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Letters to the Editor
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Branded prescribing
When to prescribe by brand
From Mr N. V. Morley, MRPharmS
I write further to William
Horsley’s letter (PJ, 11 March, p293)
on the decision by the Practice Committee of the Royal Pharmaceutical Society
to allow proprietary prescribing of sustained release opiate medicines.
That the committee has come to this decision based on sound clinical and
therapeutic conditions is undoubted.
It is a well established fact that: “In many cases the Prescription
Pricing Authority is unable to process prescriptions written generically
because no true generic approved name exists or the preparation has a number
of ingredients, eg, ointments and mixtures, and there is no recognised
combination approved name for these products. In addition to the necessity
to write by brand to facilitate the processing by the PPA there are many
pharmaceuticals where for clinical reasons it is recommended by various
medical authorities, including the British National Formulary, that preparations
should be prescribed by brand. Such therapeutic areas include nicotine
replacement therapy, opiates, anticonvulsants and most sustained release
preparations — such as nifedipine, diltiazem and modified release
patches, eg, fentanyl, and other therapeutic areas where clinical equivalence
cannot be assumed. Prescribers should for these products prescribe them
by brand to avoid patients being given the wrong product or prescriptions
being returned to a retail pharmacy contractor by the PPA for elucidation.” This
advice has been circulated to prescribers by the PPA over many years.
I would also say that, from the point of view of probity, the choice of
drug will have no effect on community pharmacy income, since invariably
these are zero discount lines.
As regards the public purse, it would be noted that in many cases the list
prices of the “me too” brands are identical to those of the
original brands or the Drug Tariff listing and, therefore, the cost to
the public purse is the same.
Finally, while noting the comment concerning possible restraint to entry
of new products, if the new products have merit, whether clinically, operationally
in drug delivery, or from the point of view of cost-effective prescribing,
then the advice to prescribe by brand is paramount.
Nigel Morley
Managing Director
Surelines Pharmaceutical Services Ltd |
The
Pharmaceutical Journal