| · Pfizer products (2)
· Fitness to practise
· The profession
· Rural practise
· Retention fees (2)
· The Society (2)
Letters to the Editor
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Pfizer products
SPGC continues to oppose Pfizer's distribution proposal
From Mr A. MacKinnon, MRPharmS
The Scottish Pharmaceutical General Council met once again with representatives
from Pfizer on 11 December to express its strong dissatisfaction at Pfizer’s
proposal to distribute its medicines in the UK through one single wholesaler.
Unfortunately Pfizer was unable to give the SPGC reassurances on any
of the issues that were raised.
As a result of this meeting, the SPGC would like to reiterate that its
position on this matter is unchanged and remains as detailed in previous
press statements. It has now issued a new press statement making it quite
clear that it is totally opposed to Pfizer’s new distribution model
and continues to maintain that this model will be hugely detrimental
to the current wholesaler network.
Despite Pfizer’s previous assurances that this initiative would
be cost neutral to the NHS, the SPGC believes it is now clearly apparent
that this proposal will have significant increased costs for the NHS
in Scotland.
The SPGC maintains that such a distribution model would also result in
significant administrative burdens for community pharmacy contractors
and their staff, thereby reducing their ability to deliver the levels
of pharmaceutical care to Scotland’s patients as envisaged within
the new Scottish Pharmaceutical Care Services contract.
The SPGC therefore will continue to urge Scottish MSPs, MPs and the Scottish
Executive Health Department to review fully this proposal by Pfizer with
the utmost urgency.
To that effect, the SPGC will also continue to encourage and recommend
that all community pharmacists in Scotland make appropriate representation
to their MSP and MP regarding Pfizer’s proposal and its detrimental
implications for patient care in Scotland.
Alex MacKinnon
Head of Parliamentary and Corporate Affairs
The Scottish Pharmaceutical General Council
Saving money?
From Mr J. L. Woodward, MRPharmS
I find Brian Curwain’s letter (PJ, 11 November, p574) disturbing
in as much as that all he is interested in is saving millions of pounds
for the tax payer, the quality of life for patients evidently being of
little consideration for him. Have we really obtained sufficient evidence
to show that the lifespan of those patients changed from atorvastatin
to simvastatin will not be decreased or affected in any way?
He is also asking community pharmacists to do his job for him. Unfortunately
we have neither the time nor the ammunition that he has at our disposal.
We do not have a prescribing incentive scheme at our fingertips whereby
we can say “Hi doc, why not change all your patients from atorvastatin
to simvastatin and I will see that you get an extra £3,000 a year.
Yes we have changed the deal. Last time we saw you, you will remember
that we were offering additional payments if you increased your level
of generic dispensing. And, by the way, do not forget our Quality Outcome
Framework scheme whereby you can earn up to a maximum of 1,050 points,
thus increasing your income by £15,000 to £20,000 per annum
when you meet the targets you will be set.”
Could you see me saying to old Miss Jones, who I know to have 11 items
on her monthly prescription, “look, Miss Jones, you bring all your
prescription items to me every month and I will give you a 10 per cent
discount on everything you purchase from my pharmacy”?
John Woodward
Stafford
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Dr CURWAIN replies:
I am sorry that Mr Woodward found my letter disturbing.
I can give my assurance that, as a pharmacist, my aim is to ensure
that all patients within my primary care trust area receive first-class
therapy
and that all prescribers are properly advised as to the underlying
clinical science.
As a servant of the NHS, I clearly have to act in
accordance
with the aims and priorities of my primary care trust. If my employer’s
wishes were to come into irresolvable conflict with my ethical duties
as a pharmacist, I would resign without hesitation.
My pledge to
prescribers has always been, and remains, that the medicines management
team will
never recommend an inferior product in order to save money. No
change we propose results in a reduced quality of treatment, based on
the
scientific evidence. Patients always have the chance to opt out
of a medication change
and, anyway, we painstakingly screen out those for whom the medical
records suggest the switch would be inappropriate.
In a recent
programme in one
surgery, over 300 patients were changed and just 11 rang my
office as invited to discuss it after reading the letter we sent them.
Of these,
only one ultimately said that he would prefer not to change
and
we respected his decision. We have generated evidence locally
that patients’ cholesterol
levels are not adversely affected by the change in medication.
There is no evidence that changing statins has an adverse effect on
lifespan
and
there is no anecdotal data that I am aware of to lead one to generate
such a hypothesis.
For the record, we paid our GPs nothing to make this change;
they are not averse to prescribing cost-effectively. We do,
where needed,
assist them with the work
involved. I was not asking community pharmacists to do my work for
me but I do encourage them, along with GPs and other contractors,
to act
in a corporate way
with respect to the priorities of the primary care trust with whom
they
contract. Our GPs have not had a prescribing incentive scheme
for the last couple of
years, but they can see the benefit to their local health economy
of saving money where
possible as this may permit service developments for which there would
otherwise be no funding. |
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The
Pharmaceutical Journal