Jeremy, 

The quickest way to reap savings is to increase your generic prescribing, if 
you have not done this already.
If you have repeats on computer (I'm sure you do) then get your partners 
agreement and do the following

RUTHs TIPS for Changing to GENERICS

Brief - all reception staff, telephone staff etc, that you are changing some 
patients drugs to generics, and explain why. If the staff understand the good 
reasons for doing this, they will communitcate their approval to patients. If 
possible have some leaftlets on generic prescribing hanging about. Put up a 
brief notice in the waiting room, explaining some drugs will have different 
names, but the drugs themselves are unchanged.

Change expensive drugs first, look at your top 20 in the PACT standard report.
Change a few at a time, or the whole project will seem overwhelming.
Common culprits are as follows
Zantac -> ranitidine
Tagamet ->cimetidine
Losec 20mg -> lansoprazole 30mg(Zoton) or pantoprazole 40mg(Protium)
Ventolin inhaler -> salbutamol inhaler
Becotide inhaler -> belcomethasone inhaler
Combination diuretics -> co-whatevers

A very limited range of drugs should NOT be generic - nifedipine, lithium, 
anti-epileptics, 
Make clear to patients, staff and partners there will be NO OTHER EXCEPTIONS 
to the generic rule
(actually, I don't change patients over the age of 80 !)

If patients say, as they will do, "This doesn't work as well as as my usual 
....."
then I suggest the following approach.
appear to be very interested, ask for details, appear concerned etc.
Then firmly state that they visit the chemist to discuss the matter.
It is your responsibility as doctor to provide an appropriate script. If 
chemist decides to use cut price generics of dubious quality, in shoddy 
packaging, then that is the chemist's responsibility - NOT YOURS.

If chemists ring, as they will do, to say "Can you alter this prescription..."
say kindly but firmly "No, sorry,it is practice policy to prescribe 
generically."

Good luck !
Our patients (when they realised why we were doing it) were usually very 
supportive.
Two patients left our list.
-- 
Ruth
http://www.stamford.co.uk/littlesurgery




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From: 	[log in to unmask] on behalf of JMSager
Sent: 	Sunday, March 08, 1998 12:04
To: 	[log in to unmask]
Subject: 	Re: Shotgun marriage

In a message dated 07/03/98 18:34:23 GMT, you write:

>My point was, that whilst there are practices who are consistently
underspending their drug budget in our area, the health authority will be
unwilling to increase ours......it has never been set fairly, despite our
protestations and it is proving increasingly difficult year by year to make
any impact on our overspend for a variety of reasons. I'm not in favour of
penalising underspenders....just envious:-)

>On a more positive note a pharmaceutical advisor has recently suggested some
changes we could make to our repeat prescribing which may help, we'll have to
wait and see. Has anybody got any personal experience of surefire simple but
effective ways to cut prescribing costs? All suggestions gratefully received.

>Jeremy Sager
GP Shadwell Medical Centre
Leeds 





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