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Drugs company offers to reimburse GP practices for the cost of switching pregabalin prescriptions

Exclusive Drugs company Pfizer has offered to refund practices for the cost of switching prescriptions of pregabalin over to the brand name as part of an ongoing legal action over the patent of the drug, Pulse can reveal.

In a letter to NHS chiefs, the company said it would pay ‘reasonable and proportionate’ costs to practices, so the switchover can ‘be progressed quickly’.

It said it would do this by paying health administrations across the four countries of the UK, who will themselves reimburse practices. The drugs company said it would reclaim the costs from producers of generic pregabalin.

The details have emerged following a High Court hearing of Pfizer’s dispute with generics companies over infringement of its patent on neuropathic pain.

An interim judgment in the dispute, handed down in March, ordered NHS England and its equivalents in the devolved nations to issue guidance to GPs, advising them they must prescribe pregabalin by the brand name Lyrica when prescribing it for neuropathic pain, switching repeat prescriptions over ‘as soon as reasonably possible’.

GPs had criticised the original ruling, which they say undermines their clinical judgement and is unfairly passing unfunded work to practices. However, the GPC advised them to comply with the guidance, in order to avoid litigation and disruption from pharmacists checking or requesting re-issues of generic prescriptions.

Pulse revealed earlier in the year that one CCG had already billed NHS England for amending the prescriptions on behalf of GPs.

In the 16 July letter, seen by Pulse, the company said it would now be willing to reimburse practices for the administrative costs involved in switching prescriptions, after it had received a ‘small number’ of requests to do so from GP surgeries and one CCG, and learning of similar requests made to NHS England and CCGs.

The letter to the DH and the Scottish Government stated: ‘Pfizer wishes to confirm that it will pay the reasonable and proportionate costs associated with these efforts as soon as possible to you (or whomever you suggest is the appropriate recipient of the funds for onward payment to the GP surgeries) so that the guidance implementation can be progressed quickly.’

It added that ‘in the interests of trying to recompense GP practices as soon as possible and to minimise the ongoing infringement by the generic companies we are content to make the upfront payment now and to follow through on the repayment of the costs from the generic companies to Pfizer later’.

In the letter, Pfizer asked NHS England to provide its ‘views on the appropriate and reasonable cost per patient or per surgery and how you would propose this cost reimbursement to GP practices is communicated and paid’.

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

Dr Steven Haigh, a GP in Lothian who raised concerns with GPC Scotland over the court order, said it ‘could take some time for GPs to act on the guidance within the context of their unsustainable workloads’ and that he was ‘very supportive of the case for reimbursement of GP practices for the cost of making the switch’.

However, Pfizer argued in court last month that the guidance has since had only ‘a limited effect’, claiming only around 30% of prescriptions were being made by brand when at least 70% of pregabalin is prescribed for neuropathic pain.


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