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• White Paper (5)
• Pseudoephedrine (2)
• Eczema
• Chemotherapy
• Community pharmacy (2)
• Locum pharmacy
• Packaging
• Dispensing
• MDS
• Parallel imports
• Prescription charges
• The Society
• Skill mix
• Professionalism
• Boots travel insurance
Letters to the Editor
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Parallel imports
Number of doses differ
From Mr R. J. Birkby, MRPharmS
The following scenario occurred in the pharmacy where I work.
A patient has recently started visiting our pharmacy. She has been using
terbutaline dry powder inhalers for over 10 years. She contacted me
to complain that the product, Bricanyl Turbohaler, that I had dispensed
did not last as long as those dispensed from other pharmacies.
On inspection of her old Bricanyl Turbohalers I found that they were
parallel imports of Spanish origin with each inhaler containing 200 doses.
Apparently she had had similar inhalers dispensed at many other pharmacies
in the area. However, the product I had dispensed was the UK Bricanyl
Turbohaler, with only 100 doses.
On checking the prescription again, I noted that the prescription did
not state the number of doses, only “2 inhalers” as the quantity
to dispense.
Out of interest, I ordered some parallel imports (Bricanyl Turbohalers)
that were freely available at a similar price to the UK pack. These,
too, had 200 doses per pack.
This raises all sorts of issues. For example, why is the parallel import
available if it is not equivalent to the UK variety? Is it deemed poor
practice to dispense the 200-dose pack? And, if you had a patient paying
the NHS levy, you could get twice as much for your money from “pharmacy
A” compared with “pharmacy B”. Furthermore, is the
patients’ asthma control worse than the prescriber realises, due
to the double quantity available?
I have noticed a similar situation with others medicines, such as a Combivent
inhaler with 300 doses per pack. One could not dispense 56 tablets if
28 were ordered, so is there a difference?
Robert Birkby
Halifax, West Yorkshire
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The
Pharmaceutical Journal