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Fury over Government plans for generic substitution by pharmacists

By Ian Quinn

The Government has released a list of 40 drugs that are set to be automatically switched to generic versions by pharmacists - even when branded drugs are indicated by a GP on the prescription.

Under the controversial proposals - which will now be consulted upon - the Government intends to hand pharmacies the power to routinely switch the list of drugs to generic versions unless the GP specifically writes the acronyn 'NGS' (not for generic substitution) next to the drug name on the prescription.

The Department of Health, which claims the scheme will save £41m a year, outlined the controversial proposals in a consultation document released yesterday - but they have drawn a furious response from leading GPs.

The DH has backed away from a different model where GPs are able to 'opt in' by indicating on prescriptions when they think generic drugs are suitable as an alternative to branded treatments.

It also rejected its own previous proposal for a tick-box system allowing GPs to indicate if substitution is suitable, each time they make a prescription, claiming it would be too expensive and too complicated.

The list of drugs the Government proposes for generic substitution include commonly used drugs such as ramipril, simvastatin and dicofenac, but excludes drugs with a narrow therapeutic index - such as epilepsy drugs - after protests that including them could harm patient safety.

Dr Peter Fellows, a member of the GPC's prescribing subcommittee and a GP in Lydney, Gloucestershire, said the UK already prescribes more generic drugs than any country in Europe and warned the new plans threaten both patient care and the pharmaceutical industry.

He said the Government's opt out option could jeopardise patient safety, because ‘most GPs won't have the time to do it because of the sheer volume of prescriptions they get through'.

He added: ‘The Government seems hell-bent on this but it's an absolute nonsense and an insult to general practice.'

However health minister Mike O'Brien claimed patient safety was the top priority.

He said: ‘We want to make sure that patients and taxpayers are getting the best medicines at the best price.'

‘Where clinically appropriate, it is only sensible to allow more expensive branded products to be substituted with the same generic medicines which are just as effective as the branded version.'

‘Introducing generic medicine substitution will deliver value for money and savings to the NHS which will go directly back into health services, ultimately benefiting patients and improving the care they receive.'

The 12 week consultation will close on 30 March 2010.

Pharmacies are to be handed the power to switch patient prescriptions from branded to generic drugs - even when branded drugs are indicated by a GP Pharmacies are to be handed the power to switch patient prescriptions from branded to generic drugs - even when branded drugs are indicated by a GP

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