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From: [log in to unmask] on behalf of TreforR
Sent: Monday, March 09, 1998 01:15
To: [log in to unmask]
Subject: Re: Shotgun marriage
In a message dated 08/03/98 00:37:42 GMT, you write:
<< For example, there IS an alternative to Losec. Lansoprazole (Zoton) and
pantoprazole (Protium) are cheaper at full strength doses. And I assume the
high spenders have made some effort to switch their patients on maintenance
doses to half strength? >>
>Yes and all the other things that should make me a good boy. All these things
are set against an average and that will be ever decreasing, the harder we
work. We are thus on a hiding to nothing all round.
>Trefor
IMNSHO prescribing economically is part of our job as GPs. And will become
increasingly part of the job with the advent of PCGs.
What average? Our prescribing budget has never been determined by the
"average". When we started fundholding we were 30% below our county "average".
We would have made wonderful pots of money if we had been given an "average"
budget !
However, there is a fallacy to my arguement, which has nothing to do with
averages.
My understanding of the system is this:-
Drug companies set the prices of their products, and these prices are agreed
in advance with some government body somewhere. Expensive drugs are priced
expensively to cover R&D, and to allow for profit on top. If a drug is used
widely, prices should eventually fall. If the drug flops, the company is
allowed to INCREASE PRICES OF THEIR OTHER PRODUCTS to make up for the
investment/profit loss.
This price fixing is a secretive business. I read about it in an article a few
years ago, and was angry to think that the responsibility for high prescribing
costs for the country as a whole was being laid at the door of the
prescribers, when, in fact, prices were being decided centrally, by some
committee.
Perhaps someone on the list knows more about this than I do? Am I wrong, am I
right, does this price fixing happen, or not?
--
Ruth
http://www.stamford.co.uk/littlesurgery
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