Medicines Optimisation discredited

Today I faced an impossible task – all down to someone who think they know about medicines optimisation.

A long term prescription for dononex ointment has been stopped – I have been told that the GP says it is now red-lighted on the formulary and they cannot prescribe it any more.

“ I can prescribe the components separately” offers the helpful GP. No you can’t! It would have to be double the steroid strength or half the steroid strength.

“what about application?” – put one on – leave for half an hour until it is absorbed and then apply the second. What!!!! – it is an ointment – it doesn’t get absorbed like that – is this what the CCG told you to say and is there any evidence for this?

“why don’t you mix them together” – yes bright idea on the dispensing bench. Or do we expect the patient to do it on their kitchen table or on their skin?

“What – you now want two prescription charges” well yes you now have two items.

“look – she has had this for ages – it keeps her psoriasis under control – can’t you just do it for her?” No says the GP it is banned you will have to take it up with the CCG – If I keep prescribing red list medicines I won’t get my prescribing incentive scheme.

Hmmm – had psoriasis for many years – admissions to hospital in the past (and very long stays) – controlled with a lot of effort down to probably 5-10% coverage and put at risk for a few pennies. She was a happy and satisfied patient.

I tell you – the world has gone mad – fast tricks and quick savings – medicines optimisation discredited. You know who you are – wise up – shape up – and don’t put us in this position again.



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