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29th April 2020

UK Drug Tariff changes

Recently, the Drug Tariff was updated with regard to sunscreens to better clarify and expand the conditions that are eligible.

Which conditions are eligible?[1–4]

The updated Drug Tariff states that sunscreen prescriptions should be considered as follows:

When prescribed for skin protection against ultraviolet and/or visible light in abnormal cutaneous photosensitivity causing severe cutaneous reactions in genetic disorders (including xeroderma pigmentosum and porphyrias), severe photodermatoses (both idiopathic and acquired) and those with increased risk of ultraviolet radiation causing severe adverse effects due to chronic disease (such as haematological malignancies), medical therapies and/or procedures. (Emphasis added)

Some examples are detailed below.

Primary photodermatoses, including:

  • Polymorphic light eruption
  • Actinic prurigo
  • Chronic actinic dermatitis
  • Solar urticaria

Metabolic photodermatoses (porphyrias), including:

  • Porphyria cutanea tarda
  • Erythropoeitic protoporphyria
  • Variegate porphyria
  • Erythropoeitic porphyria (Gunther disease)

Serious photoexacerbated dermatoses, including:

  • Lupus erythematosus
  • Dermatomytosis

Genetic disorders, including:

  • Xeroderma pigmentosum
  • Blood syndrome
  • Rothmund Thomson syndrome
  • Cockayne syndrome

Other situations, including:

  • Cases of drug-induced photosensitivity (if a suitable alternative is not available)
  • Photocontact allergic reactions
  • Following medical therapies/procedures

While the Drug Tariff only specifies a limited number of conditions as being eligible, the list is not exhaustive and NHS dermatology specialists can give consideration to other high-risk patients.[4]

Which conditions are not eligible?

Exposure to UV radiation has been shown to cause many harmful effects, from photoageing to skin cancer,[5] so sun protection should be encouraged for everyone. However, prescription sunscreen under the NHS is designed to ease the cost burden on people for whom sun protection is not just a recommendation, but a daily necessity.

Skin conditions that may be exacerbated by sunlight, like eczema, psoriasis and rosacea, are not included in the definition set out in the Drug Tariff. However, in exceptional circumstances, a sunscreen prescription should still be considered.

Similarly, for patients taking medication that can induce photosensitivity, sunscreen should only be prescribed in cases of confirmed drug-induced photosensitivity, and then only if a suitable alternative cannot be found. Sunscreen should not be prescribed as a preventative measure or ‘just in case’.

How SunSense Ultra can help

Only a small number of sunscreens are listed on the Drug Tariff. Among them is SunSense Ultra, which not only provides very high, broad-spectrum protection, with an SPF of 50+ and a 5-star UVA rating, but is a light, smooth lotion that’s easy to apply and is readily absorbed. It also contains niacinamide (Vitamin B3), which helps improve skin tone and texture as well as replenish dry skin, among a wide range of other benefits.[6]

SunSense Ultra is designed for everyday use, making it an ideal choice for people with photosensitivity conditions.

References

1. Oakley A. Photosensitivity [Internet]. DermNet NZ2016 [cited 2020 Apr 14];Available from: https://www.dermnetnz.org/topics/Photosensitivity/

2. Bylaite M, Grigaitiene J, Lapinskaite GS. Photodermatoses: classification, evaluation and management. British Journal of Dermatology 2009;161(s3):61–8.

3. Lehmann P, Schwarz T. Photodermatoses: diagnosis and treatment. Deutsches Ärzteblatt International 2011;108(9):135.

4. NHS – Wandsworth Clinical Commissioning Group. Position statement on the prescribing of sunscreens on GP FP10 prescription [Internet]. [cited 2020 Apr 15];Available from: https://www.wandsworthccg.nhs.uk/aboutus/Prescribing%20Guidelines%20v20/Sunscreen%20Prescribing%20Position%20Statement.pdf

5. Wang SQ, Balagula Y, Osterwalder U. Photoprotection: a Review of the Current and Future Technologies. Dermatologic Therapy 2010;23(1):31–47.

6. Forbat E, AlNiaimi F, Ali FR. Use of nicotinamide in dermatology. Clinical and Experimental Dermatology 2017;42(2):137–44.

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