rings (Natural)
iMEDicare Ltd
Assist Maintenance System
Select Maintenance Ring Set (Set of 3 Rings)
SureEase Maintenance Ring Set
Ultimate (Surefit) Maintenance Ring Set
Ultra Maintenance Ring Set
Mediwatch UK Ltd
ErectAssist
Set of 3 retention rings, loading cone, transfer collar and lubricating gel
February 2015
60
24.00
29.00
29.00
15109
15230
15085
15222
15444
27.00
29.00
32.00
34.00
34.00
S0007
23.00
Part III
List of Appliances
Vacuum Pumps And Constrictor Rings For Erectile Dysfunction cont
Retention Rings
Set of 3 retention rings
25mm
32mm
40mm
S0101A
S0101B
S0101C
S0101
One set of the above sizes
Mediplus Ltd
Osbon ErecAid (pack of 2 rings)
MaxElasticity tension
Standard tension
High tension
Grey
Beige
Pink
21.00
21.00
21.00
21.00
1676
1672
1674
each
35.06
35.06
35.06
Owen Mumford Ltd
Rapport Ring Loading System
(Set of five different sized rings, loading cone and transfer sleeves for maintaining an erection)
SM2220
23.18
VaxAid Ltd
VaxAid Erection Rings
Single Rings
20mm
24mm
28mm
32mm
36mm
40mm
Pack of six rings in sizes 20mm, 24mm, 28mm, 32mm, 36,mm 40mm
Pack of three rings in sizes 20mm, 24mm, 28mm
Pack of three rings in sizes 32mm, 36mm, 40mm
Vetco UK Constriction Rings
White C-Flex
Mentor
Comfort
Small, Medium, Large
Medium, Large
One size fits all
VSER20
VSER24
VSER28
VSER32
VSER36
VSER40
VPER1
VPER2
VPER3
VA005
VA006
VA007
5.00
5.00
5.00
5.00
5.00
5.00
30.00
15.00
15.00
6.50
10.00
10.00
Prescribing Restrictions Applying To Vacuum Pumps And Constrictor Rings For Erectile
Dysfunction
The products listed above may be ordered on a prescription form only if the patient is a person of a
description mentioned in column 1 below, and for the purpose specified in column 2, and if the
prescriber endorses the face of the prescription form with the reference “S11”.
(a)
(b)
(c)
Patient
a man suffering from any of the following:
Diabetes, multiple sclerosis, Parkinson’s disease,
Poliomyelitis, prostate cancer, severe pelvic injury,
single gene neurological disease, spina bifida
spinal cord injury; or
a man who is receiving treatment for renal failure by
dialysis; or
a man who has had the following surgery:
Prostatectomy, radical pelvic surgery,
renal failure treated by transplant
February 2015
61
Purpose
Treatment of erectile dysfunction
Part III
List of Appliances
Vaginal Dilator
Amielle Care
(Owen Mumford Ltd)
SM2150
per kit
26.30
Amielle Comfort
(Owen Mumford Ltd)
SM2100
35.06
Femmax
(Medical Devices Technology International Ltd)
15.26
Vaginal Moisturisers
Gynomunal
15ml tube
50ml tube
per pack
3.69
7.99
Hyalofemme
30g tube
4.60
3 pre-filled applicators
6 pre-filled applicators
12 pre-filled applicators
3.29
5.41
8.32
Repadina
10 x 2g ovules
8.14
ReplensMD
3 dose pack
6 dose pack
12 dose pack
35g tube
3.65
6.06
11.64
6.06
40g tube
5.16
6 pre-filled applicators
75ml tube
5.14
7.00
Regelle

Sylk
Yes water-based Intimate Lubricant
Yes water-based Intimate Lubricant

Please note: For reimbursement purposes Replens MD Should not be confused with the
product Replens listed in Drug Tariff part XI - Drugs and other substances not to be
prescribed under the NHS Pharmaceutical Services
Vaginal Ph Correction Products
Gels
Balance Activ BV
Multi-Gyn ActiGel
Relactagel
Lactic Acid Pessaries BP
Balance Activ
February 2015
62
7 x 5ml tubes
50ml tube
7 x 5ml tubes
Per Pack
5.25
5.25
5.25
7 pessaries
Per Pack
5.25
Part III
List of Appliances
Venous Ulcer Compression System
ActiLymph Hosiery Kit
Per pack
29.75
(Activa Healthcare)
Medical Stocking & Compression Liner
(pack contains 1 stocking and 2 liners)
Medium, Large, Extra Large, Extra Extra Large
Activa Leg Ulcer
Hoisery Kit
(Activa Healthcare)
Medical Stocking & Compression Liner
(pack contains 1 stocking and 2 liners 40mmHg)
Small, Medium, Large, Extra Large & Extra Extra Large
22.56
Compression Liner Pack Closed Toe
(pack contains 3 liners 10mmHg)
Small, Medium, Large, Extra Large & Extra Extra Large
16.92
Compression Liner Pack Open Toe
(pack contains 3 liners – 10mmhg)
Small, Medium, Large, Extra Large, Extra Extra Large
16.59
Altipress 40 UlcerKit
(Altimed Ltd)
Medical Stocking & Compression Liner
(pack contains stocking and 2 liners)
Available in Short, Regular and Long lengths
Small, Medium, Large, Extra Large, Extra Extra Large
14.28
Altipress
(Altimed Ltd)
Compression Liner Pack
(pack contains 3 liners)
Available in Short, Regular and Long lengths
Small, Medium, Large, Extra Large, Extra Extra Large
11.29
Altipress 40 Made to
Measure Ulcer Kit
(Altimed Ltd)
Medical Stocking & Compression Liner
(pack contains 1 Made to Measure stocking and 2 Made
to Measure liners)
41.42
Altipress Made to
Measure
(Altimed Ltd)
Compression Liner Pack
(pack contains 2 Made to Measure liners)
23.47
Carolon Compression Understocking Pack
(H&R Healthcare Ltd)
(pack contains 3 understockings)
Available in Short and regular length
Size
Ankle Circ
Calf Circ
A
17.5-20cm
25.5-33cm
B
20-22.5cm
30.5-38cm
C
22.5-25.5cm
35.5-43cm
D
25.5-28cm
40.5-48.5cm
E
28-30.5cm
45.5-53cm
F
30.5-33cm
51-58.5cm
G
33-35.5cm
56-66cm
February 2015
63
22.00
22.00
22.00
22.00
22.00
22.00
22.00
Part III
List of Appliances
Venous Ulcer Compression System cont
Carolon Graduated Compression System
(H&R Healthcare)
(Pack contains1 stocking and 2 understockings)
Available in Short and regular length
Size
Ankle Circ.
A
17.5-20cm
B
20-22.5cm
C
22.5-25.5cm
D
25.5-28cm
E
28-30.5cm
F
30.5-33cm
G
33-35.5cm
Calf Circ
25.5-33cm
30.5-38cm
35.5-43cm
40.5-48.5cm
45.5-53cm
51-58.5cm
56-66cm
Carolon Graduated Compression System
(Carolon Europe Ltd.) see H&R Healthcare Ltd
Clini Duo40
Medical Stocking and Compression Liner
(CliniSupplies Ltd)
(pack contains 1 stocking and 2 liners)
Small, Medium, Large, Extra Large, Extra Extra Large
Clini Duo40
Compression Liner Pack
(CliniSupplies Ltd)
(pack contains 3 liners)
Small, Medium, Large, Extra Large, Extra Extra Large
Comfipression
(Synergy Healthcare
(UK) ltd)
Jobskin Alleviant
(Jobskin Ltd)
Jobst UlcerCARE
(BSN Medical Ltd)
Jobst UlcerCARE
Custom
(BSN Medical Ltd)
February 2015
per pack
26.50
26.50
26.50
26.50
26.50
26.50
26.50
per pack
13.07
10.34
Hosiery Kit
(pack contains 1 stocking and 2 liners)
Small, Medium, Large, X Large, XX Large
Per pack
12.45
Liner Kit
(pack contains 3 liners)
Small, Medium, Large, X Large, XX Large
9.85
Medical Stocking & Compression Liner
(pack contains 1 over stocking and 2 liners)
i,ii,iii,iv,v,vi,vii
30.00
Medical Stocking & Compression Liner
(with or without zip)
(pack contains 1 stocking and 2 liners) Small – XXXX Large
31.09
Compression Liner Pack
Small – XXXX Large
18.77
Medical Stocking
62.99
Compression Liner Pack
(pack contains 2 liners)
31.50
64
Part III
List of Appliances
Venous Ulcer Compression System cont.
Juxta CURES
(Medi UK Ltd)
Compression System
(pack contains Juxta CURES, 2 standard anklets and 2 liners)
Short, Standard, Long
Comfort Leg Liner
(pack contains 2 liners)
13.19
Comfort Compression Anklet
(pack contains 2 anklets)
Standard, Large
11.16
Mediven Ulcer Kit
(Medi UK Ltd)
Medical Stocking & Compression Liner
(pack contains 1 over stocking and 2 liners)
Standard Length Kit
i,ii,iii,iv,v,vi,vii
Petite Length Kit
i,ii,iii,iv,v,vi,vii
Liner Pack (Pack contains 2 Liners
i,ii,iii,iv,v,vi,vii
SurePress Comfort Pro Graduated Compression System
Convatec Ltd. (Pack contains1 stocking and 1 liner)
Size
Ankle Circ.
Calf Circ
B
20-22.5cm
30.5-38cm
Ulcertec
(Bauerfeind UK)
Ulcer X
(Sigvaris Britain Ltd)
Medical Stocking & Compression Liner
(pack contains 1 stocking and 2 liners)
Short (Extra Small, Small, Medium, Large or Extra Large)
Long (Extra Small, Small, Medium, Large or Extra Large)
32.05
32.05
17.18
per pack
29.13
27.10
27.10
Medical Stocking & Compression Liner Pack Open Toe
(pack contains 1 stocking and 2 liners – 23-32mmHg)
Available in Short and Long lengths
Small, Medium, Large
24.23
Medical Stocking & Compression Liner Pack Open Toe Plus
(pack contains 1 stocking and 2 liners – 23-32mmHg)
Available in Short and Long lengths
Small, Medium, Large
24.23
Compression Liner Pack Closed Toe
(pack contains 4 liners – 18-21mmHg)
Available in Short and Long lengths
Small, Medium, Large
20.62
Venosan 8000 Ulcerfit
(Credenhill Limited)
February 2015
151.50
Medical Stocking & Compression Liner
(pack contains 1 stocking and 2 liners)
Available in Short and Long lengths
Small, Medium, Large, Extra Large
21.42
Compression Liner Pack Closed Toe
(pack contains 2 liners)
Available in One length, 35-42cm
Small, Medium, Large, Extra Large
12.75
65
Part III
List of Appliances
Wound Drainage Pouches
Indications:
Suitable for wounds with a low volume of exudate.
Biotrol Draina S Fistula for wound drainage and fistula management
Mini (cut to 30mm)
(H08560E)
Oakmed Option Wound Manager
Cut to fit
10mm-30mm Small
10mm-50mm Medium
10mm-50mm Large
Pack of 30
77.11
(OM-S)
(OM-M)
(OM-L)
71.44
79.15
82.90
Indications:
Suitable for wounds with a high volume of exudate
Biotrol Draina S Fistula for wound drainage and fistula management
Medium (cut to 50mm)
(H28555E)
Large (cut to 88mm)
(H28556E)
Pack of 20
76.88
94.55
Draina S Vision
Vision 50 (150ml cut to 50mm )
Vision 75 (250ml cut to 88mm )
Vision 100 (300ml cut to 100mm )
H28565E
H28566E
H28567E
Pack of 10
100.66
106.34
123.38
Eakin Wound Pouches
Fold and Tuck closure for wounds up to:
Small (45 x 30mm)
Medium (110 x 75mm)
Large (175 x 110mm)
Pack of 10
839250
839251
839252
Extra Large (horizontal wounds up to 245 x 160mm)
839253
Bung Closure for wounds up to:
Small (45 x 30mm)
Small Plus (86 x 60mm)
Medium (110 x 75mm)
Large (175 x 110mm)
839260
839267
839261
839262
Extra Large (horizontal wounds up to 245 X 160mm)
Extra Large (vertical wounds up to 245 x 160mm)
Extra Large (vertical incision wounds up to 290 x 130mm)
839263
839265
839266
53.41
62.99
74.78
101.48
Pack of 5
90.80
90.80
90.80
Bung Closure and access window for wounds up to:
Extra Large (horizontal wounds up to 245 x 160mm)
Extra Large (vertical wounds up to 245 x 160mm)
Eakin access windows for use with Eakin pouches
839264
839268
839280
101.48
99.74
37.39
Hollister Wound Drainage Collector
76mm
95mm
9701
9702
100mm x 200mm
9703
February 2015
66
48.07
69.44
90.80
Pack of 5
80.12
Pack of 10
Pack of 10
78.88
86.07
Pack of 3
51.11
Part III
List of Appliances
Wound Drainage Pouches cont
Independence Easy Access Pouch
Independence Wound Protection/Collection Pouch
Independence Xtra Large Wound Protection/Collection
Pouch
EA1
VAP1
VAP2
Pack of 10
98.55
114.12
121.85
Oakmed Option Wound Manager
Extra Small (Wounds up to 90mm x 180mm) (WWM-XS)
Small (horizontal wounds up to 245mm wide x 160mm high) (WWM-S)
Medium (vertical wounds up to 90mm wide x 260mm high) (WWM-M)
Large (Wounds up to 160mm x 260mm) (WWM-L)
Square (vertical wounds up to 160mm wide x 200mm high) (WWM-SQ)
Oblong (vertical wounds upto 60mm x 190mm) (WWM-O)
Extra Small with Access Port (Wounds up to 90mm x 180mm) (WWM-XSA)
Small with Access Port (horizontal wounds up to 245mm wide x 160mm high)
(WWM-SA)
Medium with Access Port (vertical wounds up to 90mm wide x 260mm high)
(WWM-MA)
Large with Access Port (Wounds up to 160mm x 260mm) (WWM-LA)
Square with Access Port (vertical wounds up to 160mm wide x 200mm high)
(WWM-SQA)
Oblong with Access Port (vertical wounds upto 60mm x 190mm) (WWM-OA)
Pack of 10
116.36
129.42
132.30
157.68
138.05
114.91
127.23
135.17
138.05
168.56
143.80
125.65
Salts Healthcare Confidence Wound and Fistula Pouch with
Flexifit (non sterile)
Small (horizontal wounds up to 60mm x 40mm)
Small (vertical wounds up to 40mm x 60mm)
Medium (vertical wounds up to 53mm x 150mm)
Pack of 10
CWM01
CWM02
CWM03
56.32
56.32
78.61
Welland Fistula Bag
Cut to fit up to: 40mm x 70mm
PFV700
Pack of 30
81.29
Welland Wound Manager
Small (cut to fit 30mm x 40mm) Clear
Medium (cut to fit 50mm x 70mm) Beige, split soft cover
(NOP700)
(SOP500)
Large (cut to fit 90mm x 90mm) Beige, split soft cover
Large (cut to fit 90mm x 90mm) Clear, with inspection window
(POP513)
(WOP713)
February 2015
67
Pack of 10
51.53
62.58
Pack of 5
36.02
53.87
Part III
List of Appliances
PAGE INTENTIONALLY BLANK
February 2015
68