Ask GP to prescribe best drug rather than cheapest?

[ChampagneLassie]

After considerable pushing, GP has prescribed lansoprazole for my severe reflux baby.

He's prescribed 1/4 of a tablet a day and suggested I cut tablets into 4 and put the tablet under DD tounge to dissolve. The tablets crumble on cutting. The box says not to cut or crush. if I put this in her mouth like this I fear she may breath it in / or just spit it out.

He told me to see how I get on and if I struggled he could prescribe in liquid form, but I'd have to try tablets first as the liquid is £100 a bottle. I asked if I could just pay that as I just want best for DD and he reassured me to try tablets. Obviously NHS doesn't have the option to just pay for best drugs 🙄

GP now on leave for 2 weeks (we'd agreed good amount of tkme for me to try!)

I had imagined from what he said the tablets were more like stamps designed to dissolve under a tounge, not a normal sort of tablet.

WWYD - do as suggested?

• crush tablet and try like that?
• contact GPs again Mon and demand liquid form, highlight chocking risk (perhaps reading between lines GP was telling me I could ask for drug just he was obliged to prescribe the cheapest one first 🤷‍♀️(another Dr will need to prescribe)

It makes me mad and sad the way the NHS is mus-managed and false economies. Surely another Dr appointment costs more than £100. Why not have option to provide more expensive drugs if people are able to pay.

This just highlights the importance of good communication from doctors. Doctor has actually prescribed the best option for the situation but due to poor communication, the mother is stressed, seeking advice from random strangers and has lost trust in the GP.

I had similar situation. I ended up paying privately for a paediatrician who prescribed liquid omeprazole, I then took the prescription to my GP and asked them to continue the prescription which they did.

However, I tried the tablet omeprazole first. It didn't work, but I would suggest at least trying it first. There's no harm, baby may not even need the liquid! Don't waste NHS money just because "you want the best" - surely just getting your baby comfortable is the most important thing.

Very true.

This is helpful. I want the best in so much as I want whatever is best not making do with an inferior option for sake of £100 (GP left me with impression that was the case...he explained about liquid and cost, I didn't ask, if he'd just told me about what he was prescribing it would have left less ambiguity).

Thanks all I feel reassured to try in the way prescribed and I'll mix in water if that doesn't work. And buying a pill cutter

My son was prescribed the omeprazole liquid. It has to be specially made and kept chilled even in transit. It used to arrive with the pharmacy with a little chilled jacket on. The pharmacy said it was very expensive.

That's nothing new with all treatments even cancer care, you don't necessarily get the best, they'll do their best with what is on offer.

It depends on the budgets.

Ten years ago a colleague collapsed, in hospital they administered a drug, the patients friend a private nurse asked why weren't they using the better alternative medicine as she had gold star health insurance.
She was given the alternative medicine unfortunately it didn't work either.

Unless you have private insurance.

I'm shocked GP's don't get paid per patient per year, it must be frustrating seeing the same people using up many appointments.

I'm not sure how it works in Ireland, low earners or unemployed people have a medical card for free GP visits, it is stopping GP's taking on new patients when it is €60 per visit for a non medical card holder.

£100 is probably the cost price. There will be other costs on top of it and remember this will be every month or however long the shelf life is. Can you imagine if they prescribed this for every baby with reflux? It's a common condition

No from I understand youd only dl this if it was serious but in any case I don't exoect NHS to cover I'd be happy to pay but that isn't an option. It's so mucked up. Having said that the responses made me feel that tablets might be better in any case. I'm frustrated at poor explanations from GP and a system where drugs are prescribed based on cost rather than most appropriate.

How did you get on with administration of the tablet? I'm struggling with the 'beads' that it dissolves into and them sticking to the syringe... Any advice?

My baby had lansoprazole for severe reflux. We used to dissolve the tablet in water and give in a syringe. Sorry I can't remember the measurements but your pharmacist should be able to advise. Definitely wouldn't be crushing tablets and putting under her tongue!