GP Practise, changing prescription for cheaper one!!

[birdladyfromhomealone]

. Im spitting mad today.
I have had a letter from my GP telling me the practise can not afford to pay for my cancer drugs prescribed by my Neurologist so as of next week they are changing my prescription for a different type which is cheaper for the practise.
I pay for my prescriptions £30 plus a month.
Who do they think they are?

It has taken months to get used to these drugs and they want me to change and get more side effects to get used too 😞 I am seeing the neurologist team at Kings on Monday afternoon for my 6 month check up so will complain to them and see if they will write to my GP.

Swelling is going down on my tummy now and no more bleeding.

I am having a mammagraph next week then get all my results on Aug 22nd at the Oncology unit at Royal Marsden. I have felt so much better this week.

But why should my doctor change my drugs that were rescribed to me BY AN EXPERT!!!

My practice has done this three times now with my contraceptive pill. It’s obviously nowhere near as important as yours but I agree it’s totally frustrating.

I have such heavy periods that I’ve ended up in hospital a few times. I trialled a few different pills and sent my body into chaos, I had hair loss, acne, weight loss/gain, it was awful. Finally found one that worked and they changed it.

It then took another couple of months to get used to the new pills so back to the mood swings, hair loss, etc. Then they changed it again. Repeat process. Then another change.

Not one of the changes has been like for like, this is clear from the ingredients and my body’s reaction.

A few medications you can’t switch between preparations due to being absorbed differently despite the same dose, however these are well known exceptions and most things can be switched absolutely fine.
There will likely have been guidance to make the switch for all patients in your area on the drug, and this would (hopefully!) not have been done if the switch would make any difference clinically.
I’d second the suggestion to let your consultants secretary know. Also if you let us know the medication I’m sure someone can give you sensible advice.

@GoatYoga I agree, I think it's best for OP to go and speak to her GP and her neurologist. Nobody can really comment if we don't know the circumstances.

Good for your gp. Changing to generic medicines from branded would save the NHS many millions of pounds.

OP, if you want any proper advice here you really need to say what it is you were on and what it has been changed to.

Even if it is a CCG decision there are ways that GPs can get round it. I take drugs for autoimmune disease which no ones why the work and brand is highly important. Mine were supposed to be changed, but the GP puts on the prescription 60 generic drugs (XYZ brand please). I get XYZ brand every time.
Even if you don't get exemption you should switch to a pre-payment certificate £10.40 a month for ten months of the year it is cost effective if you have more than 14prescription items in a 12 month period.

To be honest I think if someone insists on having a branded version of a medication when there isn’t a clinical need for that exact version snould be charged the difference to be honest!

I complained about being switched to a different, cheaper maintenance asthma med. Same formulation and dosage (allegedly), different method of delivery, gave me issues with my asthma after having pretty much zero issues since changing to my current prescription over 10 years ago, and headaches. Got my original one reinstated and back to mostly forgetting I'm asthmatic. This wasn't the UK, though, so reinstatement wasn't a big deal.

Generics really aren't always identical in every way to branded meds. I'd be bloody furious if this had been done to me over a cancer drug

Sometimes this sort of practice is a total false economy. SIL was on branded thyroid medication that worked fine, the prescription was changed unilaterally to a generic one which made her heart rate go haywire. So they had to put her on beta blockers, which more than wiped out the fairly minimal saving on the thyroid medication.

There was a thread recently concerning people who were experiencing awful problems with generic preparations of branded meds. All were making yellow card reports. Sometimes it does make a difference.

Why haven't you been given a FP92A form, exemption from prescription charges due to health? Dh was handed one with his first thyroxine prescription.

I wonder if some of those who report problems with generic meds would have had them if they hadnt been aware of the change. cant underestimate the placebo effect.
OP we cant really help unless you tell us what the medication is

MirriVan you read my mind!

It's probably not the GP. Every few months someone from the CCG comes in and changes a load of medications to unbranded / cheaper new alternatives. We are allowed to change them back IF the patient has tried them and didn't get one with them. Some people notice the change but most don't have any change to symptoms as the ingredients are rightly regulated.
In this case it's probably just a different brand of exactly the same med but without knowing the names it's impossible to tell. Call the secretary of your neurologist and ask them to check whether the neurologist is happy for the change or not. No need for high drama.

These situations are so often so distressing and upsetting to patients and I am sorry you are caught up in a medication change.

However, I really don't think that you understand what drives these changes. Please speak to your GP - don't go in with all guns blazing, but seek to understand what has happened.

Trust me when I say overworked and underresourced GP surgeries need the work load, the upset and the inevitable fall-out when people are upset and angry as you are and always blame GPs/individual surgeries for processes that are Healthboard or government driven.

And as to 'specialists know best'? Don't make me laugh.

The active ingredient is identical between branded and generic meds, the inactive ones often aren't. Some drugs must be prescribed by brand because of differing bioavailability, the vast majority don't.
You need more information first of all.

You also need to think about whether you think it is worthwhile changing medication to equally effective but cheaper ones is worthwhile if it keeps another, I dunno, oncology nurse in a job rather than reducing services so you are allowed to not even try an alternative drug.

The pot of money is dwindling and all of us have tough choices to make.

I keep hearing 'I know the NHS is on its knees, but..." followed by one that particular individual should be an exception

3rd paragraph should of course read 'don't need..." - oops.

But there was a box for it on the form. Also one for conditions caused by previous cancer treatment.

www.nhsbsa.nhs.uk/exemption-certificates/medical-exemption-certificates

They be a generic or a biosimilar. In either case the NHS guidance would be to use the cheaper version. These drugs are essentially the same as the brand name originator and can save the NHS millions if used instead. However a letter from your GP re you changing your cancer medication is pretty poor form. Make an appointment and go in and speak to them so you understand what is being done and can make a reasonable objection if there is one.

If you can give the name of both medicines I can tell you if they are generic / biosimilar and originator or not.

It is highly highly unlikely your £30 comes anywhere even remotely close to covering the cost of the medication. Cancer treatments are £££££££

This is for epilepsy, but I would imagine that cancer drugs should be treated the same as they're not just taken occasionally

Cancer drugs are nothing like AEDs and do not need to be treated the same.
There are very very few drugs that you can't swap for generic. It's not even all AED's, a lot of them are fine for generic as well, its just a few particular types.

Anecdotes are not helping the OP. The only way to get resolution is to speak to someone who knows her medical history and can explain the decisions that have been made.