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Gold, incentives and meh

Pharmacists' hypocrisy over Internet drug sales

For as long as pharmacists continue to coin it in for every drug they dispense, punters will find what they want on the Net.

For as long as pharmacists continue to coin it in for every drug they dispense, punters will find what they want on the Net.

My local pharmacist has adorned his window with a home made A4 poster, "Don't buy drugs off the internet". Pharmacists' spokesmen want patients to be aware of the dangers of shopping for meds online.

They'd have you believe that every product supplied is counterfeit, cut with toilet cleaner and a danger to health. One in four GPs (that's us) reckons we've treated a patient who has suffered a side effect from a drug bought online without a prescription. Not bad odds considering four out of four of us have treated patients suffering side effects of drugs we've actually prescribed ourselves.

OK, I'm no more going to advise a patient to buy his "Propecia" or "Prozac" online than I'm going to suggest he buys the brake pads for his car from a back-street set-up in Mumbai. "Original parts for your Nissan or Toyata" – no thanks.

But, and this is the Real World thing, have you noticed that every bloke to whom you prescribe a drug for erectile dysfunction who doesn't suffer from a qualifying condition for NHS supply never seems to get his repeat prescription filled? Have you ever bothered to ask why?

I have. A private prescription from me for a box of eight 100mg Viagra tablets will probably set my patient back the thick end of £70. A third of that is the pharmacist's "dispensing fee". Even if he snaps the tablets in half to save a few quid (oh, take that ‘holier than thou' look off your face, they all do it) then that's working out at about £5 per dose.

Now fire up your web browser and Google any of the generic names for P5 inhibitors – within seconds you'll find links to Indian and Chinese manufacturers who knock out unlicensed generic product. These aren't shifty blokes with buckets of powdered chalk and a printing press in a lock-up, they are the same firms that manufacture the beta-blockers, antibiotics and anti-inflammatories that pharmacists hand out quite happily in exchange for an FP10.

For around the same price as eight "kosher" Viagra tablets patients can get their hands on a hundred generic 100mg sildenafil tablets. Hell, they can even choose between pineapple, orange, strawberry, banana, vanilla, blackcurrant and butterscotch flavoured sildenafil jellies if they prefer, one for every day of the week.

The way they (that's your patients and mine) see it is that they don't understand why the NHS won't supply the drug with a standard prescription charge, no-one's going to bother counterfeiting a white label generic product and even if some of the tablets in the batch aren't up to scratch, at a tenth of the price the odds are still way in their favour.

While pharmacists have such a vested interest (£23 to take a packet down off a shelf and stick a label on) no wonder it's hard to take their "patients' best interests" spiel seriously.

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