More rigorous checks on BMI from pharmacies on the way

[IrisPallida]

It seems the era of filling in an online form and a photo of someone else is soon to be over. Unsurprisingly far too many people with eating disorders and normal or slightly overweight BMIs are managing to order WLI using the current systems in place.

The National Pharmacy Association is recommending that "a two-way consultation with the patient lasting at least 20 minutes is needed rather than relying on online questionnaires to access drugs such as Wegovy or Mounjaro".

https://www.bbc.co.uk/news/articles/cd9qyd7wd1wo

I know it will be frustrating to a lot of people who genuinely can benefit from these drugs, but I can only feel this is a good idea safeguarding vulnerable people.

But I also feel that they will still find a way around it if they want it that badly

Sounds reasonable. These medications are life changing for those who genuinely need them, but showing ID and a photo (both of which could be of anyone let's be real) isn't providing assurance they're not being abused. Of course someone could buy them on behalf of someone else, but at least it means the pharmacies are taking reasonable efforts to try and ensure their safety.

It will be interesting to see if the GPhC are moved to act in response to this letter from the NPA. I wonder if pharmacies will have the capacity to do 20 minute video consults for all customers, it might result in delays and rising costs. But, that is essentially self inflicted, as the pharmacies could have been doing more for due diligence from the start. I have no issue with pharmacies being required to do more thorough checks before prescribing.

Wonder how this will impact those who have reached a normal BMI and want to stay on a low dose. Their weight won't be high enough in any consultation.
Are they meant to just put weight back on again? 🤷🏻‍♀️

If they are with the same provider that they were approved with a qualifying BMI then they will be on a maintenance programme. The guidelines are for those starting these medications, not throughout.

Changing providers might be harder, if your BMI is lower than the initial criteria, but you may just have to show a lot more evidence of previous prescriptions and original starting weight.

20 mins is a waste of time though. They should install machines in boots where it scans your face and measures weight and then you get a code you can use at the pharmacy to confirm your weight has been checked. But otherwise just trust people ffs! Clearly you can take it below BMI 30 as many people do with no problems. I honestly couldn’t care if some influencer takes it to get extra skinny - she would probably manage to get it somehow even if they were super strict.

It will reduce price competition between UK providers (and so increase prices) as switching is going to become a lot "stickier". If they have to do an initial 20 min consultation, providers are also likely to start locking people in to say, minimum 3-6 months supply- otherwise it's not worth their time if they do the consult and then people just jump around for the LCP every month. Or they will charge for the consultation like a normal private doctor.

I think they need to tread carefully here. King Canute springs to mind, especially once these drugs are available in tablet form - the potential for a black market is (I'd argue) unprecedented for a prescription drug that doesn't get you high.

It’s just an argument and proposal. Clickbait. It really doesn’t mean it will be implemented, the cost would be enormous due to the number of staff required. And mean a lot of folks can’t afford it, so I doubt it will ever be approved as the government wants this available.

what they will do is look at the stats, in terms of people getting seriously unwell. And dying, as that is so very low, the only thing that will happen is starmer telling gp’s to review again like he did last time.

this isn’t going to go anywhere.

Also remember the nhs said 12 years to roll it out, and that’s with a 5 min consultation. Logistically this proposal would mean enormous costs, huge, due to the staffing required, and the goverment really needs it to be available as it will take the pressure off the nhs.

it’s taking a sledge hammer to crack a nut, as legit pharmacies aren’t the issue, it’s the black market and dodgy product from hairdressers or tik tok.

as said it will due a death like last time, starmer will just say gp’s to check.

This won't be up to the government and nothing to do with 'starmer'. This is being requested and required by the pharmacy regulatory bodies.

Who absolutely have actual access to the 'stats' which, to put it bluntly, we do NOT and therefore we cannot say they are 'low'. They are basing their recommendations on the figures available to them.

And yes, the cost will have to be passed on to the consumer. That is what pharmacies do with all their costs.

This is nothing to do with the NHS rollout.

When I ordered my photo had to match my passport picture. That’s Med Express. A photo of someone else wouldn’t work.

@SilenceInside I had to send three photos and have a chat and answer questions when I recently had a review as I am now (just) a healthy BMi, or just above.
I am never going to be able to change providers I don't think 😆 I'm stuck with expensive Voy forevermore!

I think you’ve misunderstood, the npa has written to the gpc to request this, the point I’m making is it won’t be permitted for the reasons stated. Of course the gpc will liaise with the government before putting something in which will mean the drugs stop being rolled out as they are.

and of course it relates to the nhs roll out, it would take them even longer,

I understand you maybe want this, for reasons only you know, I’m ok either way, so looking at it cold, they won’t stop people getting the drug if they need it and already on it, due to risk to health, they will understand the costs, and the fact it means people won’t be able to afford it.

we can wait and watch, but I guarantee this will be rejected, after they asses it for the next couple of years.

Have you read the proposal and who it is from.

becuase they are right this shouldn’t be prescribed without meeting the correct clinical guidelines and I suspect the worry is liability for those that slip through the crack

I imagine the cost would be to the consumer - and there is a model there from Covid testing and how that worked online and the potential workforce there

Yes of course.

Of course the gpc will liaise with the government before putting something in which will mean the drugs stop being rolled out as they are.

I wonder if you realise that this is to do with private prescriptions from prescribers who work for pharmacies, and nothing whatsoever to do with the NHS or the government?

If someone gets their prescription from their NHS GP, then obviously it is a completely different situation, and one that WILL NOT be affected by these recommendations. How can it be? Please read the article. No-one is stopping any sort of government or NHS roll out and it does not concern either of those bodies.

I just can’t believe it isn’t already this way - we limit ibuprofen/paracetmol etc already and it makes sense to me that some kind of interaction should be needed before any type of prescribed drug is given

online forms kind of make it on the way to black market anyway

Good, this drug isn't risk free

@Tiswa the "limits" on ibuprofen/paracetamol are very basic and exceptionally easy to circumvent. I can visit several high street stores and buy a dangerous quantity of paracetamol in no time at all with no one being any the wiser. And paracetamol injures and kills many people every year, whilst only providing a mild pain killing response. In contrast, I had to provide proof of my weight, all my medical/personal details, and my GP was informed of the prescription for Mounjaro.

Online providers do need to show due diligence, and the majority do put in place various levels of checks before prescribing. This is in line, or more diligent, than the checks that are done on other prescription only medication that's available online. The WLI are the ones that grab the headlines though, as they are currently massively increasing in their uptake.

Apparently Voy are now price matching if you email them, or if you click to cancel they will offer you £50 off. Guess they don't want to lose customers..

Same for me, I'm with juniper but only had a bmi of 28 to start with - I looked at Oushk but they want a full body photo with face showing and I don't want to do that.

Il be having to stick with juniper i think but it's over £200 a month.

Yeah, that's not going to happen.