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GPC tells GPs not to accept pregabalin costs from drugs company ‘out of principle’



Exclusive GPs should refuse payments from Pfizer for the cost of switching from a generic version of pregabalin to a branded version made by the drug maker, the GPC has said.

Pfizer has offered to refund practices for the costs involved in GPs having to switch their patients onto its branded ‘Lyrica’ drug when they are taking pregabalin to alleviate neuropathic pain following a High Court ruling in March.

However, the GPC has told Pulse that practices should not accept any payments, even if they come via the NHS or another independent body.

This is the latest in the saga, which has come about over a patent dispute involving Pfizer and generic manufacturers of pregabalin.

Pfizer claims that it owns the patent for pregabalin used for neuropathic pain, although a generic version can still be supplied to treat epilepsy and generalised anxiety disorder, which are not covered by Pfizer’s patent.

GPs have expressed outrage at the decision, warning it undermines the principle of prescribing drugs based on medical need, not for commercial reasons, and means the NHS is passing on unfunded work to practices to review and change repeat prescriptions of pregabalin.

Pfizer said in a statement that it did not wish GP practices to be ‘out of pocket’ because they prescribe Lyrica for pain relief and that it was ‘committed to doing the right thing for patients and the NHS’.

It said: ‘Pfizer is in discussion with NHS England and the Department of Health (and other interested parties) regarding the request for reimbursement from some GPs and CCGs to determine whether it is possible for Pfizer to do this and, if so, what the appropriate mechanism would be. The reimbursement for work already done that has been requested by GPs or CCGs.’

Seema Patel, medical director of established pharma at Pfizer UK, told Pulse the company is also working with the industry regulator, the Prescription Medicines Code of Practice Authority, ‘to make sure we can clear a path, so that if we make these payments it is not considered an inducement’.

However, Dr Andrew Green, chair of the GPC’s clinical and prescribing subcommittee, told Pulse: ‘This is not about remuneration, it is the principle of accepting money from a company for changing prescribing in a way which will do nothing to improve the health of their patients but everything to improve their company’s profits.

‘I would not advise accepting it no matter through what route is channelled.’

Dr Green added: ‘Given that we have serious reservations about the action that Pfizer is taking, the tone of its contact with practices and pharmacists and the significant costs they will be inflicting on the wider NHS, I would regard it as unwise to have anything to do with accepting money for this work from them.’

The directive for GPs to switch prescriptions from pregabalin to Lyrica has led to pharmacists reporting significant events where generic prescriptions were issued, while Pulse revealed that one CCG had billed NHS England for administering the prescription changes on behalf of its practices.

Pfizer has since offered an apology for causing GPs and pharmacists concern over the prescription changes, although at the recent full High Court hearing on the patent infringement, it also called for more stringent measures to stop GPs prescribing generic pregabalin.

Experts have warned that similar legal judgments in the future could further restrict GPs freedom to prescribe generic drugs.

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