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Letters to the Editor
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Pfizer products
A damaging error
From Mr G. Dobson, MRPharmS
When will Pfizer and UniChem decide to forgo their proposed nonsense?
Surely they must realise that they have made a massive error that will
only damage their reputations. Whatever the spin Pfizer is trying to
make us believe, it appears that they are attempting to control the market
in order to maximise their profits, while strangling parallel importing.
But do they realise that pharmacy stands united against them and that
there are countless ways for us to thwart them?
The chief executive officer of Community Pharmacy Wales said (PJ, 7 October,
p413): “We do
have concerns when any critical medicine is limited to a single supply
source.” But, are any Pfizer medicines “critical”?
Are there not alternatives that are significantly better value for the
NHS?
I have a close working relationship with a local GP and together we have
already started reviewing all patients on Pfizer medicines (purely for
clinical reasons, of course). It looks like a large percentage of patients
may be switched to non-Pfizer products, so the GP is pleased with the
projected budget savings.
I know that prescribing varies greatly across the UK, but imagine if,
for example, a review of statin patients meant that instead of receiving
a well known Pfizer lipid-lowering agent, they were switched to a less
expensive alternative. Surely there are millions of pounds to be saved
here without impacting on patient care.
If a review of all patients’ medicines is not an option then we
can simply wait until the inevitable product supply problems occur and
deal with each case individually by suggesting an alternative to the
GP in the way that we currently deal with manufacturing problems.
Apparently we will all receive twice daily deliveries with no minimum
order. It would be awful if the new UniChem service started to feel the
strain if it turned out all pharmacists were only ordering one packet
of the cheapest Pfizer product each morning and afternoon.
Pfizer representatives visited me recently. It appears they have been
charged with doing some “fire fighting” but clearly had neither
any answers nor new information. I did feel slightly sorry for them as
they have an unenviable task, but I made my feelings clear in the hope
that enough feedback would help Pfizer see sense.
Nevertheless, I have to say that I really like the current UniChem advertising
campaign. The pink and grey colouring is pleasing to the eye and the
strap-line “Putting you first” is a clever pun on the letter “U”.
The advertisement also features lots of words beginning with “U” like “unparalleled”, “unbelievable”, “unexpected” and “ultimate”.
Might I suggest that for the next series of advertisements it considers “unethical” and “underhand”?
Gavin Dobson
Kinross
Unintended opportunity, not a threat
From Mr C. F. Brewer, MRPharmS, and Mr A. McCourt, MRPharmS
Pharmacists unwilling to deal with UniChem for the purpose of procuring
Pfizer products may do well to consider that there are a variety of economical
alternatives to most, if not all, of them. In the North Cumbria health
economy we already experience an admirably high level of generic drug
use, and we may seek to further minimise the prescribing by brand name
of products such as Diflucan, Deltacortril and Vibramycin.
Other Pfizer brands such as Lipitor, Cardura XL and Lyrica offer no convincing
evidence demonstrating clinical superiority over cheaper alternatives.
Indeed, a policy of switching patients from Lipitor to simvastatin has
recently been identified in the medical press as being capable of saving
the NHS £2bn over five years.1 By using their influence over prescribing
colleagues, pharmacists can take this opportunity to help the NHS obtain
better value for money.
As a consequence of these events, we may in the near future find ourselves
working in dispensaries free of the Pfizer “global brand essence”.
Fortuitously, this may actually have a positive effect on patient safety
by reducing the chances of dispensing errors caused by similar packaging.
Pfizer, a company that values patient safety highly, will appreciate
this — and may one day also come to appreciate the irony.
C. F. Brewer
Medicines Information Pharmacist
North Cumbria Acute Hospitals NHS Trust
A. McCourt
Director
Alneburgh Pharmacy Ltd
Reference
1. Moon JC, Bogle, RG. Switching statins. BMJ 2006;332:1344–5.
Another question comes to mind
From Mr S. Martin, MRPharmS
With the discussion concerning the proposed monopoly of Pfizer’s
distribution with Alliance-UniChem, there is a significant difference
to the then Glaxo agency scheme that was put into effect some years ago.
The Glaxo scheme continued to use the existing competitive distribution
network of wholesalers, all being able to compete against each other.
The issue was one of discount levels being placed in the control of the
company rather than the wholesalers, a mechanism that is being used to
their commercial advantage.
The issue concerning Pfizer/Alliance-UniChem is that a similar competitive
distribution system will not be available. I believe that this is a restrictive
and anti-competitive practice that should be referred to the Competition
Commission. No doubt vast amounts of money have been poured into corporate
lawyers’ coffers to try to establish the freedom to operate such
an agreement. W. P. Watterson (PJ, 14 October, p448) asks some pertinent
questions and, rather than pharmacists asking these questions, these
should be directed to the Competition Commission. Such an agreement will
force pharmacists who currently do not use Alliance-UniChem to do so,
thereby minimising choice and competition.
With Lipitor’s patent fast running out, another question surely
comes to mind: will Pfizer use this agreement to reduce the impact of
generic competition?
Steve Martin
Staplehurst, Kent
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