The Pharmaceutical Journal
Vol 280 No 7488 p150
9 February 2008

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• Clarke Inquiry (2)
• Minor ailment scheme
• EHC
• WCPPE (2)
• Dispensing
• Community pharmacy
• PSNC
• Drug addiction
• The Society (2)

Letters to the Editor

Dispensing

Patronising not to tell people the costs of their medicines

From Dr P. J. Brown, FRPharmS

I could not agree more with the Public Accounts Committee, Malcolm Furnell and your editorial about the desirability of putting the price of NHS medicines on the packs so that patients make the best use of their medicines (PJ, 2 February 2008, p104). But in my experience this idea is not favoured by pharmaceutical manufacturers with whom I have discussed it several occasions.

The manufacturers have expressed a number of concerns. These include (a) the adverse effect on public opinion about fair pricing when branded pharmaceuticals are compared with generic equivalents and (b) price comparisons arising from the dispensing of parallel imports highlighting price differences between EU member states (provided patients know the euro to pound conversion rate).

Their overall view is why tell patients about prices when they have not asked for this information — let sleeping dogs lie.

When you speak to patients about the prices of their medicines you find that they have no idea. When informed, they are surprised either because they are “so expensive” or because they are “so inexpensive”. Branded versions evoke the first reaction and generics, the second.

Interestingly, there are cases when patients ask why they have been transferred to cheap generics suspecting that these drugs are inferior or that they are being discriminated against. This is commonly raised by elderly patients on repeat medication when the generic version is prescribed in place of the branded following patent expiry.

The case for putting the price of medicines on the pack is part and parcel of the need to ensure maximum transparency about the whys and wherefores of healthcare costs. Tax payers are aware that billions of pounds are spent annually on the NHS and are being told that there is considerable wastage. The more they know about what their medicines cost, the more likely will they appreciate what they are getting for their tax pound, which will lead to more responsible use, whether it is reducing wastage or ensuring compliance.

At the most basic level, putting prices on the packs of medicines can be justified by the argument that good decisions can only be made on the basis of having good information: the better the information, the better the decision. Ignorance may be bliss, but is it not extremely patronising to keep people in a state of ignorance about the price of what they are getting, particularly if they are paying for it?

Phillip Brown
Weybridge, Surrey

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