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A pound a puff? Not good enough

Our GP blogger, Dr Peter Weaving, takes a sharp intake of breath at one patient's meds

Like all good consortia docs I'm reviewing my Quarter One financial report – a reasonable predictor of how the year is going financially. I'm pleased to see activity is falling in a most satisfactory manner; I would be happier if expenditure were behaving commensurately but more of that another time. Today it's my drug costs I want to look at. In spite of years of putting out the same message we're still spending a fortune on expensivostatin and combination inhalers.

Yesterday I welcomed a new patient to the practice by going through his repeat meds with a pharmacological axe. His professor of urology was trying to shrink his prostate with costly-x which I switched to cheapo-y from the same family. Even if it is not quite as new is it 100% less effective which is what the price differential would have me believe?

I endorsed an e-mail our practice pharmacist had sent round about my docs prescribing a variety of drugs to treat shingles – cheapo-antipox vs, expensivo-antipox coming in at a cool £11 a course and a not so cool £150 a course respectively. I despair – don't GPs understand the power of the pen they wield? The size of the cheques they write with each prescription, referral or admission?

I know I sound like a bureaucratic, cost-cutting administrator but in a world where even Pulse columnists Copperfield and K-hole would cringe at the thought of inhalers costing a pound a puff the message is simple. If we want to be able to provide our patients with expensive treatments when they do need them, then don't blow the money on expensive treatments when they don't and for which there are perfectly good cost-effective alternatives.

Dr Peter Weaving is a GP and commissioning locality lead in Cumbria