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If a country is specificed on an item, do we have to legally supply it?

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  • If a country is specificed on an item, do we have to legally supply it?

    Hi,

    Today I had a patient come in with a script written as:

    Crestor 5mg tablets (AstraZeneca UK)

    We subsequently dispensed Crestor 5mg (honestly I didn't even register the "(AstraZeneca UK)" bit. The patient came back later all angry at me saying we made a big mistake and the consultant said she MUST have the UK version as any other country gives her muscle pains and that we didn't do our job properly etc. We had supplied an imported French version, and that was all we had on the shelves. She was having a go at me and I calmly explained they are the same brand made by the same company but she said she would refuse to take what we had supplied. In the end I gave up and said we would phone the supplier in the morning to find out if they have any UK branded ones but frankly, this seemed like a total waste of time and I am sceptical of her claims. This is not the first time I have had a patient kick off because we supplied a PI version of their medication. When I looked at the PIL, it doesn't even say where the tablets are manufactured, I would hazard a guess that they are all made in the same factory and then packaged in different places but I could not find any evidence of that.

    My questions are:
    How would you handle this situation?
    Legally wise, even if it says "UK" on it can we supply a PI of the same brand? (I reckon it is fine)

    Thanks


  • #2
    Muscle pains are a recognised side-effect of Rosuvastatin, whether made in UK, France or Mongolia. If she saw a consultant it was presumably in a hospital. I’d be inclined to contact the hospital pharmacy and find out which brand they use.

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    • #3
      Obviously I am aware of the side effect of statins but she said only the UK branded Crestor hadn't given her trouble, she wasn't being particularly logical or helpful when I was trying to discuss it with her or I would have dug deeper.

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      • #4
        Had this happen many times when Tenormin and Zocor came off patent. Remember something about Dr being charged if prescribes branded instead of generic.
        johnep

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        • #5
          If it was a brand on EPS the AMP (Actual Medicinal Product) always has the brand name in brackets.
          This causes problems when there is a joint manufacturing agreement on a brand - there can be two AMP.
          One for each manufacturer.
          Most of the time the internet is full of daft opinions and views that you should not take seriously let bother you at all.
          Note : If this posting contains personal views or opinions every endeavour is made to ensure they stay within social media guidelines.
          If you find you have read something that has upset or offended you an anyway please unread it at once.

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          • #6
            Like you, I have never seen a script for Crestor PI (France). Therefore, we can conclude that the GP merely wants her to have Rosuvastatin. In the instance where the patient preferred a PI (we had one who wanted PI Coversyl!), the GP cannot stipulate. The Rx would always read Crestor (AZ). The patient wants a UK pack. For the sake of compliance I would supply. We have 2 patients who want the orange box for the 10mg, couldn't give a hoot if it was from Mongolia, as long as the packaging conforms to their colour scheme.
            We had that nonsense with a patient wanting Bisoprolol 2.5mg Tabs (Teva), because her Consultant told her, don't you know. We always dispensed Cardicor. OK, no problem, let's clear this up. I will phone your Consultant and ask him his rationale. Reason is, the Hospital pharmacy will give you what they have. They will not be dictated to, so to help you in the long run, I will make the call. Please don't bother. So, we have established that you want this brand, nothing to do with your Consultant? OK, I will obtain them for you. In future, don't mess about, just ask, if I can help I will.
            On the Tenormin/Zocor front, patient wanted Lipitor. He was not one of our patients. In the end, he convinced GP to prescribe it privately. This Rx was brought to us. Had a word with him. You can pay £1 per day or I can give you this box (Almus), made by the same company, see, it says Pfizer on the blister, which will cost the NHS £1 per month. What would you like to do? You can guess the answer.

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            • #7
              "Don't fob me off with cheap generics, they don't work" often causes problems.
              Used to happen a lot when 'the leading UK chain' gave out the brand routinely.
              Then they used to come back and complain about the waiting time and lack of any warmth or welcome.
              Most of the time the internet is full of daft opinions and views that you should not take seriously let bother you at all.
              Note : If this posting contains personal views or opinions every endeavour is made to ensure they stay within social media guidelines.
              If you find you have read something that has upset or offended you an anyway please unread it at once.

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              • #8
                Pta seem to think that no medicine costs more than NHS charge.
                johnep

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                • #9
                  To be fair, when Salbutamol first came off patent there were complaints of a ‘difference', and I didn’t believe them. Then my son, a Ventolin user, complained that there was a difference, and convimced me that in spite of my assurances there was a difference. So I made furrther inquiries and found that there is a difference..... or was then ....... in particle size between different manufacturers. The spec said some thing about the particle size being no greater than or something like that. There was also a similar standard for propellent quality.

                  So, I wonder if the likelihood of side-effects with Rosuvastatin is affected by something in the fillers. Don’t see why, of course. And agree with Spaceghost1; chances are they’re all .... British, French and Mongolian ....... made on the same production line.
                  But there are more things in Heavan and Earth.........

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                  • #10
                    I'm sure we have all been in the situation where patients are used to a certain brand, and some pharmacies supply brands as standard and then there's a switch to generic and they aren't happy. In that case I explain to them that the NHS pays us pennies for the generic so that is what we must supply and the dr must prescribe by brand if they want it.

                    But having someone complain about the SAME BRAND but because it is a PI is rare, and I am still unsure on the legal aspect of supplying a PI if it is written as UK on the script which I always assumed to just be an automated thing and something I have always ignored. As far as I am concerned it is still the same brand no matter where it has been imported from, and legally is that correct?

                    As Pharmanaut has mentioned it sounds like the AMP is caused by the EPS system and will always state the manufacturer even if prescribed generically, and I have always ignored that.

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