The Pharmaceutical Journal
Vol 279 No 7476 p499
3 November 2007

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• Certificates
• Publications
• The profession
• Supervision (2)
• Community pharmacy (2)
• Pack sizes
• Clinical trials
• Clostridium difficile
• The Journal
• Postgraduate education
• Retention fees

Letters to the Editor

Pack sizes

Reply regarding change in pack size

From Mr M. E. James, FRPharmS

You published a “reply” from the medical directors at Sanofi-Aventis and Bristol-Myers Squibb regarding the concerns of pharmacists about the change in pack size (PJ, 27 October, p467). Rarely have I read such an irrelevant and condescending letter in The Journal.

The authors showed that that they had absolutely no concerns for the problems of the GP, the patient or the pharmacist. There were five statements, as follows:

• That the change was part of an initiative to centralise manufacturing — in other words, for the commercial advantage of the companies concerned

• That the change was to secure the supply chain across Europe against counterfeit products and that the new package will contain “security elements” — why, pray, are these security elements impossible to include in 28-day packs?

• That there had been problems with counterfeiting in the past — apart from the pack security, why and how does the number of tablets in the pack help to prevent counterfeiting?

• GP prescribing systems are being updated to default automatically to 30 days rather than 28 — by whom? I can assure the authors that any company representative who tries to get his or her fingers on the systems I know of will find themselves out on the street before they can say clopidogrel

• The daily cost of clopidogrel remains unchanged — well, bully for them, surely there ought to be a small reduction?

As far as I can see, from the perspective of a pharmacist involved in care home work, this is likely to lead to increased opportunity for error, with consequent risk to patients.

Miall E. James
Colchester, Essex

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