brand vs generic dispensing

[Rafael]

a script for mirtazapine 45mg, the patient wanted the BRAND form " zispin or something for that", we refused to make the supply" as there is around 5 pound price difference" and apparently we are not a charity org
customer took his script to try it somewhere else.

what popped into my mind " did not ask the locum as he is a bit rude, saterday locum only lol" and i prefer to avoid any long conversation with him.
if we made the patient aware of the 5 pounds price difference, and he agree to pay for the difference, if it possible to make the supply or it depends on the company's SOP and regulations? i.e if we endorse the Rx for the generic product as it says on the script, get paid for the price difference, and supply the brand product.....?

what do you think p'cists?

[Jeff]

if we made the patient aware of the 5 pounds price difference, and he agree to pay for the difference, if it possible to make the supply or it depends on the company's SOP and regulations? i.e if we endorse the Rx for the generic product as it says on the script, get paid for the price difference, and supply the brand product.....?

what do you think p'cists?

Not allowed. You are using the NHS script as a part payment for another transaction.

Jeff

[Rafael]

so is it better to refuse to supply the brand he is after?
even if it was endorsed properly, and we get paid for the generic product?

[johnep]

Pt can only have brand if Dr writes on script. We had similar situation where we wanted to supply PI against script for brand, but pt wanted UK marketed product. We did obtain for him as company emphasis on volume.

Some pts now demand a particular brand of generic.
johnep

[Fleegle]

Pt can only have brand if Dr writes on script.

Does this incude "branded generics", or can an alternative generic brand which you stock be legally substituted?

[Sir_Dispensalot]

The patient gets the cheapest bloody thing i have in my dispensary if the Rx is generic (unless there is a difference in bioavailablility eg sodium valproate) - if thats a brand on a deal from the wholesaler then so be it but most of the time its a generic or a 'branded' generic.

At my old place we used to give salamol for salbutamol cfc-free inhalers because the price was better than ventolin. At my new place it's the same price so they have a choice.

If i get a complaint I point out that the NHS reimburses us for the cost of medicines on an FP10 BUT they only pay us the cost of what's written - i'm not willing to lose money just because somone doesn't like the shape of their tablet.

HOWEVER if the patient is being made ill from not having their trusty 10x more expensive brand then i'll normally chase it up at the docs for them to get a branded prescribed & sort it out.

As regards 'top-up' payments for drugs - well this is being discussed at government level in a roundabout sort of way right now - but in my opinion this creates a two-tier health service which goes against the basic principles of the NHS.

[Sir_Dispensalot]

Does this incude "branded generics", or can an alternative generic brand which you stock be legally substituted?

'branded generics' are still generics and can be supplied against any generic script. Some GPs however will specify a particular 'branded generic' on a Rx which would then have to be given eg gp writing a script for 'Simvador' or 'Stronazon' .

[johnep]

We have lots of dispensing Drs and they prescribe brands from Trinity and Discovery which we have to obtain direct from suppliers.
johnep

[Jeff]

so is it better to refuse to supply the brand he is after?
even if it was endorsed properly, and we get paid for the generic product?

Depends on the price differential and how much you value you place on prescription and customer numbers.

That would depend on the particular circumstances of the pharmacy.

Jeff

[DavidS]

We have lots of dispensing Drs and they prescribe brands from Trinity and Discovery which we have to obtain direct from suppliers.
johnep

Would they be amenable to you giving any generic make? it would only take one phone call, logged carefully, or better still, an exchange of carefully worded letters, and yu could just get on with doing your job?

Depends on the price differential and how much you value you place on prescription and customer numbers.

Jeff

I can't understand why we are not allowed to give the customer whichever brand they want and just charge them the difference in notional retail prices. I think this would sort the problem out very quickly.