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Isosorbide Mononitrate - A Perfect Storm?

19/2/2013

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These days there are always products going in short supply - due to a variety of reasons: quota, manufacturing problems, distribution issues etc - and pharmacy staff are spending considerable time and effort attempting to obtain supplies of these drugs for patients or liaising with prescribers to get an alternative product.
 
On rare occasions, however, a perfect storm occurs...a product goes short that is really difficult to replace and this time it's isosorbide mononitrate...
 
We have been told that the 20mg tablets will be unavailable until May, so pharmacies are struggling to meet demand with 10mg and 40mg tablets. The problem is that these products are obviously getting very expensive (if you can get them)...at the time of writing I've just bought some 10mg tablets for £19-97 for 56 - and the Drug Tariff reimbursement price is £1-74 (cat M)...I was glad to here that it has now gone NCSO so that pharmacies will be not be considerably out of pocket!
 
Adding to the problem is that modified release products and the dinitrate are in short supply, so It's likely that patients will be referred back to prescribers in droves soon for alternatives - adding more complexity to the situation.
 
Make sure you keep an eye on our home page for information and local guidance.

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Should we offer self selection of P medicines?

11/2/2013

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The GPhC has made a recent decision to allow the self-selection of P medicines as part of its new standards for registered pharmacies...and this is a very contentious point...
 
On one hand, the self selection of P medicines could be seen as "in the interests of consumers and patients" as it allows them access to the medication to consider a potential purchase - and still gives pharmacists an opportunity to refuse a sale if it would not be appropriate.

But on the other hand, P medicines are P medicines because they have been classified as such to protect the public - they usually have potential for harm (large packs of paracetamol for example), or might be dangerous in other ways (side-effects, interactions etc.).
Putting them onto open display and into the hands of customers may make the decision not to sell very difficult - possession being 9/10th of the law - and all that...is this in the public interest?

Please have your say below on our online vote.
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Good will gesture that ends up with pharmacy working for nothing...

4/2/2013

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Yesterday we did a prescription for a number of items for a patient...then today that same patient came in with a fourth item...
 
The problem here is that one of the items dispensed yesterday had been stopped by the GP, but had been put on the prescription in error - and the patient pays the prescription charge!
 
So, she wanted her money back...as in her mind she had paid for a product that she can't use and had returned it...??
 
So here we have another moral dilemma - do we refuse to give a refund bearing in mind the product has left the pharmacy and will need to be destroyed...and anyway we did our job and it's reasonable to be paid for our labours; or do we shred the previous prescription, dump the stock, and give her the prescription charge back?
 
The fault here actually lies with the surgery, but as usual pharmacy loses out either way - loss of good will; or working for nothing and loss of stock?
 
What would you do in these circumstances?  (Vote Below)

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