Hi guys and gals in Britain ........ just thought I'd throw into the sunday evening melting pot the fact ...... as reported by Anticoagulation UK ......... that Basildon and Brentwood Clinical Commissioning Group (CCG) have told GP's that they are no longer permitted to prescribe the self-testing strips for the Coaguchek XS INR self monitoring system.
This goes against NICE Guidance DG14 and updated in 2017.
Has anyone else had this experience in other parts of Britain ?
Needless to say I'll be watching my local GP practice like a hawk from now on.
I haven't read the guidelines recently but originally it stated that patients should be supported in self testing. Nothing about paying for the strips. Funnily enough I was chatting to my local vampire last week and asked about this at my med centre, She said that they supplied one a week only.
I must say Bob, that when I was living up in Surrey, and now down here in Cornwall, my GP always prescribed them. My prescription is a packet of 24 which lasts me a full year maybe a bit longer. One year I had to test more frequently to use the test strips before the 'Use by' date invalidated those I had left. It helps me that I am so INR stable
I got this from the Anticoagulation UK journal and they are going to take the Basildon issue on board.
Yes, self-testing posters are up on all walls of my AC clinic! The nurses push self-testing for their patients, yet, we are being refused the strips on prescription when in clearly states in Section IX of the Drug Tariff, that the INR strips are on a prescription basis! This is just not fair. The cost of the machine is one big expense, ut, after it is paid for, it is ours for life. Thes strips, however, are an expendable item, and they are very costly....more so if you are testing each week or so.
Yeah I can understand not funding the machines ..... but I wouldn't have thought strips were a problem, given some of the rubbish NHS do fund.
I guess that's true enough. Interesting though, comparing a very wealthy county like Surrey with a relatively poor county like Cornwall. Yet both prescribe the test strips.
I'd probably get away with that personally. But methinks that would only work for those who are INR stable, those who have other issues may find that a problem.
yes, the clinic nurse told me that one patient had had a fall and her INR was all over the place and she used up all her strips in a short space of time
I buy my own strips but I really don't mind. The practise has an clinic about three days a week and if a patient is worried about their INR they can just drop in for testing so long as they don't mind a short wait. The practise say they are maintaining a clinic which they are, and it is a good one too. Self-testing suits me most of the time.
It's a crazy way of saving money. Would they prefer patients were on DOACs at a cost of hundreds of pounds p.a. or self testing for about £150?
Hi goldie,
I have done a bit more research on this and have come up with an explanation ........ "Is this item allowed?
", an extract from PSNC website.
QUICK LINKS
Factsheet: Is this item allowed?
Online Drug Tariff
Medicinal Products
Appliances
On receiving a prescription, pharmacy staff must check whether or not an item is allowed to be prescribed on the NHS prior to dispensing. A number of factors can affect the answer, the most important of which is: “Is this item a medicinal product or a medical device (also known as appliances)?“
The easiest way to tell the difference between medicinal products and medical devices is to look for a CE mark mark which signifies that the item is a medical device. The CE mark can normally be found on the packaging of a device, on the instruction leaflet and on the device itself (where practical).
In summary:
A medicinal product is allowed as long as it’s not in the blacklist (Part XVIIIA of the Drug Tariff).
An appliance is allowed as long as it appears in Part IX of the Drug Tariff."
Now, the rub here is that Test Strips packaging are marked CE, as is the device itself ! I tried to have a look through the Drug Tariff but couldn't see anything - mind you I wasn't prepared to devote the rest of my life to the exercise :-). Equally, I had a look at prohibited items too, no luck there.
So from this it seems that if a CCG wants to play fast and loose with definitions then they maybe within their rights to make Test Strips a non prescription item. What a pity NICE don't comment on this when they advocate patient self testing.
So if my CCG goes down this track I will challenge them to show me what is in Part IX of the Drug Tariff - if it is in the said Tariff then they must let me have it on prescription.
Thank you for posting. I am having one heck of a time with my GP and CCG about getting strips on prescription. Both refuse to budge! However, I personally know of one individual, by name, who is being prescribed the strips, and has been for some time, in my Trust. I got an eail last week from CCG saying that "if someone in the Trust is receiving the strips from their surgery, we cannot comment on this as we don't know who the individual is." I am soooo frustrated with fighting for the strips that one part of me is very tempted to divulge the name of the individual and his surgery just to make the point that what is happening is grossly unfair. Not only are some Trusts around the country able to to prescribe the strips, but, now, I've got a case where my Trust will NOT prescribe, yet there is at least one individual known to me who is getting these on prescription. There may well be many more getting them at different Surgeries within my Trust area..... What to do????
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