A short, dated read on the Drug Tariff, contract and QOF changes that move a dispensing practice's income. This is general information, not advice. Confirm current figures against the primary source before acting.
The apixaban (Eliquis) patent was held invalid by the Court of Appeal in 2023, and generic apixaban is now in Part VIIIA. The March 2026 Drug Tariff showed about £1.64 for 2.5mg (60) and £2.29 for 5mg (56), against branded Eliquis well above £50 a pack. A price concession of about £2.80 for 5mg (56) was granted for April 2026, so purchase prices were still above tariff in the early weeks. Why it matters: a very high-volume anticoagulant has moved from near-zero brand margin to a Category M line where buying margin is possible once supply settles. Early concession volatility means a real risk of dispensing at a loss during the switch, so watch sourcing against the tariff month by month.
The January 2026 tariff moved generic ticagrelor to Category A at about £3.97 for 60mg (56) and £4.73 for 90mg (56), down from roughly £54.60 as a brand. Why it matters: another large fall that rewards careful purchasing and punishes old stock bought at brand prices.
Dapagliflozin (Forxiga) moved into Category M in September 2025 with a significant reimbursement cut after its patent was invalidated. Why it matters: a high-volume SGLT2 inhibitor where margin now depends entirely on buying below tariff.
Rivaroxaban (Xarelto) generics have been in Categories A and M since around September 2024. Empagliflozin (Jardiance) is not expected to go generic in the UK until roughly 2028, and sitagliptin (Januvia) has been generic and low-priced since 2022 to 2023. Why it matters: the margin on a practice's highest-volume lines is a moving target across these years, so a snapshot taken once goes stale quickly.
Community Pharmacy England recorded around 201 concessions for March 2026, with more than 200 again in the following months, the highest on record, driven by supply-chain disruption. A new Part VIIIA sub-category, Category H, was introduced from March 2026 to speed up tariff adjustment for newly genericised lines. Why it matters: concession lag is the main way a dispensing practice loses money on a generic it cannot source at tariff, and the volume of concessions shows how often that is happening.
NHS England guidance directs that items for mild conditions, such as emollients for mild dry skin and drops for mild dry eye, should not routinely be prescribed, and ICBs are switching branded emollients to generics. Why it matters: each item not prescribed is a dispensing fee and a margin opportunity foregone, so the mix shift matters even when no single line looks dramatic.
The 2026/27 GP contract was imposed from 1 April 2026, having been rejected by 98.9% of GPs who voted. The Global Sum rose from £123.34 to £130.07 per weighted patient, about 5.5%, and total contract investment rose by £485m to £13,863m, about 3.6% in cash. Why it matters: the capitation rise is real but is partly offset by cost pressures and by funding moved around rather than added.
For dispensing practices the fee per item fell for the April to September 2026 period, a formula effect of rising national item volumes, with an uplift expected from October 2026 that is not yet published. The prescription charge is frozen at £9.90 for 2026/27. Why it matters: dispensing income does not move with the core uplift; it is set by the Drug Tariff and the fee scale, and the first half of the year carries a fee cut.
The National Living Wage rose to £12.71 an hour, about 4.1%; employer National Insurance stays at 15% with a £5,000 threshold, and GP practices get no Employment Allowance. The DDRB recommended 3.5% for GPs and 3.3% for other staff. Why it matters: dispensary and support staff often sit near the living wage, so these land harder on a dispensing practice than on an average urban practice.
QOF for 2026/27 rose to 582 points, from 564, with the point worth £227.95, from £225.49. Most of that rise reflects the change in the national average list size, not a real-terms increase, and there is no income protection this year. Why it matters: high achievers must now earn every point on live performance, and several indicators changed in ways that move money, including a cut to the cholesterol indicator and new all-or-nothing diabetes and heart-failure measures.
The Drug Tariff is published every month by the NHS Business Services Authority on behalf of the Department of Health and Social Care. It sets out what dispensing contractors, pharmacies and dispensing practices, are reimbursed for the medicines they dispense, plus the fees and allowances they're paid for dispensing them.
For dispensing practices the part that moves the money is Part VIIIA: the basic reimbursement prices for the generic medicines that make up the bulk of what you dispense. Each line sits in a category, and the category decides how its price is set, and how often it changes.
Three long-standing categories (A, C and M), and from March 2026 a fourth: Category H. Each is priced on a different basis and a different clock.
A weighted average of list prices from the main suppliers (AAH and Alliance weighted more heavily than Teva and Accord). Historically reset monthly; since 2024 reforms it is moving onto a quarterly, sales-data-based footing.
Cycle · quarterly (reforming)Reimbursed on the list price of a particular branded product or supplier. Used where a generic isn't readily available from multiple sources, so the price tracks one product rather than a market.
Cycle · as the listed source changesSet from manufacturers' reported actual selling prices, then deliberately uplifted so the system delivers the agreed level of retained "margin" to dispensers. It is also the lever used to claw that margin back. Reset quarterly.
Cycle · quarterlyA subset of multi-source Category C products moved into a new category. DHSC sets the price from suppliers' sales data, and it applies only where the drug is prescribed generically. Updated quarterly.
Cycle · quarterlyKnowing a line's Tariff price is only the start. Three further mechanisms decide whether you actually kept any of it.
Reimbursement category, minus clawback, plus fees, against what you actually paid after rebates, resolved for the right week, for every line. Miss one moving part and the margin you think you made is not the margin you kept.
Reimbursement is being steadily rebuilt around suppliers' real sales data. That means more accuracy for the NHS, and more frequent, harder-to-predict change for you.
The first multi-source products move from Category C into the new Category H, priced from sales data and updated quarterly (next change June 2026). Community Pharmacy England objected to the timing, warning it adds uncertainty to an already fragile supply chain, so expect early volatility as the list grows.
Category A reimbursement is transitioning from monthly supplier-list pricing to a quarterly basis driven by price-per-unit sales and volume data, smoothing some month-to-month noise but lagging the market by a quarter.
The common thread across Category M, the Category A reforms and now Category H is the same: prices set from real sales data, reviewed on quarterly cycles, with margin recovered more tightly. The net effect for a dispensary is less slack and more lines sitting close to the line between profit and loss, which is exactly where continuous, line-level monitoring earns its keep.
A dated read on the generic entries, concession trends and contract changes moving dispensing margin in 2026. General information, not advice. Confirm current figures against the Drug Tariff before acting. Last reviewed May 2026.
The UK patent on apixaban (Eliquis) was held invalid in 2023, and the protection that would have run to 19 May 2026 fell with it. Generic apixaban now sits in Part VIIIA: the March 2026 Tariff showed roughly £1.64 for 2.5mg (60) and £2.29 for 5mg (56), against branded Eliquis well above £50 a pack, with an April concession near £2.80 for 5mg (56). A very high-volume anticoagulant has moved from near-zero dispensing margin as a brand to a line where buying margin is possible once supply settles. Watch sourcing against the tariff month by month.
Generic ticagrelor (Brilique) entered the Tariff at roughly £3.97 for 60mg (56) and £4.73 for 90mg (56), down from about £54.60. A steep drop that rewards good purchasing and penalises stock bought at brand prices.
Dapagliflozin (Forxiga) moved into Category M with a significant reimbursement cut after its patent was invalidated. As with the wider SGLT2 class, margin now depends on buying below tariff.
Rivaroxaban (Xarelto) has been generic since around September 2024; sitagliptin has been generic and low-priced sin