Q: I have received a prescription for ‘Nizoral 2% cream 30g’ - it has not been endorsed as ‘SLS’ by the prescriber - will I get paid for dispensing it?

A: No, you would not be reimbursed for dispensing this prescription as it stands.

Nizoral cream 30g is listed in Part XVIIIB of the England and Wales Drug Tariff - Drugs, Medicines and other Substances that may be ordered only in certain circumstances. This is also known as the Selected List Scheme (SLS).

Nizoral cream is also listed in the equivalent sections, Part 12 of the Scotland Tariff and Part XI (b) of the Northern Ireland Tariff.

Under the tariff rules, Nizoral cream can only be prescribed on an NHS prescription for the treatment of certain specified conditions:

• Seborrhoeic dermatitis
• Pityriasis versicolor

The prescription must be marked by the prescriber with the reference ‘SLS’ in order for the item to be passed for payment.

It is not necessary for the pharmacist to confirm whether the item is being used to treat the specified conditions. The only factor affecting payment is whether it is endorsed ‘SLS’ or not.

Note that the endorsement required in Northern Ireland is ‘S. 11’ rather than ‘SLS’.

Prescriptions for Nizoral cream without the ‘SLS’ endorsement must be returned to the prescriber for amendment prior to submission to the pricing agency.

However, in England, Wales and Northern Ireland the issue is complicated further by a generic listing for Ketoconazole 2% cream in the drug tariffs.

Ketoconazole 2% cream 30g is listed in Part VIIIA (Basic prices of drugs) of the England & Wales Drug Tariff. It does not have the symbol () next to it and therefore does not fall under the Selected List Scheme.

This means that prescriptions written generically can be issued for the treatment of any appropriate medical condition and do not require the ‘SLS’ endorsement. Nizoral cream can be dispensed on a generic prescription without being out of pocket because the tariff price is based on the list price of Nizoral.

There is no generic listing for ketoconazole cream in the Scotland Tariff and therefore even generic prescriptions would require the ‘SLS’ endorsement.

So in summary:

For England, Wales and Northern Ireland

Branded prescriptions for Nizoral cream must be endorsed by the prescriber to ensure payment.
Generic prescriptions for ketoconazole cream do not require any prescriber endorsement, even if the brand Nizoral is dispensed.
In Scotland, all prescriptions, generic and branded, must be endorsed with ‘SLS’.

Tariff Tip written by Sue Swift, UK Drug Tariff and Information Technician