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My wife received a letter today from our doctors surgery, to inform her that the statin tablets she has to take forever, are to be changed for a cheaper alternative, but which will be just as effective. Is this more austerity measures?

Paul

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Seems to happen all the time - my father in law's meds were changed for the same reason!


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In this area the PCT pharmacists visited each practice and went through the repeat prescriptions. if there was a cheaper alternative (of the same medication) the GPs were asked (or instructed) to change to the cheaper one. In one particular case a patient had been prescribed a dispersible (and more expensive) variety of medication as he had difficulty in swallowing and this was queried by the pharmacists. When I explained WHY the more expensive meds had been prescribed, there was no problem.

 

Of course, it is cost cutting, but if a GP can make a case for a particular variety of mediation, in my experience it's usually OK.

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Isn't this what we should expect from our health service and every public body? We hear stories of the NHS issuing prescriptions for gluten free food amounting to over 40 pound cost to the taxpayer, when an individual could buy it in a store for just a few quid. Millions of pounds are wasted in this way. If we all ran our family budgets the way the dunderheads in the NHS do, we'd be living in cardboard boxes under Waterloo Bridge.

 

The crux of this is whether the cheaper, replacement drug is as effective and has no increased side effect risks. I would be doing my own research on this, not just believing what I'm told by a doctor. GPs work for themselves. Cynically I would be wondering whether they were pushing this replacement for their own self-gain. Are the PCTs (or whatever has replaced them) offering bonus payments or penalising GPs if they do not convert a percentage of patients over to the cheaper alternative? This has happened in the past (and maybe still does) where GPs received payments NOT to refer a patient to hospital. Hospitals were postively encouraged to discharge patients when they were not fully well and received extra payments when (surprise, surprise) the patient was re-admitted.

 

The NHS is, I believe, currently being sued by the makers of a drug licensed for macular degeneration because the NHS was using a far cheaper alternative which is not licensed to treat this disease, but has shown to be just as effective. NHS drug budgets are limited. This switch could mean that far more people could benefit from treatment.

 

The only thing I would ask of the scientists, health-care professionals, organisations such as NICE etc, is that they are open and transparent about about any issues. Cost-cutting is fine, but it should never trump patient welfare.

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Certainly agree with most of your points but feel that the gluten free food example is not perhaps the best one do use. Most of us take foods for granted but a Coeliac can't just eat a sandwich or biscuit and is forced to buy eat are in many cases very expensive gluten free alternatives. At around £2.50 for a small loaf or £1.50 for around 10 plain biscuits although the majority do not ask for presciptions, there are a large number of people who simply can't afford not to have that cost subsidised (I think only bread is available on prescription anyway). You could equally make the same argument against IVF on the NHS.

 

As with prescription drugs the main problem is the high cost of the product every bit as much as whether there is a need to prescribe them.


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I'm not saying that we should not treat coeliacs (or IVF) on the NHS, but that the NHS financiers/procurers have to be more canny with our money. Historically, like most public organisations, where they do not have to generate their own funds, there is an easy-come, easy-go attitude.

 

The cost (to the taxpayer) of a prescription to those that pay is so much more than 7.65 when you take into account the generating and processing costs. So issuing a prescription for say paracetamol which can be bought cheap as chips own-branded in Lloyds or Tesco is not intelligent.

 

I do want the NHS to be discerning in what they buy, whether it be drugs or lightbulbs or surgical gloves for in-house use, to make sure they are getting the very best deal. It is thought that the NHS could save 500 million pound a year by being savvy in this area.

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