The Pharmaceutical Journal
Vol 270 No 7233 p117
25 January 2003

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Letters to the Editor

Pack sizes

Surprised at change in pack size of disks

From Mr F. Ali, MRPharmS

I was somewhat surprised to receive a letter notifying me of a change in pack size of the Ventodisk, Becodisk, Flixotide range. The letter announces a change from treatment courses in multiples of 28 days to 30 days.

I was under the impression that most pharmacists favoured a 28-day regimen for all non-acute medicines. In addition the Rotacaps range was previously changed from packs of 100 to 112 to support this idea.

F. Ali
Birmingham

Change to 30-day pack will ruin compliance

From Mr G. A. Fox, MRPharmS

For many years I, and others, have campaigned to have manufacturers recognise the need for packaging based on a 28-day regimen. They have done so for new products but have always insisted that it was too expensive to change existing packaging. There was no way the National Health Service would accept an increase in price to achieve such changes.

Imagine my surprise to find that an employee pharmacist working for the Glaxo group has not only convinced his masters to make a pack change but has got the NHS to pay for it plus an increase in price for the product per se.

The argument was won with the advantage of providing patients with treatment courses in multiples of 30 days. What advantage? I will now be advising surgeries to delete Becodisks, etc, from their formularies. The 30-day pack will ruin painstakingly made patient compliance controls currently in place. Neither the doctors nor I can be confident that excess "preventers" that accumulate are used regularly, without increased dosage or frequency. They could also be used incorrectly for treatment of an acute asthma attack. The cost of these packs is no longer justified with little presentational or clinical advantage over much cheaper alternatives.

I am concerned that a major pharmaceutical manufacturer can front what is clearly a cynical exploitative commercial decision with a pharmacist supposedly acting in patients' interests.

What disturbs me most is how the NHS can agree to pay for a change away from a 28-day format. Could the DoH have promoted it as a new effort to oppose standard 28-day patient packaging? There is a whiff of asafoetida in the air.

Gerald Fox
Herington Pharmacy, Dunstable

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