Patients demanding brands...what to do?

[zozzer]

How do you deal with customers demanding brands or a specific generic, when it is not prescribed on the RX?
Sometimes we give the patient want they want as a gesture of goodwill if its only a bit more expensive. But lately we have a lot of requests for specific generics which we would have to order via specials and its too expensive. patients claim they are going to die if they don’t have them often GP s have told them that we have to give it to them as its only a generic.....we have asked them to change scripts to include the right salts etc... but they wont they seem to think its our duty.
Any opinions?

[lamzee]

You have to make a cost assessment each time--for instance, does the customer buy anything else? If not, and you are losing money then say no. If 50 of their relatives and their 30 item script granny gets stuff from you then say yes, so you don't lose their business, or if they buy clarins face creams from your pharmacy at 50 quid a pot, then the loss of a few pence is worth it. Also, check your drug tariff price--will the "other brand" still be a bit less than this, even if it isn't the "preferred" one?

[orangiey]

tell them you can't get it and try elsewhere!!??

[hibernia]

I have a simple policy. Patients who 'demand' something they have no right to get a polite 'sorry, no can do'. If on the other hand they ask nicely and happen to get me in one of my rare good moods I'll think about doing them a favour.

[shan]

Brands -- Exagerate the price difference and say you will be the loser and ask them to get it prescribed by their GPs instead if they still need them. The GPs will then do the rest.

Generics of a different company -- I have noted that 98% of these are well below the DT price, hence you lose nothing + you get the dispensing fee. If it was a regular customer with a 4 + item script with a request for one of the items then I will do a overall script worthiness before using any other tactics (like not available anymore, currently manufacturers cannot supply, have you tried this one, etc)

Shan

[sparkybw]

I think it depends why they want the different product. i have lactose intolerance and crohn's disease and absolutely must get lactose free versions of my drugs. I've done all the donkey work of finding appropriate brands, so it hardly seems unreasonable to expect the pharmacist to give me something that won't have me sitting on the pot 10 times a day. Even my hospital consultant prescribes the appropriate versions when i have hospital appointments but the GP seems to think that anything goes.
Given that I am one of the very few who actually pays for her prescriptions it would be nice to get the correct drugs without having to virtually seduce the pharmacist over the counter.

[andrew paxton]

I think it depends why they want the different product. i have lactose intolerance and crohn's disease and absolutely must get lactose free versions of my drugs. I've done all the donkey work of finding appropriate brands, so it hardly seems unreasonable to expect the pharmacist to give me something that won't have me sitting on the pot 10 times a day. Even my hospital consultant prescribes the appropriate versions when i have hospital appointments but the GP seems to think that anything goes.
Given that I am one of the very few who actually pays for her prescriptions it would be nice to get the correct drugs without having to virtually seduce the pharmacist over the counter.

Do an MUR and you'll find out why they want/need a different manufacturer or brand. Sending it in to the GP with the reason might get him or her to prescribe by brand or specific manufacturer (assuming they actually read the MUR - some do!) The £28 fee may also go some way towards recompensing you for the extra cost of the brand. Some patients are just awkward or stupid, but most have a good reason for their likes or dislikes. I had a patient on Sandoz Ramipril Tablets, because they are soluble (not supposed to be, but they are) The Practice Pharmacist changed all patients from Tablets to Capsules for cost-saving reasons, but with my input he had to change this lady back so she could swallow them. He didn't like it, but TOUGH! The man's an idiot, anyway