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Brand phobia is costing the NHS dear

Regarding your story on drug switching (News, 28 November), I have come to the conclusion that no-one understands how drugs are priced now that Category M pricing has been introduced for many generic drugs.

The system was introduced along with the new pharmacy contract and guarantees pharmacy a profit of £500m on dispensed generic drugs per annum.

Category M means there are now dozens of generics which are considerably more expensive than brands because of the guarantee of profit for pharmacy.

Yet because for donkey's years everyone has thought generics are cheaper, primary care trusts and the Department of Health still encourage their prescribing, at considerable cost to the NHS.

Two leading generic drugs for asthma – beclomethasone and salbutamol – are both more than double the branded price. Some other examples are:

• Sulfasalazine, 500mg generic is £28.39. Salazopyrin 500mg, the branded alternative, is £6.97.
• Metronidazole 500mg, a popular antibiotic, is £24.42. Flagyl 500mg, the branded alternative, is £6.60.

What is going on? Why don't primary care trusts and strategic health authorities understand? Some practices have Scriptswitch software, which does show the price, but even then GPs are fearful of prescribing brands.

It simply goes against PCTs' generic mantra.

From Dr Lisa Silver, Nettlebed, Oxfordshire

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