The Pharmaceutical Journal
Vol 277 No 7423 p482
21 October 2006

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· Pfizer products (3)
· Prescribing
· Sugar-free medicines
· Drug misuse
· Pharmacy in Spain
· Pharmacy ownership (2)
· The Society (3)
· Superdrug
· Hiccups

Letters to the Editor

Drug misuse

Payments must reflect the work involved

From Mr A. C Moule, MRPharmS

I would echo the concerns of Martin Bennett regarding FP10MDAs (PJ, 14 October, p449) These prescriptions were designed to ensure that those being treated for addiction were given daily accurate instalments. However there are many situations where an addict needs doses “in advance” other than closure of the pharmacy, eg, attendance at courses, community service, home visits, getting into work or as a step on the way to recovery and trust (ie, reducing supervision from daily to twice-weekly to weekly).

I have seen professionals who cannot measure and replicate accurately, say, 53ml using a conical measure so how can we expect patients to do so when the dose itself and confidence in the dose is vital. It is profoundly wrong and akin to giving a person with diabetes a pen device with no gradations or an alcohol misuser a bottle of whisky and telling him or her to take a sip each day.

Our payments must reflect the work involved, which is real (unlike being paid 12 fees for giving 12 flavours of Ensure Plus or two for Prempak-C). Giving a cup or large syringe is no answer either as this will lead to “last dose” disputes where the patient claims they have got to the seventh day and there is not enough left. Also what about prescription scripts that ask for say 40ml on day one and reduce by 2ml daily, but in advance? Separate bottles must be provided and fees paid accordingly.

Andrew Moule
Middlesbrough, Cleveland

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