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My fears over medicines quality

From Professor Chris Manning,

chief executive, Primary Care Mental Health and Education (PRIMHE)

I am very concerned about how the quality of medicines in this country is guaranteed. This arises in relation to:

• Counterfeiting of even branded mass-prescribed drugs.

• Switching from branded (and presumably usually more guaranteed quality) to generically (mass-prescribed) drugs as GPs are being encouraged to do (News,

18 January).

• Parallel importing and generic substitution generally; are drugs randomly tested?

• Is a spectrometer test of a drug sufficient to demonstrate, or is it equivalent to, bioavailability? I gather some asthma inhalers are now being recommended to be prescribed by brand again?

• Quality of complementary medicines, some of which have active ingredients.

• Self-prescribing over the internet, especially in relation to medications that people may not want to see a doctor about (antidepressants, for example) and those that are not available here or approved by NICE (Alzheimer's drugs, for example).

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