SCOTTISH DRUG TARIFF MONTHLY NOTICE OF PRICE AMENDMENTS. August 2014

Scottish Drug Tariff: Price Amendment sheets August 2014 Information Services Gyle Square 1 South Gyle Crescent EDINBURGH EH12 9EB Telephone : 0131 275 6972 Fax : 0131 275 7606 www.show.scot.nhs.uk/nss SCOTTISH DRUG TARIFF MONTHLY NOTICE OF PRICE AMENDMENTS August 2014 This document is prepared by the evadis Team, Healthcare Information Group, Information Services Division. Enquiries to: NSS.evadis@nhs.net The complete Scottish Drug Tariff is published on the ISD Scotland website: www.isdscotland.org The following price changes listed become effective from 1 st August 2014. Prices in pence per item, unless otherwise stated. The following price changes apply to Part 2 Dressings BANDAGES Polyamide and Cellulose Contour age BP 1988 Acti-wrap 8cm x 4m 67 68 10cm x 4m 79 80 High Compression ages (Extensible) Viscose, Elastane, and Cotton (High) Compression Extensible age VECCHE age Tensopress 7.5cm x 3m unstretched 265 267 10cm x 3m unstretched 341 343 Short Stretch Compression age Actico (Cohesive) 4cm x 6m 236 238 6cm x 6m 276 279 8cm x 6m 318 321 10cm x 6m 330 333 12cm x 6m 421 424 Comprilan 6cm x 5m 264 266 8cm x 5m 310 312 10cm x 5m 333 336 12cm x 5m 406 409 Sub-compression Wadding age Flexiban 3.5m unstretched 10cm x 3.5m 49 50 1

Scottish Drug Tariff: Price Amendment sheets August 2014 DRESSINGS Vapour - Permeable Adhesive Film Dressing with absorbent pad Mepore Ultra 11cm x 15cm 116 117 LOW FRICTION PRODUCTS Vapour - Permeable Adhesive Film Dressing with absorbent pad Aderma Dermal Pad Sacrum /Ankle Wrap 1672 1687 Heel Standard 1489 1502 Extra Large 1697 1712 Sheet 10x10x0.3cm 426 430 10x10x1.2cm 1278 1289 20x20x0.3cm 1701 1716 Strip 50x2.5x0.3cm 533 538 30x5.0x0.3cm 639 645 LYMPHOEDEMA GARMENTS Actilymph Class 1 (18-21mm Hg) Per pair Below Knee Closed Toe Petite S, M, L, XL 2799 2823 Below Knee Closed Toe Standard S, M, L, XL, 2799 XXL 2823 Below Knee Open Toe Standard S, M, L, XXL 2799 2823 Thigh Closed Toe with Regular Top Standard S, M, L, XL 5263 5308 Thigh Closed Toe with Wide Top Standard S, M, L, XL 5379 5424 Thigh Open Toe with Regular Top Standard S, M, L, XL, XXL 5273 5318 Per piece Armsleeve No Top Standard S, M, L, XL 1482 1494 Armsleeve with Top Standard S, M, L, XL 1976 1993 Armsleeve with Top Long S, M, L, XL 1937 1954 Combined Armsleeve No Top Standard S, M, L 2689 2712 Combined Armsleeve with Top Standard S, M, L 3184 3211 Combined Armsleeve with Top Long S, M, L 3121 3147 Per pair Below Knee Closed Toe Petite S, M, L, XL 2799 2823 Below Knee Closed Toe Standard S, M, L, XL 2799 2823 Below Knee Open Toe Petite S, M, L, XL 2799 2823 Below Knee Open Toe Standard S, M, L, XL, XXL 2799 2823 2

Scottish Drug Tariff: Price Amendment sheets August 2014 LYMPHOEDEMA GARMENTS cont. Actilymph cont. Thigh Closed Toe with Regular Top Standard S, M, L, XL 5263 5308 Thigh Closed Toe with Wide Top Standard S, M, L, XL 5379 5424 Thigh Open Toe with Wide Top Standard S, M, L, XL 5379 5424 Thigh Open Toe with Regular Top Standard S, M, L, XL, XXL 3 5273 5318 Per piece Armsleeve No Top Standard S, M, L, XL 1592 1605 Armsleeve with Top Standard S, M, L, XL 2086 2103 Armsleeve with Top Long S, M, L, XL 2045 2062 Combined Armsleeve No Top Standard S, M, L 2799 2823 Combined Armsleeve with Top Standard S, M, L 3293 3321 Combined Armsleeve with Top Long S, M, L 3229 3256 Class 3 (34-46mm Hg) Below Knee Open Toe No Top Standard S, M, L, XL 3074 3100 Thigh Open Toe with Wide Top Standard S, M, L, XL 5598 5646 Actilymph MTM Dura Stiffer Fabric for Lower Extremities Per piece Class 2 (23-32mmHg) Below Knee A-D AL-DURAC2-AD 3396 3425 Thigh Length A-G AL-DURAC2-AG 4189 4224 Thigh with Waist Attachment A-GT AL-DURAC2-AGT 5918 5968 2 Legged Panty A-T (includes cycle style pants) AL-DURAC2-AT 15541 15673 Class 3 (34-346mmHg) Below Knee A-D AL-DURAC3-AD 3602 3633 Thigh Length A-G AL-DURAC3-AG 4508 4546 Thigh with Waist Attachment A-GT AL-DURAC3-AGT 6072 6124 2 Legged Panty A-T (includes cycle style pants) AL-DURAC3-AT 16467 16607 NB. The above garments are available with optional extras. These are priced separately. See Below Closed Toe ALO-CT 103 104 2 Ankle Pads ALO-PAD 2058 2076 Silicone ALO-BAND 762 768 Slip Form ALO-FORM 669 675 T Heel Ankle Seam ALO-SEAM 669 675 Full Compression Body Part (in AT) ALO-FCBODY 2470 2491 Actilymph MTM Ease Soft Fabric for Lower Extremities Per piece Class 1 (18-21mmHg) Below Knee A-D AL-EASEC1-AD 3257 3285 Thigh Length A-G AL-EASEC1-AG 3890 3923 Thigh with Waist Attachment A-GT AL-EASEC1-AGT 5506 5553 2 Legged Panty A-T (includes cycle style pants) AL-EASEC1-AT 14079 14199 Class 2 (23-32mmHg) Below Knee A-D AL-EASEC2-AD 3396 3425 Thigh Length A-G AL-EASEC2-AG 4189 4224 Thigh with Waist Attachment A-GT AL-EASEC2-AGT 5918 5968 2 Legged Panty A-T (includes cycle style pants) AL-EASEC2-AT 15541 15673

Scottish Drug Tariff: Price Amendment sheets August 2014 LYMPHOEDEMA GARMENTS cont. Actilymph MTM Ease Soft Fabric for Lower Extremities cont. Class 3 (34-346mmHg) Below Knee A-D AL-EASEC3-AD 3602 3633 Thigh Length A-G AL-EASEC3-AG 4508 4546 Thigh with Waist Attachment A-GT AL-EASEC3-AGT 6072 6124 2 Legged Panty A-T (includes cycle style pants) AL-EASEC3-AT 16467 16607 NB. The above garments are available with optional extras. These are priced separately. See Below Closed Toe ALO-CT 103 104 Silicone ALO-BAND 762 768 Slip Form ALO-FORM 669 675 T Heel Ankle Seam ALO-SEAM 669 675 Full Compression Body Part (in AT) ALO-FCBODY 2470 2491 (only available in Class 2 and 3) Altiven Class 1 (18-21mm Hg) (per pair) Below Knee Open Toe Short,Regular I-VII 2111 2129 Below Knee Closed Toe Short,Regular I-VII 2111 2129 Hold-up Open Toe Short,Regular I-VII 4058 4093 Hold-up Closed Toe Short,Regular I-VII 4058 4093 Hold-up (Extra Wide) Open Toe Short,Regular I-VII 4058 4093 Hold-up (Extra Wide) Closed Toe Short,Regular I-VII 4058 4093 Tights Open Toe Short,Regular I-VII 4194 4230 Tights Closed Toe Short,Regular I-VII 4194 4230 (per piece) Thigh with Waist Attachment Open Toe Short,Regular I-VII 2177 2195 Thigh with Waist Attachment Closed Toe Short,Regular I-VII 2177 2195 (per pair) Below Knee Open Toe Short,Regular I-VII 2111 2129 Below Knee Closed Toe Short,Regular I-VII 2111 2129 Hold-up Open Toe Short,Regular I-VII 4058 4093 Hold-up Closed Toe Short,Regular I-VII 4058 4093 Hold-up (Extra Wide) Open Toe Short,Regular I-VII 4058 4093 Hold-up (Extra Wide) Closed Toe Short,Regular I-VII 4058 4093 Tights Open Toe Short,Regular I-VII 4607 4646 Tights Closed Toe Short,Regular I-VII 4607 4646 (per piece) Thigh with Waist Attachment Open Toe Short,Regular I-VII 2177 2195 Thigh with Waist Attachment Closed Toe Short,Regular I-VII 2177 2195 Class 3 (34-46mm Hg) (per pair) Below Knee Open Toe Short,Regular I-VII 2111 2129 Below Knee Closed Toe Short,Regular I-VII 2111 2129 Hold-up Open Toe Short,Regular I-VII 4058 4093 Hold-up Closed Toe Short,Regular I-VII 4058 4093 Hold-up (Extra Wide) Open Toe Short,Regular I-VII 4058 4093 Hold-up (Extra Wide) Closed Toe Short,Regular I-VII 4058 4093 Tights Open Toe Short,Regular I-VII 4910 4952 4

Scottish Drug Tariff: Price Amendment sheets August 2014 LYMPHOEDEMA GARMENTS cont. Altiven cont. Tights Closed Toe Short,Regular I-VII 4910 4952 (per piece) Thigh with Waist Attachment Open Toe Short,Regular I-VII 2396 2416 Thigh with Waist Attachment Closed Toe Short,Regular I-VII 2396 2416 Altiven Armsleeves Class 1 (18-21mm Hg) (per piece) Axilla Wrist Regular I-V 1118 1127 Axilla Wrist with Grip Top Regular I-V 1491 1504 Axilla Mitten Regular I-V 2029 2046 Axilla Mitten with Grip Top Regular I-V 2401 2422 Axilla Wrist with Elbow Pouch Regular I-V 1118 1127 Axilla Wrist with Grip Top and Elbow Pouch Regular I-V 1491 1504 Axilla Mitten with Elbow Pouch Regular I-V 2029 2046 Axilla Mitten with Grip Top and Elbow Pouch Regular I-V 2401 2422 (per piece) Axilla Wrist Regular I-V 1201 1211 Axilla Wrist with Grip Top Regular I-V 1574 1587 Axilla Mitten Regular I-V 2111 2129 Axilla Mitten with Grip Top Regular I-V 2484 2506 Axilla Wrist with Elbow Pouch Regular I-V 1201 1211 Axilla Wrist with Grip Top and Elbow Pouch Regular I-V 1574 1587 Axilla Mitten with Elbow Pouch Regular I-V 2111 2129 Axilla Mitten with Grip Top and Elbow Pouch Regular I-V 2484 2506 Altiven Made to Measure Low Compression (14-18mm Hg) (per pair) Below Knee Open Toe 2677 2700 Below Knee Closed Toe 2677 2700 Thigh High Hold-up Open Toe 4631 4671 Thigh High Hold-up Closed Toe 4631 4671 Tights Open Toe 4940 4982 Tights Closed Toe 4940 4982 (per piece) Thigh with Waist Attachment Open Toe 2701 2724 Thigh with Waist Attachment Closed Toe 2701 2724 Class 1 (18-21mm Hg) (per pair) Below Knee Open Toe 2677 2700 Below Knee Closed Toe 2677 2700 Thigh High Hold-up Open Toe 4631 4671 Thigh High Hold-up Closed Toe 4631 4671 Tights Open Toe 4940 4982 Tights Closed Toe 4940 4982 (per piece) Thigh with Waist Attachment Open Toe 2701 2724 Thigh with Waist Attachment Closed Toe 2701 2724 (per pair) Below Knee Open Toe 2677 2700 5

Scottish Drug Tariff: Price Amendment sheets August 2014 LYMPHOEDEMA GARMENTS cont. Altiven Made to Measure cont. Below Knee Closed Toe 2677 2700 Thigh High Hold-up Open Toe 4631 4671 Thigh High Hold-up Closed Toe 4631 4671 Tights Open Toe 4940 4982 Tights Closed Toe 4940 4982 (per piece) Thigh with Waist Attachment Open Toe 2701 2724 Thigh with Waist Attachment Closed Toe 2701 2724 Class 3 (34-46mm Hg) (per pair) Below Knee Open Toe 2949 2974 Below Knee Closed Toe 2949 2974 Thigh High Hold-up Open Toe 5043 5086 Thigh High Hold-up Closed Toe 5043 5086 Tights Open Toe 4940 4982 Tights Closed Toe 4940 4982 (per piece) Thigh with Waist Attachment Open Toe 2973 2999 Thigh with Waist Attachment Closed Toe 2973 2999 Altiven Made to Measure Arm Sleeves Low Compression (12-16mm Hg) (per piece) Armsleeve Axilla Wrist with elbow pocket 1417 1429 Armsleeve Axilla Wrist 1417 1429 Armsleeve Axilla Wrist with Top and elbow pocket 1890 1906 Armsleeve Axilla Wrist with Top 1890 1906 Armsleeve Axilla Mitten with elbow pocket 2572 2594 Armsleeve Axilla Mitten 2572 2594 Armsleeve Axilla Mitten with Top and elbow pocket 3044 3070 Armsleeve Axilla Mitten with Top 3044 3070 Class 1 (18-21mmHg) (per piece) Armsleeve Axilla Wrist with elbow pocket 1417 1429 Armsleeve Axilla Wrist 1417 1429 Armsleeve Axilla Wrist with Top and elbow pocket 1890 1906 Armsleeve Axilla Wrist with Top 1890 1906 Armsleeve Axilla Mitten with elbow pocket 2572 2594 Armsleeve Axilla Mitten 2572 2594 Armsleeve Axilla Mitten with Top and elbow pocket 3044 3070 Armsleeve Axilla Mitten with Top 3044 3070 Class 2 (23-32mmHg) (per piece) Armsleeve Axilla Wrist with elbow pocket 1522 1535 Armsleeve Axilla Wrist 1522 1535 Armsleeve Axilla Wrist with Top and elbow pocket 1995 2012 Armsleeve Axilla Wrist with Top 1995 2012 Armsleeve Axilla Mitten with elbow pocket 2677 2700 Armsleeve Axilla Mitten 2677 2700 Armsleeve Axilla Mitten with Top and elbow pocket 3149 3176 Armsleeve Axilla Mitten with Top 3149 3176 6

Scottish Drug Tariff: Price Amendment sheets August 2014 LYMPHOEDEMA GARMENTS cont. Jobst Bellavar Knee High, Open Toe Short, Long I,II,III,IV,V,VI 2630 2652 Tights, Open Toe Short, Long I,II,III,IV,V,VI 4579 4618 Class 3 (34-46mm Hg) Knee High, Open Toe Short, Long I,II,III,IV,V,VI 2887 2911 Thigh High, Open Toe with Knitted Standard I,II,III,IV,V,VI 5464 5511 Thigh High, Open Toe with Silicone Standard I,II,III,IV,V,VI 5464 5511 Tights Open Toe Short, Long I,II,III,IV,V,VI 4950 4992 Jobst Elvarex Soft Custom Fit for lower extremities Class 1 18-21mm Hg Soft Seamless Foot Cap with Toes L1-11-02 4155 4191 Soft Knee High L1-10-04 3257 3285 Soft Thigh High L1-10-06 3792 3824 Soft Body age L1-10-08 6697 6754 Class 2 23-32mm Hg Soft Seamless Foot Cap with Toes L2-07-02 4402 4439 Soft Knee High L2-08-04 3460 3490 Soft Thigh High L2-08-06 4249 4285 Soft Body age L2-08-08 7516 7580 Class 3 34-46mm Hg Soft Knee High L3-09-04 3698 3729 Soft Thigh High L3-09-06 4489 4528 Soft Body age L3-08-08 7668 7733 N.B.: The above garments are available with additional options. These are priced Separately below: Adjustable Waistband L-A013S 899 907 Closed Toe Soft L-A001S 10 11 Non-Standard Colour L-A008S 302 304 Slipform Soft L-A011S 647 653 Silicone Soft L-A004S 770 776 Jobst Elvarex Soft Custom Fit for upper extremities Class 1 (15-21mm Hg) Soft Armsleeve from Wrist to Axilla U1-10-07 3126 3152 Soft Seamless Gauntlet to Wrist U1-11-01 3410 3439 Soft Seamless Gauntlet to Elbow U1-11-03 3867 3900 Class 2 23-32mm Hg Soft Armsleeve from Wrist to Axilla U2-08-07 3727 3759 Soft Seamless Gauntlet to Wrist AC1-WF-WT 3634 3665 Soft Seamless Gauntlet to Elbow U2-07-03 3964 3998 N.B.: The above garments are available with additional options. These are priced Separately below: Non-Standard Colour U-A007S 302 304 7

Scottish Drug Tariff: Price Amendment sheets August 2014 LYMPHOEDEMA GARMENTS cont. Jobst Elvarex Soft Custom Fit for upper extremities cont. Silicone Soft U-A002S 456 460 1 Soft Seamless Finger (Class 1 15-21mm Hg) U1-A015 381 384 1 Soft Seamless Finger (Class 2 23-32mm Hg) U2-A014 500 504 Jobst Opaque Class 1 (18-21mm Hg) (per pair) Knee High Closed Toe Short, Long I-VI 2630 2652 Knee High Open Toe Short, Long I-VI 2630 2652 Tights Closed Toe Short, Long I-VI 4579 4618 Tights Open Toe Short, Long I-VI 4579 4618 (per pair) Knee High Closed Toe Short, Long I-VI 2630 2652 Knee High Open Toe Short, Long I-VI 2630 2652 Thigh High Open Toe Standard Width with Dotted Short, Long I-VI 4996 5038 Silicone Thigh High Open Toe Wide Width with Dotted Short, Long I-VI 4996 5038 Silicone Tights Closed Toe Short, Long I-VI 4579 4618 Tights Open Toe Short, Long I-VI 4579 4618 VENOUS ULCER COMPRESSION SYSTEM ActiLymph Hosiery Kit (Activa Healthcare) Medical stocking & compression liner Per Pack (p) (Pack contains 1 stocking + 2 liners) M, L, XL, XXL 2950 2975 Activa Leg Ulcer Hosiery Kit (Activa Healthcare) Medical stocking & compression liner S, M, L, XL, XXL 2237 2256 (Pack contains 1 stocking + 2 liners 40MMHg) Compression Liner Pack Closed Toe S, M, L, XL, XXL 1678 1692 (Pack contains 3 liners 10mm Hg) Compression Liner Pack Open Toe S, M, L, XL, XXL 1645 1659 (Pack contains 3 liners 10mm Hg) Altipress 40 Ulcer Kit (Altimed Ltd) Medical stocking & compression liner S, M, L, XL, XXL 1416 1428 (Pack contains 1 stocking + 2 liners) Available in Short, Regular and Long Lengths Altipress (Altimed Ltd) Compression Liner Pack S, M, L, XL, XXL 1120 1129 (Pack contains 3 liners) Available in Short, Regular and Long Lengths 8

Scottish Drug Tariff: Price Amendment sheets August 2014 VENOUS ULCER COMPRESSION SYSTEM cont. Altipress 40 Made to Measure Ulcer Kit (Altimed Ltd) Medical stocking & compression liner 4108 4142 (Pack contains 1 Made to Measure stocking + 2 Made to Measure liners) Altipress Made to Measure (Altimed Ltd) Compression Liner Pack 2327 2347 (Pack contains 2 Made to Measure liners) Jobst UlcerCare (BSN Medical Ltd.) Medical stocking & compression liner S, M, L, XL, XXL, XXXL XXXXL 3082 3109 With or without zip (Pack contains 1 stocking + 2 liners) Compression Liner Pack (pack contains 3 liners) S, M, L, XL, XXL, XXXL, XXXXL 1861 1877 Jobst UlcerCare Custom (BSN Medical Ltd.) Medical stocking 6246 6299 Compression Liner Pack 3123 3150 (pack contains 2 liners) 9

Scottish Drug Tariff: Price Amendment sheets August 2014 WOUND MANAGEMENT DRESSINGS Hydrogel Sheet Without adhesive Border ActiFormCool Square 10cm x 10cm 261 263 20cm x 20 cm 786 793 Rectangular 5cm x 6.5cm 178 179 10cm x 15cm 375 379 Soft Silicone Wound Contact Dressing with Polyurethane Foam Film Backing Sterile CE With silicone adhesive border Allevyn Gentle Border Sacrum 21.6cm x 23cm 553 558 Topical Negative Pressure System Accessories Renasys Y Connector ( for use with soft port) 325 324 Wound Dressing Pack Pico 10cm x 30cm 12350 12455 15cm x 15cm 12350 12455 15cm x 20cm 12350 12455 Renasys G Dressing Kit Round Drain 10fr 2321 2341 19fr 2321 2341 Flat Drain 10mm 2321 2341 Channel Drain 15fr 2321 2341 V.A.C GranuFoam dressing kit Small 2276 2295 Medium 2709 2732 Large 3143 3170 Wound Drainage Collection Device ActiV.A.C. Canister with gel 300ml 2818 2842 The following price changes apply to Part 3 Appliances CATHETERS, ACCESSORIES Clinifix Tube Holder Pack of 10 40-310 110mm x 25mm 1701 1715 40-410 140mm x 40mm 1860 1876 CATHETERS C) Intermittent Catheter with finger grip and lid Gauge (Ch) Per pack of 30 Hunter Urology Ltd 46F12-30-UK 12 3960 3994 Emteva 10

Scottish Drug Tariff: Price Amendment sheets August 2014 The following price changes apply to Part 4 Elastic Hosiery ELASTIC HOSIERY Accessories Price Per Item in Pence Acti-glide 1428 1440 Sockaid 1288 1299 The following price changes apply to Part 5 Incontinence Appliances NIGHT DRAINAGE BAGS L.IN.C Medical Systems Ltd Price Per Item in Pence S LINC-Flo Urinary Drainage Bag SLC13 10 1050 940 S LINC-Flo Urinary Drainage Bag with lever tap SLC13-L 10 1050 940 11

Scottish Drug Tariff: Amendment sheets for August 2014 Information Services Gyle Square 1 South Gyle Crescent EDINBURGH EH12 9EB Telephone : 0131 275 6972 Fax : 0131 275 7606 www.show.scot.nhs.uk/nss SCOTTISH DRUG TARIFF MONTHLY NOTICE OF AMENDMENTS August 2014 This document is prepared by the evadis Team, Healthcare Information Group, Information Services Division. Enquiries to: NSS.evadis@nhs.net The complete Scottish Drug Tariff is published on the ISD Scotland website: www.isdscotland.org The following amendments take effect from 1st August 2014. The following amendments apply to Part 1 Annex A (Zero Discount list) Additions none Deletions Arzip 250mg caps DocOmega oral powder 4g sachets Entrocalm Loperamide Caps 2mg Ketalar Inj 500mg/10ml Lidocaine 4% oromucosal solution Laryngojet pre-filled syringes Sustiva Caps 200mg Timentin 3.2g powder for solution for infusion vials Tonpular XL Caps 150mg Other changes Perfalgan solution for infusion vials (ALL) Now reads Perfalgan 1g/100ml solution for infusion vials 1

Scottish Drug Tariff: Amendment sheets for August 2014 ADDITIONS The following additions apply to Part 2 (Dressings) EMOLLIENT AND BARRIER PREPARATIONS Preparations containing Urea imuderm emollient 500g pump 650 LYMPHOEDEMA GARMENTS Style Lengths Sizes Sigvaris Cotton Class 1 (18-21mm Hg) Below Knee Open Toe Normal, Long XXS 2713 Below Knee Xtra Closed Toe Normal, Long XXS 2713 Thigh High Open Toe with Grip Top Short, Normal, Long XXS 5713 Below Knee Open Toe Normal, Long XXS 2713 Below Knee Open Toe Short XXS-XL 2713 Below Knee Open Toe Plus Short XS-XL 2713 Below Knee Xtra Closed Toe Normal, Long XXS 2713 Below Knee Open Toe with Grip Top Normal, Long XXS 2713 Below Knee Closed Toe with Grip Top Normal, Long XXS 2713 Thigh High Open Toe with Grip Top Short, Normal, Long XXS 5213 Thigh High Closed Toe with Grip Top Short, Normal, Long XXS 5213 Panty Open Toe Normal, Long XXS 5213 Panty Closed Toe Normal, Long XXS 5213 Style Lengths Sizes Sigvaris Magic Class 1 (18-21mm Hg) Below Knee Open Toe Normal, Long XXS,XL 2713 Below Knee Open Toe Plus Normal, Long XXS,XL 2713 Below Knee Closed Toe Normal, Long XXS,XL 2713 Below Knee Closed Toe Plus Normal, Long XXS,XL 2713 Thigh High Grip Top Open Toe Female Short, Normal, Long XXS,XL 5213 Thigh High Grip Top Open Toe Plus Female Short, Normal, Long XXS,XL 5213 Thigh High Grip Top Closed Toe Female Short, Normal, Long XXS,XL 5213 Thigh High Grip Top Closed Toe Plus Female Short, Normal, Long XXS,XL 5213 Tights Open Toe Normal, Long XXS,XL 5213 Tights Closed Toe Normal, Long XXS,XL 5213 Tights Open Toe Plus Normal, Long XXS,XL 5213 Tights Closed Toe Plus Normal, Long XXS,XL 5213 2

Scottish Drug Tariff: Amendment sheets for August 2014 LYMPHOEDEMA GARMENTS cont. Sigvaris Magic cont. Below Knee Open Toe Normal, Long XXS,XL 2713 Below Knee Open Toe Plus Normal, Long XXS,XL 2713 Below Knee Closed Toe Normal, Long XXS,XL 2713 Below Knee Closed Toe Plus Normal, Long XXS,XL 2713 Thigh High Grip Top Open Toe Female Short, Normal, Long XXS,XL 5213 Thigh High Grip Top Open Toe Plus Female Short, Normal, Long XXS,XL 5213 Thigh High Grip Top Closed Toe Female Short, Normal, Long XXS,XL 5213 Thigh High Grip Top Closed Toe Plus Female Short, Normal, Long XXS,XL 5213 Tights Open Toe Normal, Long XXS,XL 5213 Tights Closed Toe Normal, Long XXS,XL 5213 Tights Open Toe Plus Normal, Long XXS,XL 5213 Tights Closed Toe Plus Normal, Long XXS,XL 5213 PLANTAR PRESSURE OFFLOADING DEVICE Liqua Care Diabetic FlowGel Orthotics 9-3536 Size 35-36 1745 9-3738 Size 37-38 1745 9-3940 Size 39-40 1745 9-4142 Size 41-42 1745 9-4344 Size 43-44 1745 9-4546 Size 45-46 1745 TRACHEOSTOMY AND LARYNGECTOMY APPLIANCES TRACHEOSTOMY BREATHING AIDS SpiroTect HME System SpiroTect Laryngectomy Tube (Perforated) 44mm length Size 8 (outer diam 12mm) PTT2001 7245 Size 9 (outer diam 13.5mm) PTT2002 7245 Size 10 (outer diam 15mm) PTT2003 7245 Size 12 (outer diam 17mm) PTT2004 7245 62mm length Size 8 (outer diam 12mm) PTT2005 7245 Size 9 (outer diam 13.5mm) PTT2006 7245 Size 10 (outer diam 15mm) PTT2007 7245 Size 12 (outer diam 17mm) PTT2008 7245 3

Scottish Drug Tariff: Amendment sheets for August 2014 TRACHEOSTOMY AND LARYNGECTOMY APPLIANCES cont. TRACHEOSTOMY BREATHING AIDS cont. SpiroTect Laryngectomy Tube (Non-Perforated) 44mm length Size 8 (outer diam 12mm) PTT2009 7245 Size 9 (outer diam 13.5mm) PTT2010 7245 Size 10 (outer diam 15mm) PTT2011 7245 Size 12 (outer diam 17mm) PTT2012 7245 62mm length Size 8 (outer diam 12mm) PTT2013 7245 Size 9 (outer diam 13.5mm) PTT2014 7245 Size 10 (outer diam 15mm) PTT2015 7245 Size 12 (outer diam 17mm) PTT2016 7245 TRACHEOSTOMY TUBE HOLDER SpiroTect Tube Holder 1 piece PTA200 239 2 piece adult PTA201 320 2 piece child PTA301 320 TRACHEOSTOMY CLEANING DEVICES SpiroTect Tube Cleaning Swabs Pack of 50 (Prosys International) PTA300 880 WOUND MANAGEMENT DRESSINGS Keratin Dressing keragelt 5g tube 3960 Soft Polymer Wound Contact Dressing with Polyurethane Foam Film Backing Sterile CE Aquacel Foam Adhesive Sacral 24cm x 21.5cm 550 Soft Silicone Wound Contact Dressing Sterile CE Cuticell Contact 5cm x 7.5cm 109 7.5cm x 10cm 209 10cm x 18cm 435 15cm x 25cm 729 Soft Silicone Wound Contact Dressing with Polyurethane Foam Film Backing Sterile CE With silicone adhesive border KerraFoam Gentle Border Sacrum 17cm x 17.5cm 446 KerraFoam Gentle Border Heel 23cm x 25cm 795 4

Scottish Drug Tariff: Amendment sheets for August 2014 The following additions apply to Part 3 (Appliances) CATHETERS, Urethral, Urinary (A) i Nelaton Catheters ( Ordinary cylindrical catheter) WyMedical Ltd Order No Gauge Pack of 30 WyCath Uncoated catheter (Paediatric) WUP05 5 3300 (A) ii Nelaton Catheters ( ordinary cylindrical catheter) single use Vesica Urology Ltd Gauge Pack of 60 OptiSmooth Mitro with 4 staggered drainage eyes (40cm) OSM4008 8 7680 (50cm) OSM5008 8 7680 (B) (ii)(a) Foley Catheter 2 Way For Long Term Use Adult: CliniSupplies Ltd Balloon size Gauge Pack of 1 Prosys All-Silicone Foley Catheter (Male) PCF12M10-PCF18M10 10 12-18 564 (Female) PCF12F10-PCF18F10 10 12-18 564 L.IN.C Medical Systems Ltd 2 Way Foley all Silicone Catheter Pack of 1 (Tiemann Tip) 1011-14-1011-18 5 14-18 850 EYE PRODUCTS Eye Drops Hypromellose Hypromellose 0.3% (Alissa Healthcare) (10ml preservative free bottle) 575 PF Drops Hypromellose 0.3% (10ml preservative free bottle) 575 Sodium Chloride PF Drops Sodium Chloride 5% (10ml preservative free bottle) 2520 PELVIC TONING DEVICE Kegel8 1500 5

Scottish Drug Tariff: Amendment sheets for August 2014 The following additions apply to Part 5 (Incontinence Appliances) CATHETER VALVES Manufacturer Appliance Order No Qty Optimum Medical S Ugo Catheter Valve 3000 5 1080 Solutions INCONTINENCE SHEATHS Manufacturer Appliance Order No Qty Great Bear Healthcare Ltd GB Libra Sheath Latex free self-adhesive penile sheath Standard 24mm GBLSS24 30 4680 28mm GBLSS28 30 4680 31mm GBLSS31 30 4680 35mm GBLSS35 30 4680 40mm GBLSS40 30 4680 Pop On 24mm GBLSP24 30 4680 28mm GBLSP28 30 4680 31mm GBLSP31 30 4680 35mm GBLSP35 30 4680 40mm GBLSP40 30 4680 Wide 24mm GBLSW24 30 4680 28mm GBLSW28 30 4680 31mm GBLSW31 30 4680 35mm GBLSW35 30 4680 40mm GBLSW40 30 4680 LEG BAGS Manufacturer Appliance Order No Qty Manfred Sauer UK Ltd Comfort Leg Bag 600ml, twist tap with connecting tube attached, needle free sample port and universal adapter, latex free system, soft wide and narrow straps (1 pair per box of 10) S * 49cm inlet tube twist tap T710S 10 2856 Comfort Leg Bag 1000ml, twist tap with connecting tube attached, needle free sample port and universal adapter, latex free system, soft wide and narrow straps (1 pair per box of 10) S * 49cm inlet tube twist tap T711S 10 2910 6

Scottish Drug Tariff: Amendment sheets for August 2014 TUBING AND ACCESSORIES Manufacturer Appliance Order No Qty U-drain Ltd U-drain consumable pack (contains connecting tubes, syringes, bed clips and emergency night drainage bags) U/D-CTN-003 1 6500 DELETIONS The following deletion applies to Part 3 (Appliances) CATHETERS, Urethral, Urinary (A) i Nelaton Catheters ( Ordinary cylindrical catheter) Bard Ltd Order No Gauge Bard Reliacath Plastic D5030 18 746 The following deletions apply to Part 5 (Incontinence Appliances) INCONTINENCE SHEATHS FIXING STRIPS & ADHESIVES Manufacturer Appliance Order No Qty Camp Ltd Posey Sheath Holder Adult 90500 12 1299 Paeidiatric 6555 12 1000 7

Scottish Drug Tariff: Amendment sheets for August 2014 Other Changes The following changes apply to Part 2 (Dressings) LYMPHOEDEMA GARMENTS Style Lengths Sizes Jobst Bellavar Knee High, Open Toe Short, Long I-VI 2630 Tights, Open Toe Short, Long I-VI 4579 Now reads Jobst Bellavar Knee High, Open Toe Petite, Regular I-VI 2652 Tights, Open Toe Petite, Regular I-VI 4618 Style Lengths Sizes Jobst Bellavar Class 3 (34-46mm Hg) Knee High, Open Toe Short, Long I-VI 2887 Tights, Open Toe Short, Long I-VI 4950 Now reads Jobst Bellavar Class 3 (34-46mm Hg) Knee High, Open Toe Petite, Regular I-VI 2911 Tights, Open Toe Petite, Regular I-VI 4992 8

Scottish Drug Tariff: Amendment sheets for August 2014 Style Lengths Sizes Jobst Opaque Class 1 (18-21mm Hg) Knee High Closed Toe Short, Long I-VI 2630 Knee High Open Toe Short, Long I-VI 2630 Thigh High Open Toe with Silicone Standard Width Short, Long I-VI 5053 Thigh High Open Toe with Silicone Wide Width Short, Long I-VI 5053 Thigh High Closed Toe Standard Width with Soft Silicone Short, Long I-VI 5053 Thigh High Closed Toe Wide Width with Soft Silicone Short, Long I-VI 5053 Thigh High Closed Toe Standard Width with Lace Silicone Short, Long I-VI 5053 Thigh High Closed Toe Wide Width with Lace Silicone Short, Long I-VI 5053 Thigh High Closed Toe Standard Width with Dotted Silicone Short, Long I-VI 5053 Thigh High Closed Toe Wide Width with Dotted Silicone Short, Long I-VI 5053 Thigh High Open Toe Standard Width with Dotted Silicone Short, Long I-VI 5053 Thigh High Open Toe Wide Width with Dotted Silicone Short, Long I-VI 5053 Thigh High Open Toe Standard Width with Lace Silicone Short, Long I-VI 5053 Thigh High Open Toe Wide Width with Lace Silicone Short, Long I-VI 5053 Tights Closed Toe Short, Long I-VI 4579 Tights Open Toe Short, Long I-VI 4579 Now reads Jobst Opaque Class 1 (18-21mm Hg) Knee High Closed Toe Petite, Regular I-VI 2652 Knee High Open Toe Petite, Regular I-VI 2652 Thigh High Open Toe with Silicone Standard Width Petite, Regular I-VI 5053 Thigh High Open Toe with Silicone Wide Width Petite, Regular I-VI 5053 Thigh High Closed Toe Standard Width with Soft Silicone Petite, Regular I-VI 5053 Thigh High Closed Toe Wide Width with Soft Silicone Petite, Regular I-VI 5053 Thigh High Closed Toe Standard Width with Lace Silicone Petite, Regular I-VI 5053 Thigh High Closed Toe Wide Width with Lace Silicone Petite, Regular I-VI 5053 Thigh High Closed Toe Standard Width with Dotted Silicone Petite, Regular I-VI 5053 Thigh High Closed Toe Wide Width with Dotted Silicone Petite, Regular I-VI 5053 Thigh High Open Toe Standard Width with Dotted Silicone Petite, Regular I-VI 5053 Thigh High Open Toe Wide Width with Dotted Silicone Petite, Regular I-VI 5053 Thigh High Open Toe Standard Width with Lace Silicone Petite, Regular I-VI 5053 Thigh High Open Toe Wide Width with Lace Silicone Petite, Regular I-VI 5053 Tights Closed Toe Petite, Regular I-VI 4618 Tights Open Toe Petite, Regular I-VI 4618 9

Scottish Drug Tariff: Amendment sheets for August 2014 Style Lengths Sizes Jobst Opaque Knee High Closed Toe Short, Long I-VI 2630 Knee High Open Toe Short, Long I-VI 2630 Thigh High Open Toe with Silicone Standard Width Short, Long I-VI 5053 Thigh High Open Toe with Silicone Wide Width Short, Long I-VI 5053 Thigh High Closed Toe Standard Width with Soft Silicone Short, Long I-VI 5053 Thigh High Closed Toe Wide Width with Soft Silicone Short, Long I-VI 5053 Thigh High Closed Toe Standard Width with Lace Silicone Short, Long I-VI 5053 Thigh High Closed Toe Wide Width with Lace Silicone Short, Long I-VI 5053 Thigh High Closed Toe Standard Width with Dotted Silicone Short, Long I-VI 5053 Thigh High Closed Toe Wide Width with Dotted Silicone Short, Long I-VI 5053 Thigh High Open Toe Standard Width with Dotted Silicone Short, Long I-VI 4996 Thigh High Open Toe Wide Width with Dotted Silicone Short, Long I-VI 4996 Thigh High Open Toe Standard Width with Lace Silicone Short, Long I-VI 5053 Thigh High Open Toe Wide Width with Lace Silicone Short, Long I-VI 5053 Tights Closed Toe Short, Long I-VI 4579 Tights Open Toe Short, Long I-VI 4579 Now reads Jobst Opaque Knee High Closed Toe Petite, Regular I-VI 2652 Knee High Open Toe Petite, Regular I-VI 2652 Thigh High Open Toe with Silicone Standard Width Petite, Regular I-VI 5053 Thigh High Open Toe with Silicone Wide Width Petite, Regular I-VI 5053 Thigh High Closed Toe Standard Width with Soft Silicone Petite, Regular I-VI 5053 Thigh High Closed Toe Wide Width with Soft Silicone Petite, Regular I-VI 5053 Thigh High Closed Toe Standard Width with Lace Silicone Petite, Regular I-VI 5053 Thigh High Closed Toe Wide Width with Lace Silicone Petite, Regular I-VI 5053 Thigh High Closed Toe Standard Width with Dotted Silicone Petite, Regular I-VI 5053 Thigh High Closed Toe Wide Width with Dotted Silicone Petite, Regular I-VI 5053 Thigh High Open Toe Standard Width with Dotted Silicone Petite, Regular I-VI 5038 Thigh High Open Toe Wide Width with Dotted Silicone Petite, Regular I-VI 5038 Thigh High Open Toe Standard Width with Lace Silicone Petite, Regular I-VI 5053 Thigh High Open Toe Wide Width with Lace Silicone Petite, Regular I-VI 5053 Tights Closed Toe Petite, Regular I-VI 4618 Tights Open Toe Petite, Regular I-VI 4618 10

Scottish Drug Tariff: Amendment sheets for August 2014 Style Lengths Sizes Sigvaris Cotton Class 1 (18-21mm Hg) Below Knee Open Toe Normal, Long XS,S,M,L,XL 2713 Below Knee Xtra Closed Toe Normal, Long XS,S,M,L,XL 2713 Thigh High Open Toe with Grip Top Short, Normal, Long XS,S,M,L,XL 5213 Now reads Style Lengths Sizes Sigvaris Cotton Class 1 (18-21mm Hg) Below Knee Open Toe Normal, Long XXS,XS,S,M,L,XL 2713 Below Knee Xtra Closed Toe Normal, Long XXS,XS,S,M,L,XL 2713 Thigh High Open Toe with Grip Top Short, Normal, Long XXS,XS,S,M,L,XL 5213 Style Lengths Sizes Sigvaris Cotton Below Knee Open Toe Normal, Long XS,S,M,L,XL 2713 Below knee Open Toe Plus Normal, Long XS,S,M,L,XL 2713 Below Knee Xtra Closed Toe Normal, Long XS,S,M,L,XL 2713 Below Knee Open Toe with Grip Top Normal, Long XS,S,M,L,XL 2713 Below Knee Closed Toe with Grip Top Normal, Long XS,S,M,L,XL 2713 Thigh High Closed Toe with Grip Top Short, Normal, Long XS,S,M,L,XL 5213 Thigh High Open Toe with Grip Top Short, Normal, Long XS,S,M,L,XL 5213 Panty Open Toe Normal, Long XS,S,M,L,XL 5213 Panty Closed Toe Normal, Long XS,S,M,L,XL 5213 Now reads Style Lengths Sizes Sigvaris Cotton Below Knee Open Toe Short, Normal, Long XXS,XS,S,M,L,XL 2713 Below knee Open Toe Plus Short, Normal, Long XS,S,M,L,XL 2713 Below Knee Xtra Closed Toe Normal, Long XXS,XS,S,M,L,XL 2713 Below Knee Open Toe with Grip Top Normal, Long XXS,XS,S,M,L,XL 2713 Below Knee Closed Toe with Grip Top Normal, Long XXS,XS,S,M,L,XL 2713 Thigh High Closed Toe with Grip Top Short, Normal, Long XXS,XS,S,M,L,XL 5213 Thigh High Open Toe with Grip Top Short, Normal, Long XXS,XS,S,M,L,XL 5213 Panty Open Toe Normal, Long XXS,XS,S,M,L,XL 5213 Panty Closed Toe Normal, Long XXS,XS,S,M,L,XL 5213 Style Lengths Sizes 11

Scottish Drug Tariff: Amendment sheets for August 2014 Sigvaris Magic Class 1 (18-21mm Hg) Below Knee Closed Toe Normal, Long XS,S,M,L 2713 Below Knee Closed Toe Plus Normal, Long XS,S,M,L 2713 Below Knee Open Toe Plus Normal, Long XS,S,M,L 2713 Below Knee Open Toe Normal, Long XS,S,M,L 2713 Thigh High Grip Top Closed Toe Female Short, Normal, Long XS,S,M,L 5213 Thigh High Grip Top Closed Toe Plus Female Short, Normal, Long XS,S,M,L 5213 Thigh High Grip Top Open Toe Female Short, Normal, Long XS,S,M,L 5213 Thigh High Grip Top Open Toe Plus Female Short, Normal, Long XS,S,M,L 5213 Tights Open Toe Normal, Long XS,S,M,L 5213 Tights Closed Toe Normal, Long XS,S,M,L 5213 Tights Open Toe Plus Normal, Long XS,S,M,L 5213 Tights Closed Toe Plus Normal, Long XS,S,M,L 5213 Now reads Sigvaris Magic Class 1 (18-21mm Hg) Below Knee Closed Toe Normal, Long XXS,XS,S,M,L,XL 2713 Below Knee Closed Toe Plus Normal, Long XXS,XS,S,M,L,XL 2713 Below Knee Open Toe Plus Normal, Long XXS,XS,S,M,L,XL 2713 Below Knee Open Toe Normal, Long XXS,XS,S,M,L,XL 2713 Thigh High Grip Top Closed Toe Female Short, Normal, Long XXS,XS,S,M,L,XL 5213 Thigh High Grip Top Closed Toe Plus Female Short, Normal, Long XXS,XS,S,M,L,XL 5213 Thigh High Grip Top Open Toe Female Short, Normal, Long XXS,XS,S,M,L,XL 5213 Thigh High Grip Top Open Toe Plus Female Short, Normal, Long XXS,XS,S,M,L,XL 5213 Tights Open Toe Normal, Long XXS,XS,S,M,L,XL 5213 Tights Closed Toe Normal, Long XXS,XS,S,M,L,XL 5213 Tights Open Toe Plus Normal, Long XXS,XS,S,M,L,XL 5213 Tights Closed Toe Plus Normal, Long XXS,XS,S,M,L,XL 5213 12

Scottish Drug Tariff: Amendment sheets for August 2014 Style Lengths Sizes Sigvaris Magic Below Knee Closed Toe Normal, Long XS,S,M,L 2713 Below Knee Closed Toe Plus Normal, Long XS,S,M,L 2713 Below Knee Open Toe Plus Normal, Long XS,S,M,L 2713 Below Knee Open Toe Normal, Long XS,S,M,L 2713 Thigh High Grip Top Closed Toe Female Short, Normal, Long XS,S,M,L 5213 Thigh High Grip Top Closed Toe Plus Female Short, Normal, Long XS,S,M,L 5213 Thigh High Grip Top Open Toe Female Short, Normal, Long XS,S,M,L 5213 Thigh High Grip Top Open Toe Plus Female Short, Normal, Long XS,S,M,L 5213 Tights Open Toe Normal, Long XS,S,M,L 5213 Tights Closed Toe Normal, Long XS,S,M,L 5213 Tights Open Toe Plus Normal, Long XS,S,M,L 5213 Tights Closed Toe Plus Normal, Long XS,S,M,L 5213 Now reads Sigvaris Magic Below Knee Closed Toe Normal, Long XXS,XS,S,M,L.XL 2713 Below Knee Closed Toe Plus Normal, Long XXS,XS,S,M,L.XL 2713 Below Knee Open Toe Plus Normal, Long XXS,XS,S,M,L.XL 2713 Below Knee Open Toe Normal, Long XXS,XS,S,M,L.XL 2713 Thigh High Grip Top Closed Toe Female Short, Normal, Long XXS,XS,S,M,L.XL 5213 Thigh High Grip Top Closed Toe Plus Female Short, Normal, Long XXS,XS,S,M,L.XL 5213 Thigh High Grip Top Open Toe Female Short, Normal, Long XXS,XS,S,M,L.XL 5213 Thigh High Grip Top Open Toe Plus Female Short, Normal, Long XXS,XS,S,M,L.XL 5213 Tights Open Toe Normal, Long XXS,XS,S,M,L.XL 5213 Tights Closed Toe Normal, Long XXS,XS,S,M,L.XL 5213 Tights Open Toe Plus Normal, Long XXS,XS,S,M,L.XL 5213 Tights Closed Toe Plus Normal, Long XXS,XS,S,M,L.XL 5213 13

Scottish Drug Tariff: Amendment sheets for August 2014 The following changes apply to Part 3 (Appliances) CATHETERS, Urethral, Urinary (A) ii Nelaton Catheters ( ordinary cylindrical catheter) single use Vesica Urology Ltd Gauge Pack of 60 OptiSmooth Mitro with 4 staggered drainage eyes (40cm) OSM4010-OSM4018 10-18 7680 (50cm) OSM5010-OSM5018 10-18 7680 Now reads (A) ii Nelaton Catheters ( ordinary cylindrical catheter) single use Vesica Urology Ltd Gauge Pack of 60 OptiSmooth Mitro with 4 staggered drainage eyes (40cm) OSM4008-OSM4018 8-18 7680 (50cm) OSM5008-OSM5018 8-18 7680 EYE PRODUCTS Eye Drops Sodium Chloride Sodium Chloride 5% (Alissa Healthcare) (5g preservative free tube) 2250 Now reads Eye Ointment Sodium Chloride Sodium Chloride 5% (Alissa Healthcare) (5g preservative free tube) 2250 HYPODERMIC EQUIPMENT Needles for Pre-filled & Reusable Pen Injectors Unifine Pentips Plus 5mm/31gauge 1274 6mm/31 gauge 1274 8mm/31 gauge 895 12mm/29 gauge 895 Now reads Needles for Pre-filled & Reusable Pen Injectors Unifine Pentips Plus 5mm/31gauge 1274 6mm/31 gauge 1274 8mm/31 gauge 895 12mm/29 gauge 895 14

Stoma Appliances- Reimbursement Prices: Amendment sheets for August 2014 Information Services Gyle Square 1 South Gyle Crescent EDINBURGH EH12 9EB Telephone : 0131 275 6972 Fax : 0131 275 7606 www.show.scot.nhs.uk/nss MONTHLY NOTICE OF AMENDMENTS TO STOMA APPLIANCES August 2014 This document is prepared by the evadis Team, Healthcare Information Group, Information Services Division. Enquiries to: NSS.evadis@nhs.net The following amendments to Stoma Appliances take effect from 1 st August 2014. Please note that potential additions to Stoma Appliances Reimbursement prices must be referred through National Procurement (NSS). The full list of Stoma Appliances Reimbursement prices is available at: http://www.isdscotland.org/health-topics/prescribing-and-medicines/stoma-supplies ADDITIONS ADHESIVE DISCS/RINGS/PADS/PLASTERS Manufacturer Appliance Order No Qty Price(p) Oakmed Ltd. Curvies Flange Extenders CUR001 30 1857 BELTS Order No Qty Price(p) Manufacturer Appliance Kavendor Ltd. Unisex Boxer (level II support) Small/Medium Black 2BOX-S/M-B 1 1735 Medium/Large Black 2BOX-M/L- B 1 1735 Large/X Large Black 2BOX-L/XL- B 1 1735 X Large/XX Large Black 2BOX-XL/2XL- B 1 1735 XX Large/XXX Large Black 2BOX-2XL/3XL- B 1 1735 Ladies Brief (level II support) Small/Medium Black 2BRF-S/M-B 1 1735 Medium/Large Black 2BRF-M/L-B 1 1735 Large/X Large Black 2BRF-L/XL-B 1 1735 X Large/XX Large Black 2BRF-XL/2XL-B 1 1735 XX Large/XXX Large Black 2BRF-2XL/3XL-B 1 1735 1

Stoma Appliances- Reimbursement Prices: Amendment sheets for August 2014 BELTS cont Order No Qty Price(p) Manufacturer Appliance Kavendor Ltd. Comfizz Multi Support Belt (level III) Medium Neutral WNM-L3-0/15 1 5610 Large Neutral WNL-L3-0/15 1 5610 X Large Neutral WNXL-L3-0/15 1 5610 XX Large Neutral WN2XL-L3-0/15 1 5610 XXXLarge Neutral WN3XL-L3-0/15 1 5610 XXXXL Large Neutral WN4XL-L3-0/15 1 5610 Comfizz Support Belt (level III) 60mm shallow Medium Neutral WNM-L3-60/10 1 5610 Large Neutral WNL-L3-60/10 1 5610 X Large Neutral WNXL-L3-60/10 1 5610 XX Large Neutral WN2XL-L3-60/10 1 5610 XXX Large Neutral WN3XL-L3-60/10 1 5610 XXXX Large Neutral WN4XL-L3-60/10 1 5610 Comfizz Support Belt (level III) 72mm shallow Medium Neutral WNM-L3-72/10 1 5610 Large Neutral WNL-L3-72/10 1 5610 X Large Neutral WNXL-L3-72/10 1 5610 XX Large Neutral WN2XL-L3-72/10 1 5610 XXX Large Neutral WN3XL-L3-72/10 1 5610 XXXX Large Neutral WN4XL-L3-72/10 1 5610 Comfizz Support Belt (level III) 85mm Medium Neutral WNM-L3-85/15 1 5610 Large Neutral WNL-L3-85/15 1 5610 X Large Neutral WNXL-L3-85/15 1 5610 XX Large Neutral WN2XL-L3-85/15 1 5610 XXX Large Neutral WN3XL-L3-85/15 1 5610 XXXX Large Neutral WN4XL-L3-85/15 1 5610 DISCHARGE SOLIDIFYING AGENTS Order No Qty Price(p) Manufacturer Appliance Medicareplus International Ltd Medi Gelsorb Sachets 61052 100 2975 2

Stoma Appliances- Reimbursement Prices: Amendment sheets for August 2014 DELETIONS BELTS Order No Qty Manufacturer Appliance B. Braun Medical Almarys Twin Belt (support) 120mm for Two Piece system 036780E 1 466 Kavendor Ltd Comfizz Stoma Support Wear (level 1 support) Boxer Junior XSmall Grey BOX-JXS-G 1 1200 Junior Small Grey BOX-JS-G 1 1200 Junior Medium Grey BOX-JM-G 1 1200 Junior Large Grey BOX-JL-G 1 1200 COLOSTOMY BAGS Order No Qty Manufacturer Appliance B. Braun Medical Biotrol Preference bag with filter, skin protector adhesive, fabric backing Beige Starter hole 36-615 30 7389 25mm 36-625 30 7389 30mm 36-630 30 7389 35mm 36-635 30 7389 40mm 36-640 30 7389 45mm 36-645 30 7389 50mm 36-650 30 7389 60mm 36-660 30 7389 White Starter hole 32-610 30 7262 25mm 32-625 30 7262 35mm 32-635 30 7262 40mm 32-640 30 7262 45mm 32-645 30 7262 50mm 32-650 30 7262 60mm 32-660 30 7262 Softima closed pouch with filter, skin protector and protective cover Mini Beige Cut-to-fit 16-50mm 043216E 30 7556 3

Stoma Appliances- Reimbursement Prices: Amendment sheets for August 2014 ILEOSTOMY BAGS Order No Qty Manufacturer Appliance B. Braun Medical Biotrol Almarys Optima Mini Drainable Bag with all over soft non-woven cover Beige 20mm F008820E 30 6440 25mm F008825E 30 6440 30mm F008830E 30 6440 35mm F008835E 30 6440 40mm F008840E 30 6440 Ileo S Bag with skin protector White 60mm 32-760 30 7950 70mm 32-770 30 7950 IRRIGATION/WASH-OUT APPLIANCES - (Replacement Parts) (SLEEVES/DRAINS/BAGS/CONES/LUBRICANTS) Order No Qty Manufacturer Appliance B. Braun Medical Irrimatic Pump Accessories Belt 22780 1 488 Plate for Irrigation 25064 1 498 Sleeves 25061 50 2788 Iryflex Reservior F05060E 1 1329 Set F05065E 1 6049 OTHER CHANGES Manufacturer name change Comfizz Ltd Now Kavendor Ltd 4