Irish Prescribing guidelines.

[Nimrec]

I've been in the U.K for years but I'm from Ireland. My mum recently went on to Lipitor and Micardis paying rediculous prices every month. Whats going on with prescribing practices? Wouldn't it have been better to start her on Ramipril and Simvastatin? Or is it just that the doctor doesn't care because the moneys not leaving his pocket o pay for it?

To be honest I qualified over here and I have no intentions of dipping a toe in the Irish shark tank any time soon.

[lamzee]

Lipitor is the most commonly prescribed statin in Ireland, mainly because of the Pfizer effect. (Rep tells doc to prescribe their products to keep local jobs/economy). You would find that simvastatin branded generics (or zocor) aren't much cheaper anyway. Also, it is sold to the docs as more convenient, since simvastatin needs to be taken at night whereas atorvastatin can be taken at any time.

Likewise, big push on Abbott diabetic equipment, as it is made in Ireland etc..

[hibernia]

There are NO prescribing guidelines in Ireland. Every doctor is free to prescribe exactly what they want and are not answerable to ANYONE for their choices, unless they are so dangerous as to attract the attention of the medical council.
As Lamzee says most prescribing is heavily influenced by drug companies. Lipitor has easily 80% of the statin market in my area. I would be shocked to see a patient started on anything else in the community. Ask GPs why and they tell you they get the best results from it. That passes as evidence based prescribing here!

On the other hand I feel patients get more individual care from their GP and pharmacist here than in the UK, where you just get whatever the guideline states. This opinion is based on reports from my patients who have moved from the UK and family members living in both countries. Not very evidence based either!

As your mother is a private patient her GP will probably be quite happy to prescribe what you suggest, or just about anything else. For GMS patients they will not tolerate any interference with their choices. Our beloved Minister for Health has vowed to introduce reference pricing and generic substitution so stand back and watch the skin and hair fly.