Hi all. I take Seretide and get my inhalers from Boots. This month they have switched from Glaxo Smith Kline branded Seretide to a different brand called Aloflute/Mylan. Some formula though.
Do you think there's a difference or is it just a brand name? I'm sure it is cheaper for them.
I have Seretide too. At the moment I’m still getting the brand name one. A while ago I got a generic version of Ventolin which I assumed would be the same but I didn’t get on well with it. As far as I understand it, the drug is the same but all the other stuff that goes into an inhaler can be different in a generic one.
It's all about money. 3 of my medications have changed from the original brand I was first given.
Hello, it is cheaper, and there is a difference; I think its the propellant from memory. Both myself and son were changed a few years ago, and swiftly put back ‘on brand’. It made my son more breathless, and me wheezy. My seretide now comes with a English ingredient sticker over Italian writing, & a stamp of €77 each!
I was changed from Seretide to Airflusal. I reacted immediately with sore throat, hoarseness, sinus problems etc although the drugs are the same. Changed back to Seretide and everything went back to normal.
I was changed from Seretide to Airflusal. Yesterday I received a letter that I am being changed to another one as they are having problems getting Airflusal. I also had Asacol changed - not sure if it is as effective as I now have to have bowel inestugation! Not sure If the genetics are as good.
For me personal Seretide is the better brand. Its more expensive for pharmacies that is why they try to give the cheaper version.
Last time I was given the generic version my asthma wasn't controlled, therefore I only use Seretide now. Make sure that your Dr writes Seretide on your prescription and not the generic name, so then they have to give you Seretide 
(I’m a healthcare professional as well as having asthma myself.)
The way to tell if a generic is the same as a branded product is to look for the PL number, highlighted by MoneySavingExpert in an expose about cold/flu medicines but applicable to all drugs. I don’t seem to be able to paste the link here but if you Google “PL number medicines” you can read more about it
Some generics will feature different (cheaper) ingredients that are not considered “active”, eg the propellants, as others have said. They are TECHNICALLY the same medicine as the “active ingredient” is the same, but they can be produced and sold cheaper as the other ingredients cost less.
This means the NHS pays less money for them - and pharmacists have an obligation to provide the cheapest medicine to you which meets the requirements of the prescription. So, if you’re prescribed “Fluticasone/salmeterol inhaler”, you can legitimately be given a generic inhaler, or Seretide - whatever the cheapest thing the pharmacist has in stock is.
In fact, doctors are actively encouraged to prescribe the drug name, NOT the brand name - partly so that the NHS can save money, but also because if your pharmacy has run out of Seretide, but your script is for the drug itself, you can be given the generic, meaning you don’t find yourself without medicine.
Both of these reasons are actually really good reasons, and we all know how important it is to save the NHS money… however, if you have concerns about a generic that you’ve been given, eg getting side-effects that you don’t get from the brand name one - you are perfectly entitled to ask your GP to prescribe you the brand name instead.
Hope that helps
it's interesting you say that katie, as I've never found the generic versions of Ventolin and Seretide as effective as the branded GSK/Allen&Hanburys (in the old days...!) versions even though they contain the same active ingredient. I don't think it's a psychological thing either. Perhaps the quality of the medication provided in the non-generic version is a bit better and that's why these providers charge the NHS more?
I think you may have misunderstood me… I haven’t actually said that generics are as good as branded versions, merely explained the difference between them… and explained how using generics CAN be a good thing, as long as they are effective…
As I said, generics and branded are ONLY the same medicine if they have the same PL number. I don’t know whether generics do have the same PL number as the brand name Seretide!
Regarding the “active ingredient” part… whilst the companies producing generic medicines must include the “active ingredient”, if the OTHER ingredients they use (such as propellants, ie the bit that gets the drug from the inhaler into your lungs) are not as good than the ingredients in the branded version, then they MAY be less effective… and considering that the generics are using cheaper propellants, it is very plausible that for them to not be as effective…
However, it is very much down to individuals… personally, when I was on a generic beclometasone made by Teva, I DIDN’T notice a difference… but at that point, I was in my early 20s, yet managing my asthma with a paediatric dose and virtually never using salbutamol… my asthma was not as difficult as it is now… so there are many factors to consider… I may possibly notice the difference if I were put on a generic version of Fostair tomorrow!
Thanks for that reply. What I take issue with regarding cost is this it may be in the interest of the NHS to save money by prescribing generic inhalers but it isn't necessarily in the patient's interest. A few years ago I was switched onto Salamol. I woke up one night feeling breathless and took it and it didn't work as well and it was only because I found an old Ventolin inhaler which did work that I managed to stabilise my breathing. The GP and the pharmacist based at the surgery swore blind it was the same stuff and it took a battle to get it switched back to the point where my consultant had to get involved. It now means when I do get breathless I now take Ventolin and it keeps me out of hospital (which also saves the NHS money).
I really wish that the patient is consulted before switches like this are made because in my experience (and that's all I can speak from) the chemist gives you the generic inhaler on the prescription, they can't change it because only the GP can change it and whether the GP agrees to change it can take a lot of time and persuasion (and I've had GPs in the past who have refused to change things). Meanwhile the patient just wants to take the medication that they know helps them to control their asthma because the NHS has too much focus on front-line cost and not on the totality of someone's asthma care.
Okay, so, hypothetical situation: a generic inhaler might cost the NHS £5, and a branded inhaler might cost £15.
If you have 20 patients like me, who find that Salamol is no less effective than Ventolin… and they go through 3 of those inhalers each, per year… by prescribing them “salbutamol” instead of “Ventolin”, enabling the pharmacist to give Salamol, you can save £600… which could go towards emergency nebs for A&E, or antibiotics for someone with a chest infection… or anything else, not even asthma-related.
The thing is… ALL medication is trial-and-error. The only way to find out what does/doesn’t work is to try it.
I ended up on Fostair because Qvar wasn’t working for me anymore… over the course of a year and a lot of experimentation, my asthma nurse and GP and myself had to test out different dosages, different regimes, until we found something that worked. I did end up in A&E on a nebuliser a few times. Because that’s how figuring out what meds work goes… sometimes you get lucky and the first thing you try works. Sometimes you don’t.
Prescribing by the drug name, to enable pharmacies to give people the cheapest option, so that they can save the NHS money… that’s fine.
If the pharmacist were to alert the patient “this drug might not work as well because it’s like a Tesco Value version” is highly likely to trigger the norcebo effect (the opposite of placebo) and result in it not working as well. It’s better to just not say anything, and if the patient’s asthma management gets worse (which they should notice through monitoring, hopefully before they reach crisis point - peak flow, use of salbutamol, how many salbutamol puffs are needed…) then they can go back to their doctor for help. They take the inhalers with them, the doctor then sees that they’ve been given a generic and can change the prescription to specify the brand name…
Or, imagine the Salamol vs Ventolin situation came up. Say you’ve noticed the name on your inhaler has changed… you could just say to your pharmacist “this Salamol isn’t working as well as the Ventolin you used to give me, can I go back to that?” — and because the prescription is for the drug name, ie salbutamol … they could still give you Ventolin, without the doctor changing the prescription, if they have it available…
(This is a perk to using independent pharmacies as well… my pharmacist owns the business, so he doesn’t have as many bureaucratic loops to jump through… if I went to Lloydspharmacy or Boots or whatever, they might say “the rules say no”… my pharmacist would likely say “let’s have a look at your peak flow readings, oh, okay, yep, I see you’re right, you can have the branded one…”)
At the end of the day the NHS is required to provide *efficient* care… a combination of cost-effective and quality… they HAVE to save money… because the alternative is the insurance model and co-pays… and then, there won’t be people like me taking home the cheap generic to subsidise the cost of the more expensive Ventolin… you’ll have to find the extra money for it yourself…
I’d rather see the NHS survive, and if its survival means that my prescriptions are written so that I can be given the cheapest inhaler, to see whether or not it works for me… I’m okay with that.
Hi All
I totally agree that the nhs need to try and save money wherever is sensible... that said I have a couple of problems when it comes to inhalers.
Firstly I just don’t like the way it is not explained to you face to face in a proper manner as to why they feel the need to change an inhaler. Picking up your meds from the pharmacist and getting home with a different one without explanation is not good patient care.
Secondly I am at a loss to understand why these ‘expensive’ inhalers are still being prescribed to asthmatics only then to be taken away again. There is no continuity of care with inhalers... it’s pot luck if you have a generous GP or not. This lack of standardisation is the biggest problem that the nhs face with the costs of asthma inhalers.
All take care!!!😜
Pipsqueak
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