Disappointed

[m33ary]

I had my rheumy apt yesterday and asked about the 1 mg coated prednisolone. She told me they have been told not to prescribe it! Has anyone got a private prescription for it??

[SnazzyD]

Did you ask why? Wondering if it has become extra expensive or just unobtainable or something else.

[m33ary in reply to SnazzyD]

Cost is the reason

[SnazzyD in reply to m33ary]

I argued with my GP that if I’m not having to take a PPI it balances itself out. However, from what I remember of the system I used to work in, in a GP surgery, the software sentinels for detecting prescription of black listed drugs (not black triangle) didn’t have the wit to do maths to come out with any net gain or loss.

[Q-owl]

I'm still receiving 1mg coated Pred on prescription (UK). Do you know why they've been told not to prescribe it?

[m33ary in reply to Q-owl]

Yes its the extra cost of it.

[Q-owl in reply to m33ary]

I thought Pred was a very cheap medication. Pennies rather than pounds.

[PMRpro Ambassador in reply to Q-owl]

Plain pred is - enteric coated costs a bit more. When it first arose it was said to be a 17-fold difference but when the NHS got sticky about it then, the manufacturers increased the price of plain pred so the difference was much less, especially when you take the PPI cost into consideration too plus the 2 dispensing fees for 2 different drugs.

[Hidden]

She may have been told there is/was a shortage (as we know) & told not to prescribe it ‘for now’

[m33ary in reply to Hidden]

She told me it is more expensive. My GP says the same

[Hidden in reply to m33ary]

It is, slightly! Dorset Lady posted a Price Comparison List recently, l’ll see if l can find it for you.

[Hidden in reply to m33ary]

mims.co.uk/drugs/endocrine/...

30 EC £2.24

28 Plain 83p

[m33ary in reply to Hidden]

Thank you for this. I will push for a private script I think. I cant take the chance as I had a Nissen fundoplication a few years ago and was warned not to take meds that weren't gastro resistant.

[PMRpro Ambassador in reply to m33ary]

Then the "too expensive" shouldn't apply.

[Hidden in reply to m33ary]

My GP hauled me over the coals when l said the Rheumatologist had given me Enteric Coated, he said ‘No Way! They are too expensive!’ When l asked him how much more he just stuttered & said ‘They Just Are!’

I left muttering about looking it up in the BNF when l went into work!....

[DorsetLady PMRGCAuk volunteer in reply to m33ary]

OCTOBER prices-

30 EC £2.20p

28 Plain £0.73p plus

Omeprazole or similar 28 £0.87p

[PMRpro Ambassador in reply to DorsetLady]

Plus 2 dispensing fees for pred plus PPI, IRO £1 for each so add another £2 ...

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Trouble is at face value the EC look more expensive - but some of oldies know face value isn’t always the best option! 😳

[Blearyeyed in reply to m33ary]

If that's the case you should remind them of that.

You could also suggest that you are not happy and let them know you are going to make a complaint about this to the Trust .

It could be that rather than an area decision it is just your surgery that are taking this cost cutting strategy and that they become willing to change their minds if they know that their behaviour is being highlighted.

You shouldn't have to resort to getting private prescriptions for medications if any other area of the NHS in your region ( England, Wales , Scotland , N.I) is prescribing any type if medication.

There are NHS rules about Parity of Care which means that all Patients have equal rights to the same drugs and services.

Basically if it's prescribed in one area you have the right to demand it in another , even if they have made their own local rules not to prescribe it.

Private prescriptions should be a final straw and a decision taken with great care.

It's more costly than the amounts stated for the NHS prescription , but most importantly , in some regions if you choose to get private medications or treatments for one part of your illness they can refuse to give you NHS care for the rest of the care for that illness.

That's why it's better only using Private Care for intial consultations , one off surgeries , treatments or therapies and one off medications , unless it is done in consultation with your NHS providers.

[scats]

My GP said the same, too expensive.

I do find the uncoated more useful because they can be divided, however I cannot take them in the evening when I usually take my pred, because of acid reflux.

I have found coated pred in the evening stops me waking in the early hours with leg pains so I don't want to change this. I also didn't want to add a PPI to my meds so I started splitting my dose and taking any uncoated tabs first thing in the morning with thick yoghurt. This has worked for me so far.

Hope this is of help.

[m33ary]

Thank you

[PMRpro Ambassador]

When were they told that? An edict was issued some years ago that enteric coated was too expensive and wasn't worth it. Then the GPs who had agreed to it suddenly got loads of patients turning up with gastric problems - and in some cases they were made worse by the PPI they had been told to prescribe alongside plain pred!

But the difference in price is minimal when you add it all up and anyway, the removal of a layer of side effects should more than compensate!

I do like the system here - you get the cost of the cheapest generic covered, if you want a brand then you pay the difference. ONLY the difference. It has the occasional downside, both OH and I need the brand of something because they are slightly different in the way they release/work but still have to pay that difference. But since the script costs a whole 1 euro it isn't too bad!

[m33ary in reply to PMRpro]

My Rheumy told me yesterday. I reminded her I had a Nissen fundoplication a few years ago and was not prepared to take the ordinary ones and be back to square one. The surgery was severe and took me months to recover. I'm so fed up with all the medics at the minute

[PMRpro Ambassador in reply to m33ary]

Are you still under a GI specialist?

[m33ary in reply to PMRpro]

No unfortunately I was discharged last year.

[PMRpro Ambassador in reply to m33ary]

I would try to contact them and ask for some backing for the pred. Shame - they will be good back-up.

[Blearyeyed in reply to m33ary]

You will still be able to access your records and get copies as evidence to show the GP.

Plus , it should be on your GP medical history anyway , if not , you can remind them that that is a surgery error and is administrative negligence.