AIBU to think this is a silly waste of NHS money...

[LoopyLou1981]

Before I start, I’d like to say I love the NHS and this isn’t having a go at the Drs, nurses etc (it’s more of an admin thing).
My lb has been prescribed amoxicillin. The dose is 3 x 5ml per day for 7 days (so 105ml for the full prescription). In order for the pharmacy to fulfil this they have to give my 2 100ml bottles so I’m wasting most of the 2nd bottle. Now I understand that the dose for this medicine will be different for older children but this seems like a ridiculous waste.
Wibu to think it wouldn’t be that hard to make a 105ml bottle (or other convenient bottle sizes for other common doses)?!x

[Llanali]

And do you jump off the deep end like this in real life?! I genuinely can’t see that anyone said you couldn’t care for your kids. You must be seeing posts I can’t see.

[Spikeyball]

We had 3 bottles for a 210ml prescription but the 3rd bottle was only about half full.

In the past I've been told 6 days which keeps it to 1 bottle.

[CantChoose]

I just prescribe 100ml and explain to parents that the final dose doesn't matter enough to bother with a whole new bottle. 5 days of abx is adequate for most conditions anyway.

[user1471549672]

Very unusual 200ml being given for a 7 day course. In most cases a GP will prescribe 100ml.

[LoopyLou1981]

See CantChoose, now that makes sense to me!x

[LemonShark]

Yes I do! I can't imagine you do though, you wouldn't get very far.

[NeedsAsockamnesty]

Do you get given both bottles already made up?

Every time I’ve had on eof my kids prescribed it if it’s two bottles I’ve only ever had one liquid one given to me the other bottle is handed to me with a line on telling me where to fill it up to because apparently it doesn’t store well once the water is added

[LoopyLou1981]

Lemon of course I do. I don’t have to put people down to make me feel better. I find being nice to people gets you further in the long run.

Needsasock, yes both bottles are made up. I figured that was just how it came!x

[Spikeyball]

I had to get ds's 2nd and 3rd bottle a couple of days after the first.

[AcademicOwl]

Loopy don't worry; you are indeed tired, with two small ill people to look after. I'm not sure anyone was having a go at you, but don't feel upset by this thread. Have a cup of tea (or equivalent) and give yourself a breather. Small ill people are a tough gig.
As for antibiotics in bottles, it is indeed one of those things where it's about scale. Making millions of bottles of 100mls is cheaper than try to make 105ml bottles. Because antibiotic mix isn't like formula from a box :)
As for anyone thinking you get the exact dose; nope, that'd be crazy. You get more than is prescribed to allow for spillage, etc. And the fact that getting the last 20mls out of a bottle with a syringe is tricky.
Sending and hoping you get some rest, OP

[LoopyLou1981]

Aww thanks AcademicOwl...now I’m in tears again! 🙈
It just seemed like a good idea in my head and thought I’d share whilst stuck in bed with 2 ill bubs pinning me in 😂
As an aside...how do you tag people’s names in messages?! I can’t work it out x

[MakeMisogynyAHateCrime]

Was it dispensed from a pharmacy attached to a GP surgery or hospital etc.?

[LoopyLou1981]

No, there’s a pharmacy on the way back from the surgery. Our surgery doesn’t have one attached x

[SDTGisAnEvilWolefGenius]

@LoopyLou1981, you tag people in posts by putting @ before their name, as I have for you, or by putting an asterisk before and after their names, to put it in bold.

I believe that, if you use the @ option, and they have email notifications turned on, they get an email telling them they have been tagged (but I’ve never known if that actually works, as I don’t have the notifications switched on).

[madamginger]

My Pharmacy always gives 200ml if the script says 105ml.
The second bottle is waste once it’s made up, we can’t give the rest to anyone else.
We do however tell patients to throw the rest away.
The bottles also have extra room in them because you need room to shake the bottle to mix the powder and water..
This only applies to abx every other liquid you would get the exact amount the gp prescribes.

[LemonShark]

And in what way do you feel I've suggested you can't take of your kids? I'm baffled as to where you got that from or why you're kicking off?

[delusionsofadequacy]

The bottles arrive in the pharmacy as powder and have to be made up. My theory with the bottle sizes has always been that if they did 105ml bottles the water you have to add in would be a ridiculous volume like 33.567ml or something even harder to measure out.

They also only cost about 90p a bottle so I wouldn't worry too much about the cost!

[ImADadButThatsOKIsntIt]

The system for how the NHS pays for medicines is complex and archaic. It does however deliver some of the cheapest generic medicines in the developed world. The graph I attached and article linked show this.
onlinelibrary.wiley.com/doi/10.1111/1468-0009.12279/full
So the posters who argue the NHS is an inefficient buyer of medicines are incorrect. This is down to the nature of the community pharmacy contractual framework basically subcontracting out the procurement process to commercial buyers from pharmacy chains who are incentivised to push the price down. The NHS then plays catch-up and lowers the price they pay to the pharmacy to match what the pharmacy pay the manufacturer. At which point the pharmacy buyer negotiates an even cheaper price to maintain their margin, and the NHS plays catch up again. It goes awry when the price gets so low manufacturers drop out of the market because they cannot cut prices any further and things go out of stock.

Back to the 100ml v 105ml amoxicillin, 5ml three times a day for 7 days is 105ml, but most prescribers who prescribe by computer (and therefore quantity) will in this situation give 100ml because clinical experience tells them that the last 5ml dose is neither here or there and prescribing systems prompt to give a single pack. If however they do it by hand (common at a dentists) then often the prescription is written without a quantity, from which the pharmacist then calculates the quantity, hence ending up with 105ml for a 7 day course of 5ml three times a day. The pharmacist is then legally obliged to supply this quantity (and could in theory go to prison if they didn't). Re-constituted anti-biotics have a very short shelf life of 7-14 days, so the NHS recognise that it would be unfair for the pharmacy to make up a whole second bottle and take 5ml out because they would be unlikely to use up the remainder and be out of pocket. Therefore in this instance of 105ml, the NHS will reimburse the pharmacy for 200ml, the pharmacy may choose to just give 105ml either by adding to the 100ml bottle (ir a second bottle of 5ml) or giving 2 x 100ml and advising the patient to disgard the remainder after the 7 days.

[SDTGisAnEvilWolefGenius]

”The bottles also have extra room in them because you need room to shake the bottle to mix the powder and water.”

So would it be right to say that, if they put more in the bottles, as the OP suggests, @madamginger, they might not be able to mix the powder and water properly? Because there wouldn’t be enough room in the bottle to shake it well enough?

[madamginger]

Possibly, the bottles are mostly a standard size especially from the same manufacturer, so they will get them cheaper because they buy the same bottle for all there products, if you

[Ellisandra]

I find being nice to people gets you further in the long run

Then why have you been so rude to people who shared their experience and knowledge with you perfectly politely?

[madamginger]

Sorry....
If you make the bottle bigger this pushes the price up, both for the product and the packaging.
This is also why sometimes tablets come in ridiculous sized boxes and the blisters inside are tiny.

[LemonShark]

Ellisandra the irony is strong with this one. Not sure if trolling or just completely clueless. 🤷🏻‍♀️

[NeedsAsockamnesty]

As you have probably figured out by now it comes in a bottle with powder in it amd you have to add the specified amount of distilled water and mix

[madamginger]

They don’t use distilled water (or sterile), they use potable water which is tap water from a mains supply.