Varenicline Claiming for Accurate Reimbursement
Published: 06/05/25
This article includes guidance around the process of submitting claims for the generic version of Varenicline. This applies to dispensing against prescriptions and the use of the newly re-launched PGD.
The Community Pharmacy Public Health Service Smoking Cessation Varenicline PGD has been reintroduced as of April 2025. The PGD has been and signed off by NHS 24 for use in all Health Boards. Health Boards are responsible for local governance processes to approve, sign and publish these PGDs and have been asked to complete this as soon as possible. Once this is complete, your pharmacists will be asked to review and sign these off. Please refer to your local health board community pharmacy website for confirmation of when the PGD goes live in your area.
This accompanies the re-entry to market of Varenicline, which is now available to be ordered as a generic product via wholesalers. This includes initiation packs, 0.5mg and 1mg packs. As Varenicline is not in part 7 of the tariff, more than one reimbursement price exists, and the price that you will be paid for each pack depends entirely on how you process and submit claims on your PMR. As part of our audit work, we have assured ourselves that the reference prices on DM+D that are used for payment are reflective of the purchase prices available on the market.
To ensure you are being reimbursed correctly for PGD supplies, please be careful to select the correct stock line via your PMR when labelling the item. For example, if you are physically dispensing stock that you have purchased from Alliance, then ensure that the stock line that specifies this is selected as part of your labelling and electronic claiming process on your PMR.
Failure to do this may result in you being reimbursed incorrectly.
The CPS Policy Team are also hosting an Ask Me Anything webinar on the relaunch of this PGD element of the smoking cessation service. This will be held on Wednesday 7th of May at 7:30pm via Microsoft Teams. This event is open to all members of the pharmacy team. If you have not yet done so and would like to sign up to the event, please do so via this link.
If you have any questions relating to this communication or the PGD, please contact us via enquiries@cps.scot
This article includes guidance around the process of submitting claims for the generic version of Varenicline. This applies to dispensing against prescriptions and the use of the newly re-launched PGD.