Prescription Pricing 2010

I was reading on another forum that from the beginning of next year, pharmacists will be expected to substitute brand named prescriptions for generic equivalents without consulting with doctors or patients in an effort to cut costs.

Obviously in many cases, generic and branded are the same, but there can be differences and this can have implications. Does anyone know much about this and how it will apply to/impact on people with asthma?

For instance, will we automatically be changed from Ventolin inhalers to those horrid little blue ones (I use this as an example because it's one where I feel there is a difference and that the little ones don't give me the relief the Ventolin inhalers do)?

I could have got this completely wrong BTW and would be happy to be corrected!! :)

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  • hey i'm not sure about other meds, but I was told by one of the doctors in hospital once that if you are started on a particular brand of Aminophylline or Theophylline you have to stay on that brand unless your doctor feels it needs changing to an alternative as different brands of these drugs can have different absorptions rates or something like that I've completely forgot oops. For example if you are on Uniphyllin you can't be given Nuelin instead the next time you get your meds apparently. But I guess if they standardised all Theophylline and Aminophylline variants into generics maybe it wouldnt be an issue????

    confuzzled simi x

  • Theophylline based tablets should never be substituted for other brands as they all absorb at different rates. I know from bitter experience when this has been done in hospitals when away from home - results in either too low a level or vomiting!

    I am happy for most other brands of tablets to be generic, though I am having second thoughts about my decision to go for plain pred instead of enteric coated pred as had problems with the generic coated ones when we couldn't get the pfizer brand. ( Un coated = ?? curent stomach problems??)

    Inhalers & nebs need to be brand ones because of other aditives in the generics for me. My chemists are usually very good, and realised their mistake the other day with the nebs even before I phoned!

    I have not hear of this proposal.

    Kate

    x

  • Some further info about this. I'm quite concerned - either it's not actually happening (which would be good) or it is happening without patients being made aware (doubly bad).

    A research report on Automatic Generic Substitution:

    tinyurl.com/lurv26

    And a fact sheet on the same:

    tinyurl.com/create.php

    From another forum, it appears that the law has already changed and that these new dispensing practises WILL be in place from January:

    ""As some of you may already be aware, from January 2010 new dispensing regulations will be in place throughout the UK. Pharmacists will be expected to change the brand of drug named on a prescription and replace it with a different, generic brand. This is as part of the Department of Health’s 2009 Pharmaceutical Price Regulation Scheme agreement.

    This agreement will make 'generic substitution' legal. This means a pharmacist can (and will) replace more expensive branded versions of drugs for cheaper generic versions. They will not have to consult with either the patient or the doctor who wrote the prescription. The National Health Service estimates this will save £40 million a year.

    Epilepsy Action is concerned about this. Unless epilepsy is excluded from this legislation it could lead to thousands of people with epilepsy having their medication switched, for purely financial reasons. There will be no consideration of how this will affect them, or their epilepsy.""

    I'm sure asthma (or many other conditions) could easily be substituted into the above.

  • Get friendly with your Pharmacist!

    My advice is written above. The more you voice your worries/needs the more likely you are to be dispensed the brands you would prefer. I think GPs have to print generic names, regardless of what the pharmacy dispenses-but I always get branded everything, every time, as I requested this specifically and my Pharmacist is really sweet about understanding my needs.

    Kate-same as you-some generics have additive issues that upset my delicateness,and others simply don't work as well-plain obvious really!

    My experience of once being given 50mg of white (non e/c) pred was a hellish gut ache all night long-in hospital-and I had to have it as it was either that or the evil syrup and I'm a 'no red colouring' intolerant person!

    I hadn't heard about this either-will spread the word at my surgery for clarification!

    Sus

  • I have to say I would be concerned if they attempted to substitute things without consulting the doctor or patient. Most doctors prescribe generic whenever possible and the only things i have prescribed as specific brands are done that way for a reason. For instance I do not get along with Salamol Nebs/Inhalers or any form of generic Ipratropium Nebs so they are branded on my prescription - ie Atrovent/Combivent and Ventolin. Pharmacy are very good at remembering even if different doc has prescribed generics. I have moved through various brands of theophylline and think that any attempts to substitute them would be disastrous as I vary rather drastically on my absorption of different brands. The other one that oddly appears to make a difference is some of the antibiotics. In particular for me I get stomach problems with generic Clarithromycin and Co-Amoxiclav, but I am perfectly fine with Augmentin and Klaricid.... Maybe my body is reflecting my addiction to designer labels on demanding labelled drugs!

    I hope that this does not happen and if it does I shall be moving around pharmacies if mine does not continue to dispense the branded products I require.

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