Co-Proxamol plea again

A HUGE THANK YOU to people who have signed the petition and to any friends or family of people who may feel like they could sign as well, also for comments.

The gent who started the petition has also written a proto type letter to go to MPs should anybody feel they could do that, MPs can be emailed, doesn't have to be pen and paper so it can just be a copy and paste whenever hands are least sore or Dragon dictate type program is working:) actually maybe the help of a Dragon might galvanise some MPS:) It's fairly long but makes sense. The more MPS who read this the more will understand that the suggestion that Co-Proxamol is more dangerous than other drugs is just not true. If other MPS understand too then maybe there's a chance of regaining Co-prox and more safety for other drugs.

HERE is the LETTER for MPS

Co-proxamol, Is This the Final Nail in the Coffin?

Please sign my petition @ change.org/p/rt-hon-jeremy-...

The MHRA admitted in published documentation that there would be “some” patients left without suitable alternate pain management,” and guaranteed that these patients would be protected and their well-being made safe by their “Named Patient Safety Net.” I was placed in this group in 2008 and received a regular supply until November 2015 when I received a call from my surgery telling me they were no longer able to supply me. The only explanation given was “it is a highly toxic and dangerous drug and no longer safe to prescribe.” (This was the reason given by MHRA in 2005)

Following this decision I started to search for a reason, and soon came across an NHS bulletin which was first released in May 2013 and again in July 2015. This PrescQipp bulletin is still regurgitating the same old nonsense originally distributed by the MHRA in 2004. The bulletin was prepared by Melitta Mudaly who holds the position of “Pharmacist Project Manager” I’m unsure if she has had any training in medicines or holds any medical qualifications. It’s quite possible she is just a professional “penny pincher” for the NHS.

Two Quotes from PrescQipp Bulletin 117

(1)

The DROP-List has now been updated and incorporates drugs prescribed across the NHS that are considered low priority and poor value for money and also some of the NICE do not do items, which can be easily measured using prescribing data. It also incorporates drugs which could potentially be provided as self-care, with advice and support from the community pharmacists, and discusses the potential to support medicines optimisation for the drugs listed. The DROP-List acronym now represents Drugs to Review for Optimised Prescribing.

Medicines optimisation is key to achieving the best outcomes for patients. The Royal Pharmaceutical Society good practice guide on medicines optimisation suggests the following principles are key to helping patients get the most out of their medicines. 2 These principles would apply when reviewing drugs in the DROP-List.

Treatments of limited clinical value are not used and medicines no longer required are stopped.

Optimal patient outcomes are obtained from choosing a medicine using best evidence (for example, following NICE guidance, local formularies etc.) and these outcomes are measured.

Medicines wastage is reduced.

The NHS achieves greater value for money invested in medicines.

Patients are more engaged, understand more about their medicines, and are able to make choices, including choices about prevention and healthy living.

It becomes routine practice to signpost patients to further help with their medicines and to local patient support groups.

Incidents of avoidable harm from medicines are reduced.

Summary

(2)

The PrescQIPP DROP-List is an accumulation of drugs that NICE have comprehensively reviewed and produced ‘do not dos’ for or where PrescQIPP CCG members consider them to be low priority, poor value for money and can safely be considered for self-care or where safer alternatives are available.

The top items are highlighted as the PrescQIPP Drop-List and over £336 million is spent each year on these medicines on the NHS.

Prescribers are encouraged to review all patients prescribed these medicines, checking if the drugs are appropriate, safe and if they are providing the NHS with value for money. If prescribing were changed in line with suggested alternatives, this could save over £50 million across the PrescQIPP membership. This equates to £89,390 per 100,000 population.

PrescQIPP (The Organisation)

Chief Operating Officer at PrescQIPP/ CIC is Liam Cahill and appears to hold a 1st Class BSc, in Management Information Systems from Birmingham City University.

I have contacted my MP with this information and posed the question “is my health and welfare now in the hands of Doctors or Accountants? I would appreciate an appointment at one of your surgeries to discuss my situation further.

I would advise every patient who find themselves in this situation to contact their own MP urgently before the NHS finally obliterates the Co-proxamol “Named Patient Safety Net” altogether. This is certainly their intention according to the PrescQIPP bulletins they have issued to the CCG’s.

Questions;

DID THE CSM / MHRA REPORT DELIBERATELY MISLEAD PARLIAMENT REGARDING THIS MATTER

DID PARLIAMENT SINCERELY BELIEVE THAT THE 14% RESPONSE TO THE CSM REQUEST FOR INFORMATION WAS SUFFICIENT AND THEIR FINDINGS TO BE PART OF A “GENUINE AND RIGOROUS REVIEW” OF ALL THE AVAILABLE EVIDENCE ON THE RISKS AND BENEFITS OF CO-PROXAMOL?

WAS PARLIAMENT RIGHT TO IGNORE THE VIEWS OF 70% GP’S AND 94% OF RHEUMATOLOGISTS WHILE ACCEPTING RECOMMENDATIONS FROM AN ALREADY DISCREDITED MHRA? (RE: THEIR DECISIONS REGARDING SEROXAT & VIOXX)

WERE PARLIAMENT RIGHT TO IGNORE THE FACTS PRESENTED TO THEM BY RT.HON ANN BEGG MP DURING HER THREE ADJOURNMENT DEBATES ON THIS SUBJECT?

Co-Proxamol: The Facts So Far

Before the ban it was estimated that 1.7 million GP patients per year received 7.5 million prescriptions for co-proxamol. At an approximate cost of £2.70 per 100 tablets.

The MHRA admitted in published documentation that there would be “some” patients left without suitable alternate pain management, and guaranteed that these patients would be protected and their wellbeing made safe by their “Named Patient Safety Net.” THE MHRA SUBSEQUENTLY BROKE THEIR PROMISES RESULTING WITH THIS ASSURANCE BECOMING WORTHLESS. Because when they delicensed the product they simultaneously introduced a policy that the “RESPONSIBILITY FOR THE PRESCRIBING OF COPROXAMOL BY UK DOCTORS WOULD FALL ON THEM.

This resulted in their insurers refusing to insure doctors. The medical unions such as MDDUS advised a blanket ban on any prescription of Coproxamol. As a direct result of this action tens of thousands of patients were left to live with horrendous side effects or with unmedicated pain.

Many patients, MP’s, doctors, consultants, and heads of pain management clinics pleaded with the MHRA to review their Coproxamol ban with many requesting the repair of their shambolic “Named Patient Safety Net.”

As a direct result of their intervention the cost of Co-proxamol rocketed from £2.70 per box of 100 to £21.38 plus additional expenses, (quote from prescQipp) bulletin “co-proxamol is now an unlicensed medicine, it has to be obtained from specific suppliers, and this incurs out-of-pocket expenses e.g. posting, packaging, courier costs.

Despite requests from MPs, Doctors, and patients no government department appears to have challenged the MHRA’s ludicrous decision which had been based on an extremely dubious review RESULTING IN 1.7 MILLION PATIENTS SERIOUSLY DISADVANTAGED!

On 27 June 2006 MHRA; Based on the review of the data on quality, safety and efficacy the UK granted a marketing authorisation for the medicinal product Tramadol 50mg Capsules (PL 17907/0110) to Bristol Laboratories Limited. Tramadol 50mg Capsules is a prescription only medicine. Was this another mistake made by MHRA? ) Because on the 13th of Feb 2013 the Advisory Council on the Misuse of Drugs sent a letter to Parliament Re- Tramadol (Dear Home Secretary and Secretary of State for Health)

Extract from letter;

“Prescribing data from the NHS Business Services Authority (NHSBSA) indicate an increase in prescribing, with the number of Daily Defined Doses (England) increasing from approximately 5.9 million in September 2005 to 11.1 million in September 2012. This may be associated with Co-proxamol’s phased withdrawal from 2005. Data from the Office of National Statistics (ONS) for 2011 shows 154 deaths where tramadol had been mentioned on the death certificates; in 2009 there were 87 such mentions and in 2008 this figure was 83. The majority of tramadol related deaths are where it has been obtained through non–prescribed means.”

______________________________________________________

Tramadol presents interesting data in the UK; in 1996, England and Wales reported one death with the drug mentioned, but by 2011 there were 154 deaths. (Rising to 240 in 2014) In Scotland, tramadol-related deaths increased from eight in 2001 to 34 deaths in 2011. The increase in tramadol-related deaths may reflect a rise in tramadol prescriptions, thus availability, but also points to the need to monitor closely any increase in deaths caused by opioid analgesics because it may signal an emerging problem in the UK.

Co-codamol (paracetamol and codeine) increased by 21% in 2014 to a new high of 63 deaths.

Deaths involving Codeine increased from 130 in 2013 to 136 (2014)

Deaths involving other specified opiate increased From 93 in 2013 to 129 (2014)

June 2014 The Home Office issued an Urgent Communication (Rendering Tramadol a Controlled Drug.) Most Clinicians would have welcomed “Controlled Status” for Co-proxamol back in 2007!

10 Years after the Rt Hon Paul Flynn’s request for an independent probe into the MHRA little has changed. CCG’s are now determined to stamp out the “Named Patient safeguard” guaranteed by MHRA during (2004 – 2007). The high cost of Co-Proxamol was caused entirely by the MHRA’s so called “Rigorous & Robust Review.”

Their catastrophic decision has resulted in worldwide misery! The UK’s initiative influenced the US Food and Drug Administration to take action in 2010 to withdraw Co-proxamol (dextropropoxyphene) in the USA.This resulted in Canada, Singapore, Taiwan, and New Zealand to follow the same path. In December 2011 Australia also announced a decision to withdraw all analgesics containing dextropropoxyphene (Co-proxamol). However in April 2013 the AAT concluded that the quality, safety, and efficacy of Di-Gesic and Doloxene (Co-proxamol) were not unacceptable, provided that additional conditions and monitoring arrangements were imposed. The drug is now available for prescribing again in Australia.

16th November 2015 CCG’s informed GP’s to stop prescribing Co-proxamol as the price had increased again to £49.50. This now appears to have put the final nail in the coffin of the MHRA’s shambolic “named patients safeguard.”

The number of suicides in UK continues to increase, with male rate at its highest since 2001. The male suicide rate has increased significantly since 2007, the ONS said, while female rates have stayed relatively constant and were consistently lower than those for men.

UK deaths from alternate pain killers have also increased since the ban. The MHRA appears to be in the same situation with Tramadol as they were with Co-proxamol back in 2004. Surely it’s now time for a responsible government to reconsider the Co-proxamol debate again.

JANUARY 2016, DEMAND THAT CO-PROXAMOL IS RELICENSED IMMEDIATELY!

2 Replies

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  • A really worthwhile campaign. I would be distraught if my painkillers were suddenly taken away from me for no medical reason.

    I have signed the petition, and would urge anyone else who hasn't to do the same, and support everyone impacted by this awful decision. M x

  • Thank you jx

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