Confused dot com

[3rdNettydoon]

Medicinal forms | Hydroxocobalamin | Drugs | BNF | NICE

bnf.nice.org.uk/drugs/hydro...

Just browsing and saw this. Does it mean we can buy B12 ampoules here?

[Gambit62 Administrator]

In the UK the supply of injectable medications need a prescription.B12 injections are also available as a vitamin supplement. This is not covered by the same regulations but also not covered by the same requirements in relation to quality etc of a medication.

Under humanitarian rules we can source medications from abroad for personal use (including another member of the same household) if they are not available in the UK. Strictly speaking the EU has an arrangement with the UK that would stop something that needs a prescription in the UK but not in an EU country being supplied to someone in the UK. However, EU pharmacies have no way of knowing whether the customer has requested the supply as a vitamin supplement or a medication so the situation with injectable B12 is quite ambiguous and it is still possible to source from the EU, though some EU pharmacies no longer supply to the UK because of VAT and import red-tape post Brexit. These are generally pharmacies that would limit supplies before hand to avoid exceeding thresholds that required registration in the UK.

Basically the situation is very muddled. You cannot purchase injectable B12 for medical purposes but you can purchase it as a vitamin supplement but you'll end up paying a significant premium if sourcing it as a vitamin supplement from a UK source.

The BNF is intended to give guidance to medical professionals on what drugs have been licenced for what medical purposes in the UK.

One of the vagaries of the current licencing rules is that they are driven by suppliers applying rather than being an independent way of ensuring that medications are safe.

[deniseinmilden]

Looking to hear others' views but I think you have managed to find the listing of drugs available to Drs to order their drug supplies from.

If you look at the bottom of each supplier option its says

"Legal category

POM (Prescription-only medicine"

so this shows that they are definitely only available on prescription.

I think that the suppliers on the list are ones that have been vetted by an NHS drug purchaser and the drugs - in this case B12 - are approved for Drs/GPs, and maybe pharmacies, to buy. Definitely an interesting link!

If this is the case then I can see why there are considerable political gripes about NHS spending and budgets because we, as individuals, are generally buying small amounts for less than the NHS are paying, despite in theory being able to get a discount for bulk. What a shambles and financial fiasco!

[helvella]

The British National Formulary gets its information about makes of medicines and suppliers from dm+d:

Dictionary of medicines and devices (dm+d)

The dm+d is a dictionary of descriptions and codes which represent medicines and devices in use across the NHS. The dm+d data is refreshed weekly and contains a huge variety of information, including:

whether a product will be reimbursed by NHSBSA, if submitted for reimbursement by a dispensing contractor

the indicative price of each pack of a product (where a price is maintained)

current and discontinued products and packs available from manufacturers and suppliers

nhsbsa.nhs.uk/pharmacies-gp... contractors/dictionary-medicines-and-devices-dmd

One of its problems is that you have to be very aware in order to identify which suppliers are distributors and which are manufacturers/importers. What you see is a list of both mixed in with each other.

The list of hydroxocobalamin products by overall specification is here:

services.nhsbsa.nhs.uk/dmd-...

But that includes oral solutions and discontinued powder.

The list of 1mg/mL hydroxocobalamin ampoule products is here:

services.nhsbsa.nhs.uk/dmd-...

Towards half of which are discontinued.

You can click on each one to get some further information.

deniseinmilden

[3rdNettydoon]

Thank you for these interesting details. I will need to read them a few times before I get to grips with it all. Another question; where there is a price, is this referring to one ampoule or a pack of them? Thank you.