Dr MARTIN FORD, medical director, Aventis Pharma, replies:

We are grateful for the opportunity to address the concerns that Mr Argomandkhah raises.

Turning to the most important issue first, namely, that of patient safety, we are totally confident that patient safety will not be compromised in any way by the change to the presentation of Tritace from capsules to tablets for the following reasons. First, the two presentations are bioequivalent and so they perform in the same pharmacokinetic and therefore pharmacodynamic manner. Secondly, as generic products almost always have physical characteristics that are different from the branded product they copy, we are confident that patients will adapt to this change in presentation in the same way as they do when they are dispensed generic solid dosage form pharmaceuticals. Thirdly, as the product is presented in original packs with artwork and information enclosures licensed by the Medicines and Healthcare products Regulatory Agency, we are certain that pharmacists will not be confused during normal good dispensing practice.

Concerning the questions and comments regarding why we have initiated this change, quite simply, the transition from Tritace capsules to tablets is happening due to global manufacturing rationalisation within Aventis. The United Kingdom is one of few countries that sell capsules. As a result of a worldwide initiative to streamline our manufacturing operations it is more economical to produce tablets. Importantly, with the loss of patent next year in the UK and the considerable drop in forecast volumes, the economic sense of switching to tablets becomes overwhelming.

Finally, we know that there will be several generic presentations on the market from the beginning of 2004, thus ensuring strong price competition to the considerable benefit of the NHS.