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GPC tells GPs not to accept pregabalin costs from drugs company 'out of principle'

Exclusive GPs should refuse payments from Pfizer for the cost of switching from a generic version of pregabalin to a branded version made by the drug maker, the GPC has said.

Pfizer has offered to refund practices for the costs involved in GPs having to switch their patients onto its branded ‘Lyrica’ drug when they are taking pregabalin to alleviate neuropathic pain following a High Court ruling in March.

However, the GPC has told Pulse that practices should not accept any payments, even if they come via the NHS or another independent body.

This is the latest in the saga, which has come about over a patent dispute involving Pfizer and generic manufacturers of pregabalin.

Pfizer claims that it owns the patent for pregabalin used for neuropathic pain, although a generic version can still be supplied to treat epilepsy and generalised anxiety disorder, which are not covered by Pfizer’s patent.

GPs have expressed outrage at the decision, warning it undermines the principle of prescribing drugs based on medical need, not for commercial reasons, and means the NHS is passing on unfunded work to practices to review and change repeat prescriptions of pregabalin.

Pfizer said in a statement that it did not wish GP practices to be ‘out of pocket’ because they prescribe Lyrica for pain relief and that it was ‘committed to doing the right thing for patients and the NHS’.

It said: ‘Pfizer is in discussion with NHS England and the Department of Health (and other interested parties) regarding the request for reimbursement from some GPs and CCGs to determine whether it is possible for Pfizer to do this and, if so, what the appropriate mechanism would be. The reimbursement for work already done that has been requested by GPs or CCGs.’

Seema Patel, medical director of established pharma at Pfizer UK, told Pulse the company is also working with the industry regulator, the Prescription Medicines Code of Practice Authority, ‘to make sure we can clear a path, so that if we make these payments it is not considered an inducement’.

However, Dr Andrew Green, chair of the GPC’s clinical and prescribing subcommittee, told Pulse: ‘This is not about remuneration, it is the principle of accepting money from a company for changing prescribing in a way which will do nothing to improve the health of their patients but everything to improve their company’s profits.

‘I would not advise accepting it no matter through what route is channelled.’

Dr Green added: ‘Given that we have serious reservations about the action that Pfizer is taking, the tone of its contact with practices and pharmacists and the significant costs they will be inflicting on the wider NHS, I would regard it as unwise to have anything to do with accepting money for this work from them.’

The directive for GPs to switch prescriptions from pregabalin to Lyrica has led to pharmacists reporting significant events where generic prescriptions were issued, while Pulse revealed that one CCG had billed NHS England for administering the prescription changes on behalf of its practices.

Pfizer has since offered an apology for causing GPs and pharmacists concern over the prescription changes, although at the recent full High Court hearing on the patent infringement, it also called for more stringent measures to stop GPs prescribing generic pregabalin.

Experts have warned that similar legal judgments in the future could further restrict GPs freedom to prescribe generic drugs.

NHS England said: ‘We are in discussions with interested parties so it would be inappropriate to comment at this stage.’

Readers' comments (9)

  • What is even more perverse is that Pfizer stated categorically in May 2012 that, after exhaustive clinical trials, Lyrica DOES NOT WORK for neuropathic pain . Yes, Pfizer withdrew approval for its own drug Lyrica (pregabalin) for the treatment of diabetes and HIV-related neuropathy. Many people weren't surprised, considering the number of side effects and court cases that Pfizer had to settle. Many doctors have still not yet caught up with the news and are still prescribing Lyrica for those two forms of neuropathy. It would be interesting to hear what discussions doctors have had with their patients about the implications of Pfizers decision in the light of their actions to protect the patent on a drug they cannot endorse for the use covered by that patent.

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  • Took Early Retirement

    Becoming a very popular drug of abuse too.

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  • move away from Lyrica, there are other alternatives.also by the way sitagliptin is made by pfizer too. potentially these will go on to generic. Linagliptin or saxagliptin are pretty good alternatives. I am a bit worried about prescribing pfizer medication as the company have proven to be disruptive. This is a shame as we should all have positive relationships with one another for the benefit of our patients.

    what happens if this now opens a cascade of other companies now behaving in this aggressive ungentlemanly manner?

    - anonymous salaried!

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  • Vinci Ho

    Inevitably , this country is being americanised gradually but I believe certain virtues and values should remain British. These are virtues which are non-market or non market orientated . The reason why NHS still stands despite the fact that our politicians are constantly trying to destroy it , is simply our frontline 'fighters' are still upholding these values (of course, there is always a limit when the government continues to be disrespectful and negligent).
    The extreme capitalism however will try its best to erode into these non-market norms by monetary means. After all , economics is simply a study of financial incentives,as our Chancellor said , no economy, no NHS.
    Yes, I can understand some of us will believe the American system is more superior but I think there is a lot more for our 'friends' on the other side of the Atlantic to learn about this country instead. That may be one of the reasons Pfizer failed to take over AstraZeneca last year, who knows ?

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  • The Government (HMG) and Pfizer know exactly how many scripts have been done within any given period. It takes not a lot of research to come up with a percentage of those who are given it for neuropathic pain.

    It then comes down to a bit of haggling exactly how much should transfer between HMG and Pfizer. I suspect Pfizer have probably made this approach already.

    That this process has not happened and it has devolved to the GPs tells me that HMG see this as yet another way of keeping GPs in fear and at the same time saving some money.

    Cynic moi?

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  • If its still on patent I thinkits fair enough to ask people to prescribe lyrica for neuropathic pain but every time I read about it I instantly forget and would prescribe generic if I ever prescribe it that is.

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  • "Anonymous | Work for third sector | 29 August 2015 0:05am

    What is even more perverse is that Pfizer stated categorically in May 2012 that, after exhaustive clinical trials, Lyrica DOES NOT WORK for neuropathic pain . Yes, Pfizer withdrew approval for its own drug Lyrica (pregabalin) for the treatment of diabetes and HIV-related neuropathy. ...."

    While anonymous posting is everyone's right, I do smell a slight conflict of interest here. Do you perchance work for a rival drugs firm??

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  • To quote someone from a previous article about this:

    "There are plenty of other drugs that also don't work but have fewer side effects"

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  • Re:
    'While anonymous posting is everyone's right, I do smell a slight conflict of interest here. Do you perchance work for a rival drugs firm??'

    No, but I do use Lyrica for neuropathic pain. The point I was making is the Pfizer should not be allowed to have their very expensive cake and eat it at the expense of the NHS. Either the drug works as per the patent or it does not. Pfizer says it does NOT work, so becoming proprietorial about it is hypocritical and unethical. The issue here is Pfizer's bottomline. Obviously 'reputational damage' has now become a factor as a result of an ill considered corporate decision.
    As someone who uses pregabalin I actually think it does have some efficacy for neuropathic pain, not much, but some. One doesn't expect too much from it because it's use for neuropathic pain is essentially nothing more than a 'side effect' . I would be happy to use a cheaper generic. No conflict of interest, just common sense.

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