On Thu, 03 Oct 96 21:24:09 GMT, [log in to unmask] wrote:
>I understand that non-exempt UK residents pay a charge of 5.50 p for
>each prescribed item. I also understand that a considerable number of
>products cost much less than the present level of the charge.
>1) How can GPs resist the pressure from the patient to prescribe on
>"private" form or just to indicate the therapy that is then prescribed
>by another doctor?
Generally it is against our Terms and Conditions of Service for GPs to
write private prescriptions for NHS patients. Whether that applies to
this situation is arguable, but I use it to let me off the hook. One
problem is that we cannot know what retail price and private
dispensing fee a pharmacist might charge, so it is often impossible to
know whether the drug would be cheaper on private script without
ringing the patient's favourite chemist first, and I have better
things to do!
I can only recall one or two occasions when I have been asked about
it. One reason for this may be that only about 20% (I think) of
prescriptions are paid for - most of our customers are either under
16, over 60, below the income threshold or have prepayment
certificates.
>2) isn't there an incentive to prescribe very long therapies with the
>risk that the dispensed drug is not used?
Yes. We usually give 8 weeks supply for long term drugs. This is
partly for our benefit, to reduce the chore of prescription signing. I
understand that there is talk of allowing long term prescriptions to
be dispensed in installments by pharmacists, which sounds like an
excellent idea for all concerned.
>Also, is there someone who can tell me which are the main drugs that
>were blacklisted in 1995? I have found many articles saying that in
>1995 the blacklisted products were extended, but in no one I have
>found the name of the products.
All NHS GPs are sent a list of the blacklisted drugs but it is long
and I don't have a scanner! They are also indicated in the standard
references such as the British National Formulary (BNF). So far they
mainly cover things like benzodiazepine tranquillisers and the
blacklisted drugs tend to be non essential or "me too" drugs of
dubious value, so I can't say I feel restricted by the current list.
As I understand it the original list was imposed without consultation
with the profession and contained some serious errors which had to be
corrected. There have also been rumours of its extension to more
important areas such as contraception.
Dr David Evans
Cardiff
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