Hi All
My husband Ted (on 800mg Glivec), has always been prescribed 3 months supply at a time. Now, according to the Pharmacist, Novartis are only allowing one month at a time to be issued. Has anyone else heard of this?
Cheers
Bee
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Glivec for only one month at a time?
local hospital (Royal Berks) have always only given me 1 month at a time, and I have to go and pick it up at the hospital pharmacy every month, which is a PITA
I actually get a prescription (free now anyway so not that it matters) for 3 months at a time, just they only give me 1 months supply at a time.
Always assumed it was a local pharmacy regulation thing and nothing to do with Novartis, somethign along the lines of the costs of the drug and not wanting the patient to loose so much in one go... I cannot understand how a company could dictate to the NHS the prescription length of times, nothing to do with them.
When I was on glivec, It used to be delivered one month at a time by bupa.
The consultants told met that it was cheaper for the hospital to have bupa arrainge delivery, than have me pick it up from the pharmacy.
Apparently if bupa delivered the drugs, then the hospital did not pay vat.
When I asked further the consultant just shook her head & said not to ask.
Ask at the hospital about home delivery, it might solve one problem for you.
As for the amount I was given, it did go down to monthly, once deliveries started.
Bob
Hi All
Ted has been on 800mg (in 3 monthly prescriptions) for 5 years and collecting it from our local pharmacy for over 2 years. Apparently it became cheaper for us to do this than get it from the Hospital pharmacy (something to do with the VAT)? Never ever had any change to this until now.
It definitely says on the label "Novartis will only supply one month at a time" so we have been wondering if it is maybe something to do with Glivec nearing the end of it's patent or whatever? This is not a problem at the moment - but we like to find winter sun and sometimes stay 6-8 weeks away if possible.
I used to get two months suppy when I was on Glivec,I got it from the co op pharmacy,I think your pharmacy wants to stock one month supply at a time to save money, not much change out of 10k for 3 months supply.
Over the last 4 years I have been given 6 month's supply of 400mg tablets with two exceptions when the hospital pharmacy did not enough in stock. However, last week I was told by the consultant that they could no longer supply 6 months dose in one go so there has obviously been a policy change.
In fact, he has changed me onto 200mg tablets (see Post on reducing dosage) and they did supply me with 4 month's worth. At the moment, I expect to be staying on the 400mg dose and, if so, I only have 2 month's supply and will then require a new prescription. Johnh
Just a question, does your NHS system pay for all your CML requirement, no hassle?
I am in South Africa, I am on a very good medical aid (common practice in SA although quite expensive) and they pay for it under chronic care, I would hate to have to go through our government health care. I've seen the queues at our state hospitals and heard what people have to go through to get chronic medication
Well - it can be a bit of a lottery depending on where you live in the UK - although Glivec is the front line treatment for CML and I don't believe anyone has a problem having it prescribed nowadays.
However I believe with some of the newer cancer drugs, folks can have a hard time getting them through the NHS if their particular Health Area can't or won't finance them or they've not been approved by NICE....Sometimes this has stopped people moving around the country with their job etc.
Also contrary to popular belief - the NHS is not a "free" Health Service. Everyone working between the ages of 16 and 60-65 will be paying a percentage (I think its around 10% or maybe a bit more) of their wages)and until you are 60 you have to pay prescription charges as well and there are many parts of the NHS where you actually have to pay for your treatment.
Taking effect in April 2009 Cancer Patients are no longer charged for prescriptions.
see my post under 'essential reading' on right hand of this page.
I will try to find out about the reduction in the amount of drug prescribed at any one time.... I agree with Rob that it would likely be to do with the PCT/hospital trust rather than the pharma co.
Sandy
I get 12 weeks supply of 400mg regularly. When I was going on a long trip my specialist prescribed extra so I could take some spares to mitigate any risk from lost baggage, but these were subtracted from my next prescription. Have had one occasion early this year where the hospital pharmacy did not have sufficient supply, but got them in a few days. Too much of this is about where the budgets are held in our "patient centric" NHS.
Alastair
It does seem as though there's a variation of how much Glivec is issued at a time.
We now realise that our designated local pharmacy has recently been taken over by Boots - wonder if this can be a Boots policy? but the label definitely says "Novartis"...
Sorry I forgot that cancer patients don't have to pay prescription charges now. Ted hasn't paid since he was 60, so have been out of the loop.
Kurt, the queue's at our NHS hospital are not bad at all nowadays. For instance, the blood tests and the PCR sample are done at 12.30 and the consultant appointment is at 1.30, giving an hour to get the results back for the blood counts etc and the PCR to be sent to Hammersmith the same day. There is not usually a delay in clinic, unless they have an emergency - once someone broke their leg - don't ask! Nowadays we don't have to hang around for an hour or so to collect the Glivec from the hospital pharmacy, so we're usually done and dusted by 2.00pm. Much, much better than when everyone used to have, say a 1.30 appointment and be there all afternoon. Does this still happen anywhere?
Until last year I was a hospital Pharmacist, perhaps I can shed some light on this, and also relay what arrangements are made for my wife's supply of medication.
a) The issue of quantity supplied if through a hospital pharmacy may be down to local policies - I would have thought that the consultant haematologist would be aware of the policy applying in their hospital. There may be issues with the amount of medication actually in stock at any one time - as a very high cost drug, the hospital pharmacy would NOT overstock, but would attempt to have an initial supply available and then obtain further supplies as necessary.
b) Many hospitals are now prescribing Glivec on a prescription form which is taken to your local community pharmacy (chemist) - the reason for this is has been mentioned, it is the matter of VAT.
The following may seem ludicrous to us mere mortals, but customs and excise officials deem prescription medicines supplied to patients from a hospital pharmacy are subject to vat, however medicines supplied on prescription from a community pharmacy are vat exempt. (This becomes a real issue with high cost medicines)
Therefore the hospital / trust saves 15% vat if the consultant prescribes on a prescription form which can be taken to your local chemist. However, your local pharmacist will NOT be able to dispense medication prescribed on a hospital prescription form.
In my wife's case, she gets seen every three months at universit hospital of Wales in Cardiff, and is prescribed enough for three months on each visit, we then collect from our local pharmacy (takes them a couple of days to obtain - they dont keep such expensive drugs on the shelf)
Prescriptions charges do not enter the equation - there are none in Wales for anyone. As has been mentioned, prescriptions should now be exempt from charges in England if they are for persons suffering from any form of cancer.
Hope that this is of help
Paul
Thanks Paul, for that clear and concise explanation - we knew there was some reason about the VAT.
We are now going to speak to the Pharmacist at our "designated community pharmacy" (now a branch of Boots) and see what they say about reverting to our usual 3 monthly supply. (Even 2 months at once, would be OK for us). It always took a week for them to obtain the drug, as they don't keep it in stock.
We'll also visit an independent pharmacy and ask there about a 3 monthly supply. We'd change if necessary. ("Healthy Competition" and all that)! Will let you know what happens........
Thanks for all the replies.
Bee
I get 12 weeks' supply with no problems from my local Boots pharmacy. My hospital advised the crazy VAT situation a couple of years ago, so the hospital sends Boots the prescription and they get it straight from Novartis in a day or so. My understanding is that Boots don't care about the cost, except that they get a percentage rake-off. I can perhaps understand the NHS wanting to restrict supplies, but why would Novartis have any incentive to do so?
John
26.11.09 Boots have told me that Novartis have sent only one month's supply. They speculate that it is due to production problems, but they don't know.
I'm not able to access Boots as I live rurally and so use my local independent chemist. My oncologist gives me three separate monthly prescriptions as the local chemist can't finance all three at once! This gives me no problems as I can always take a prescription with me when I go away and cash it in elsewhere.
I take Dasatinib which now arrives by post to the pharmacy, but when I was on Glivec, a courier (armed?!!) used to arrive in our village with three months supply!
Vickie
It is a long time since my last post but thought I should mention my position regarding supply of Glivec.
Worcester Royal Infirmary have arranged my delivery of Glivec at 3 month intervals via BUPA and I recently received a letter from them giving the delivery dates for the next year. It is all very simple and long may it last.
Interestingly, I never go to Worcester for my 8 week checks but see Charlie Craddock at the QE in Birmingham so my drug deliveries are very much on trust. I am also always asked at Birmingham if I want drugs there and they would provide Glivec to last until my next appointment.
It would seem that it is very much down to the Local Health Authority.
There has been a lot of discussion about prescriptions for longer than 1 month in the Thyroid Association magazine where they suggest that it is purely a Health Authority issue and that patients should request prescriptions from their GPs for longer periods based upon the stress of having to obtain drugs 1 month at a time for conditions that are long term.
Regards
Phil & Babs