Serious Shortage Protocol (SSP) for Monomil® XL 60mg
modified-release tablets – corresponding guidance on
endorsement, prescription charges, remuneration andreimbursement plus Q&A.
SSP 059 for Monomil® XL 60mg modified-release tablets
1) Endorsement
The contractor must endorse the prescription form or Electronic
Reimbursement Endorsement Message (EREM) as per Clause 9, Part II of
the Drug Tariff.
Electronic prescription:
Where SSP endorsement functionality is available on the dispensing system
the contractor must select SSP and input the three-digit reference number.
The contractor must also select in the system the SSP item that has been
supplied.
ExampleEndorsement
OptionExample 1: Prescription for Monomil® SSP 059
XL 60mg modified-release tablets x
Pharmacy contractor selects in
28 tablets
system Chemydur® 60XL 60mg
modified release tablets x 28
Pharmacy contractor supplies
Chemydur® 60XL 60mg modified
release tablets x 28
Example 2: Prescription for Monomil® SSP 059
XL 60mg modified-release tablets x
Pharmacy contractor selects in
28 tablets
system Isotard® 60XL modified
release tablets x 28
Pharmacy contractor supplies Isotard®
60XL modified release tablets x 28
Example 3: Prescription for Monomil® SSP 059
XL 60mg modified-release tablets x
Pharmacy contractor selects in28 tablets
system Monomax® XL 60mg
modified release tablets x 28
Pharmacy contractor supplies
Monomax® XL 60mg modified releasetablets x 28

Example 4: Prescription for Monomil® SSP 059
XL 60mg modified-release tablets x
Pharmacy contractor selects in
28 tablets
system Tardisc® XL 60mg
modified release tablets x 28
Pharmacy contractor supplies Tardisc®
XL 60mg modified release tablets x 28
Non-electronic prescription form:
ExampleEndorsement
OptionExample 1: Prescription for Monomil® SSP 059
XL 60mg modified-release tablets x
Pharmacy contractor endorses
28 tablets
Chemydur® 60XL 60mg
modified release tablets x 28
Pharmacy contractor supplies
Chemydur® 60XL 60mg modifiedrelease tablets x 28
Example 2: Prescription for Monomil® SSP 059
XL 60mg modified-release tablets x
Pharmacy contractor endorses
28 tablets
Isotard® 60XL modified releasetablets x 28
Pharmacy contractor supplies Isotard®
60XL modified release tablets x 28
Example 3: Prescription for Monomil® SSP 059
XL 60mg modified-release tablets x
Pharmacy contractor endorses
28 tablets
Monomax® XL 60mg modified
release tablets x 28
Pharmacy contractor supplies
Monomax® XL 60mg modified releasetablets x 28
Example 4: Prescription for Monomil® SSP 059
XL 60mg modified-release tablets x
Pharmacy contractor endorses
28 tablets
Tardisc® XL 60mg modified
release tablets x 28
Pharmacy contractor supplies Tardisc®
XL 60mg modified release tablets x 282) Prescription charges
Pharmacy contractors must take one prescription levy. Only one prescription
charge will be applicable for patients who are not exempt from prescription
charges.

3) Remuneration
Supply in accordance with this SSP 059 will result in the following fees being
paid to the contactor:• One Single Activity Fee (£1.27)• One SSP fee (£5.35)
4) Reimbursement
The supplied product in accordance with this SSP 059 will be reimbursed as if
it was dispensed against a prescription. In this instance, contractors will bereimbursed the NHS list price for the following products depending on thequantity supplied:• Chemydur® 60XL 60mg modified release tablets• Relosorb® XL 60mg modified release tablets• Isotard® 60XL modified release tablets• Monomax® XL 60mg modified release tablets• Monosorb® XL 60mg modified release tablets• Tardisc® XL 60mg modified release tablets
As of June 2023, a VAT allowance will no longer be paid as products suppliedin accordance with an SSP are considered to be VAT zero-rated.

Q&A
Will the SSP apply to cross-border prescriptions?
Yes. Patients from England, Scotland, Wales or Northern Ireland who present theirprescriptions for Monomil® XL 60mg modified-release tablets are eligible to receive asubstituted product under the terms of this SSP 059.

Does the SSP apply to private prescriptions?
Yes. The scope of this SSP 059 applies to valid prescriptions that meets therequirements of the Human Medicine Regulations 2012, so it would cover both NHS
and private prescriptions, unless where it stated otherwise on the SSP itself.

Will prescription charges apply under the SSP?
Yes, patients who are not exempt from prescription charges would continue to pay
for this as usual. The only circumstance in which patients would not have to pay for aprescription charge is where an SSP specifies a lower quantity to be supplied.
Please note that the SSP for Monomil® XL 60mg modified-release tablets does notspecify a lower quantity to be supplied, so patients will continue to pay prescription

charges (unless they are already exempt). For more information, please see theabove guidance.

What brand would I supply as an alternative under this SSP?
Pharmacies should supply from the medicines in Group 1 in the first instance,supplying from Group 2 where those products in Group 1 are not available. This isbased on supply volumes and not clinical interchangeability.
Group 1
• Chemydur® 60XL 60mg modified release tablets; or• Relosorb® XL 60mg modified release tablets; or• Isotard® 60XL modified release tablets.
Group 2
• Monomax® XL 60mg modified release tablets; or• Monosorb® XL 60mg modified release tablets; or• Tardisc® XL 60mg modified release tablets.

Can pharmacists use their professional judgement to supply an alternative
product to patients?
If the pharmacist thinks that an alternative product, other than those listed within theSSP would be suitable for the patient, they should either contact the prescriber todiscuss this (with the patient’s consent) or direct the patient back to the prescriber.

Should pharmacists provide additional counselling when supplying patientswith an alternative product?
The pharmacist will need to discuss with the patient/carer whether they have used
any of the alternative brands listed in the SSP before. Where appropriate thepatient/carer should be made aware of the change and be warned of possible
adverse events that they may experience particularly in the first few days. Pleaserefer to the cautions listed in the SSP, including any relevant actions that need to betaken.

Does the SSP apply to other auto-injector pens?
No, this SSP 059 only applies to prescriptions for Monomil® XL 60mg modifiedrelease tablets.