Is Fostair 100/6 blacklisted? - Asthma UK communi...

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Is Fostair 100/6 blacklisted?

spike5000 profile image

I was recently prescribed Fostair 100/6 by the hospital respiratory clinic. I was told to get the repeat prescription from my GP, but they say it is blacklisted and they cannot prescribe it. They are going to contact the clinic to discuss it. It all seems a bit odd to me, has anyone else experience this?

44 Replies

Thats rubbish fostair in various forms has had loads of hype from the manufacturer and the reps pushing it.... loads of people have been switched from other inhalers to fostair

I'm also on fostair but the nexthaler 200 (powder one) it's definitely not blacklisted and it was my gp who prescribed it

spike5000 profile image
spike5000 in reply to Chip_y2kuk

Thanks for your reply. It did seem really odd to me that my GP thinks she can't prescribe it. I'm hoping she has got wrong and will sort it out soon. Thankyou.

I'm on the same, Nexthaler 200 powder, collected repeat prescription yesterday and all good. How strange. Intruiged to hear what happens with your GP spike5000

Thankyou, I'll post an update when it is resolved.

There can be issues if a medication isn't on your local CCG's list of things permitted to be prescribed by GPs for particular conditions. Google 'joint formulary' and the name of your local trust. This doesn't mean that it is 'blacklisted' or that it cannot be prescribed, but it can mean that the GP has to override CCG guidance and justify the decision which takes time, effort and inclination to do so on their part. Also there are particular rules about when GPs are allowed to take on prescribing for certain meds. I believe that there are national rules but they can vary slightly at a local level also.

Could it be something like this? GPs do get this wrong sometimes as well if it is a drug they are not very familiar with!

Hopefully the respiratory clinic can clear up any misinterpretation or misunderstanding...

spike5000 profile image
spike5000 in reply to helenac77

Oh right, that is interesting. I didn't realise there can be a difference regionally, that would probably explain things. Thankyou for your reply.

I'm on fostair I get mine every month from my GP they have not said it was black list or taken me of the fostair and when I was in hospital last year they made sure I was using mine, seems weird why your GP would come out with that

Thankyou, yes it is weird isn't it. Hopefully it will be sorted soon.

A GP can refuse to accept the responsibility of prescribing a consultant recommended medicine where it's a specialist area and treatment, such as cancer therapy or biologics. But Fostair doesn't fall into that category, in that it doesn't require initial consultant approval and the GP is refusing to accept responsibility for prescribing in a field where they have limited experience.

Fostair is also detailed on prescribing charts for the treatment of asthma - you may have noticed these pictorial charts in the room used by your asthma nurse. In fact it was my asthma nurse who recommended Fostair for me.

You could ask whether your GP has received prescription advice from your consultant and what their response was in light of their refusal to prescribe Fostair. What they can't do is ignore the consultant, at the very least they have to tell the consultant that they refuse to prescribe Fostair. Then telephone your consultant.

I hope you get this resolved!

spike5000 profile image
spike5000 in reply to Poobah

Thankyou for your reply. It wasn't that the GP didn't want to issue the Fostair, she was actively trying to do so but 'computer said no'. She has been chasing up the respiratory clinic to find a way to resolve the issue. Thankyou.

Poobah profile image
Poobah in reply to spike5000

That's promising that your GP is being pro active. But I'm baffled by Fostair being blocked by the prescribing programme - looking at the cost against other combos in the 100/6 range, it's not stand out expensive.

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spike5000 profile image
spike5000 in reply to Poobah

It is odd, although someone replied below to suggest that it could be an interaction with one of my other mediations that prevents the doctor prescribing.

Poobah profile image
Poobah in reply to spike5000

That could be it, some sort of block while you're on another medication. But I would expect a warning message to appear for the GP so that they're made aware as to why there's a problem in prescribing a new med. The mysteries of computer programmes and their inconsistencies!

spike5000 profile image
spike5000 in reply to Poobah

Computers are a law unto themselves.

runcyclexcski profile image
runcyclexcski in reply to Poobah

Poobah -- that's a neat chart; may I ask for the link to the original?

Poobah profile image
Poobah in reply to runcyclexcski

It's a pdf download, so you can find it if you Google "cost chart respiratory medications".

runcyclexcski profile image
runcyclexcski in reply to Poobah

Got it! here it is gmmmg.nhs.uk/docs/cost_comp...

dsddsd profile image
dsddsd in reply to Poobah

Are they the prices for one item/ pack? If so, its another reason to be extremely thankful for the NHS.

Poobah profile image
Poobah in reply to dsddsd

I believe it's for a year's supply, but it depends on how many doses a patient is prescribed. I get through a Fostair Nexthaler in a 30 days, and they are £30, equates to £365 annually. As you say, we're lucky we don't pay the full cost, bearing in mind that these are UK prices. In the States inhalers can range from $250 to $350 each. Here's a link to a handy average cost list per inhaler: dontwasteabreath.com/view/i...

Just be aware that if you are on other medication of certain types you may not be able to take fostair. I have had similar problems but not because it is blacklisted but because system came up with warnings against taking it

spike5000 profile image
spike5000 in reply to Flower00

That might explain it! I'm on a few other medications so maybe they interact with each other. Thankyou for your reply.

Poobah profile image
Poobah in reply to spike5000

The patient leaflet lists a range of potential contradictions: medicines.org.uk/emc/medici...

spike5000 profile image
spike5000 in reply to Poobah

It does list one of my existing medications, although the consultant knew about that when she initally prescribed it. Hopefully it will be resolved today.

Poobah profile image
Poobah in reply to spike5000

🤞

I’m on fostair 100/6 on a repeat. Unless you are on another medication that they’re worried about it seems like it must be an error.

spike5000 profile image
spike5000 in reply to Birch_

Yes I think that must be it. Thankyou.

Also, drugs.com will let you put up to 5 meds in and check for interactions so if you’re on a lot of meds I’d recommend doing it occasionally to double check that everything is ok.

spike5000 profile image
spike5000 in reply to Birch_

I didn't know that. Thankyou, I'll check it out.

Hi I get the prescription on repeat from GP.

Hope this helps

Jan

spike5000 profile image
spike5000 in reply to Jwalsh16

Thankyou. Hopefully I'll be getting it sorted today.

If it is an interaction thing the system will flag a warning but it can be overridden easily. An interaction doesn’t always mean it can’t be prescribed as there are varying levels of interaction for a variety of reasons. An example of a type of an interaction where one of the drugs may need to be prescribed in a higher dose due to the other being so highly protein bound. An example of this would be smokers needing higher doses of some anti epileptics.

Are you on beta blockers? They are one that the system would really throw a pansy about if there is a beta agonist prescribed (LABA/salbutamol)

spike5000 profile image
spike5000 in reply to Dogruff

Oh okay. No I'm not on beta blockers. I take co-codamol and amitriptyline for pain and low dose sertaline. It seems there may be an interaction with the sertraline. Thankyou.

Dogruff profile image
Dogruff in reply to spike5000

Nah, . Lowered potassium can be an issue with the amitriptylline and sertraline but not something that would prevent prescribing. Ultimately nothing that can’t be corrected witn a banana a day.

Definitely not an interaction thing.

spike5000 profile image
spike5000 in reply to Dogruff

Hmm, the plot thickens. Thankyou for your reply.

Dogruff profile image
Dogruff in reply to spike5000

No problem. There was a memo sent to all prescribers in Feb ‘20 saying to switch people from Fostair to seretide as seretide is cheaper. It wasn’t mandatory though and the system wouldn’t block it being prescribed.

I’m wondering if it is more the individual GP who is having issues with the system. In the past I had a medication changed because the system wouldn’t allow it. The replacement done sweet FA. Saw another GP, and there was a work around to prescribe it.

There are a lot of healthcare settings changing their records providers at present so I’m putting money on a user knowledge gap.

spike5000 profile image
spike5000 in reply to Dogruff

That is quite possibly the case as she was perfectly willing to let me have it. It was a case of 'computer says no'. The surgery is contacting the respiratory clinic to find out if there is a way around the system. Thankyou.

Hi, I have been on Fostair for quite some time now and have it prescribed on a monthly basis, so not sure why your GP uses the term 'blacklisted'? 🤔

spike5000 profile image
spike5000 in reply to Calboba

It does seem that I’m the only one having this issue. Hopefully they will get it sorted out. Thankyou.

Thanks to everyone who replied. I never did get to the route of the issue but I have got a repeat prescription for the fostair inhaler now sorted out.

Poobah profile image
Poobah in reply to spike5000

Excellent!

I hope that's just a blip. Fostair worked wonders for me. I've described it at facebook.com/aspirin2relief Basically, I was getting nightmare scenario of chest cold going quickly to pneumonia-like condition but haven't had that happen once since put onto Fostair in 2018, and I just take one puff per day mostly, in the evening.

Did have a bumpy start though, perhaps body getting used to it - airway closed and 'stuck' together once on a breezy cold day. Started with a non-stoppable coughing fit, airway then closed and I could not breathe. Twisting body got it open again .... Googled and found other people had the experience but not mentioning Fostair...

ck101 profile image
ck101 in reply to gerrytlloyd

GerryT, I’ve a similar experience with Symbicort and chest infections / pneumonia. Also just kicked off with Fostair today. I had a quick look at your Facebook page. What’s the story with the Asprin / Disprin, you reckon it can help with Asthma and morning wheeze? Any idea of the mechanism here?

gerrytlloyd profile image
gerrytlloyd in reply to ck101

It's useful here and there, like if you feel slightly wheezy but not wanting to dose yourself. I simply pop the dispersible type pill onto my tongue and let it break up slowly. In some situations you definitely feel a benefit, because it's an almost-natural anti-inflammatory. People who like to operate with minimal use of meds would like it.

I picked up Fostair 100/6 today in a chemist in Northern Ireland. I’m from the south and we don’t have it for some bizarre reason. Took a blast at 2.30 and so far so good! Please let this be the one 🤞

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