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Pharmacists want to be able to swap GP-prescribed drugs for generics

Pharmacists should be able to change GP prescriptions to ‘therapeutically equivalent generics’ when dispensing drugs, the Pharmaceutical Services Negotiating Committee (PSNC) has said.

This would enable pharmacies to earn more money, as they gain more profit from generics than branded generic drugs.

The BMA suggested it could also be a positive change for GPs who are bombarded with notifications about which version of a drug they should be prescribing based on cost.

The call follows joint discussions with the BMA, PSNC and Dispensing Doctors’ Association, who are actively lobbying the Government to review the reimbursements system for dispensing doctors and pharmacists.

Speaking at the annual local pharmaceutical committees (LPC) conference in Birmingham, the PSNC director of pharmacy funding Mike Dent told delegates that pharmacists should be able to give a ‘therapeutically equivalent generic’, instead of the branded version prescribed by the GP, in order for them to earn higher margins.

Mr Dent said: ‘You either tell the GPs they have to prescribe generically or you say to a pharmacy – regardless what’s written on the prescription – “you can give a therapeutically equivalent product”’.

BMA Wales chair Dr David Bailey, who is leading on the matter for the BMA, said: ‘It’s helpful because GPs get these messages flashing up on their screen all the time saying “can you change to this branded generic because it’s tuppence a month cheaper” and actually what that means is GPs end up turning off to the safety messages that are in the same notification system.'

He warned the current system 'potentially means' GPs are 'missing safety information' because they are 'conditioned to ignore the pedantic nonsense'.

He said: '[It] basically saves tuppence a month for the health board or CCG, but actually costs twice as much a year down the line when the government has to allow for transactional costs in the reimbursement.'

He said having pharmacists make the call instead would be 'easier for prescribing GPs, it’s easier for patients, it’s easier for contractors – whether they are dispensing pharmacist or doctors'

'The only people who lose out in the short-term are the people who are trying to count the beans in the CCGs and health boards. The NHS as a whole gains,' he added.

Earlier this year the Department of Health and Social Care was given ‘new powers’ to control the price of generic medicines, after an investigation found that price hikes led to CCGs spending an extra £315m on medicines in 2017/18.

 

Readers' comments (12)

  • So long as they deal with the patient when they complain.

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  • Agree would like to be able to tell patients not happy with one generic over another to book an appointment with the pharmacist not me ,and I imagine pharmacist must be just as well informed as us about the importance of compliance,nocebo ,placebo effects and able to deal with someone whose frail parent refuses the larger orange generic ones.....I suspect they are also better at making sure they are paid properly for the extra time and medico legal responsibilities- there’s a lot more to generic prescribing than just pressing the Script Switch button!

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  • ok in most instances but well what if you don't want to give a generic or you want to prescribe a certain generic the patient got on better with. the bioavailability of drugs made by different companies and so the side effects and benefits does vary. not necessariuly that the generic is worse just different. is simplistic to say they are identical and if patients get side effects with one brand I think that is valid not just some people whingeing and being difficult. I don't want other people changing my prescriptions.
    you could add as in other countries no substitutions if you particularly want to give a brand.

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  • Let them tick the button at their own peril as long as patient doesn't hold GP responsible for his intolerance of any sort.

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  • This is a good idea. In Australia scripts have a little box than can be ticked if you do not want an alternative generic prescribed. It works well.

    Most will opt for the generic as it is cheaper and they have to pay for their medication.

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  • penis mcTaggart- I agree with your point about valid patient differences- and a Pharmacist would be 'ideally placed' to recognise this and know all the different makes aailable and their prices to the nhs .

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  • excellent idea, been asking for it for years

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  • Pharmacists show their true colours. How can we maximise profits and pretend we are taking the moral high ground at the same time. Certainly in respiratory disease it is highly irresponsible not to prescribe generically as formulations differ substantially as do devices.I would not trust a pharmacist to perform a generic substitution nor would I want to be held responsible for the lack of control which ensues when the device is changed and the patient loses control. In fact high street pharmacists should be phased out.

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  • doctordog.

    Fantastic idea provided done with patient consent.

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  • Dermot:
    "In fact high street pharmacists should be phased out."

    Are you really a locum GP?
    Or are you a dispensing practice partner?

    Because if we didn't have high Street pharmacies, would you suggest we should all get into the dispensing game?

    In 2018, pharmacists add value to the NHS, on tight margins. They are promised a certain margin over and above cost price, to keep the lights on.

    Script switching to branded generics that undercut the NHS list price, is CCGs trying to undermine this agreement.
    That's not ok, any more than CCGs trying to claw back practice funding.

    http://www.pulsetoday.co.uk/clinical/clinical-specialties/prescribing/medicines-optimisation-schemes-simply-rob-peter-to-pay-paul-gps-should-boycott-them/20035359.article

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