Author Topic: Slightly Sinister Development, Or?  (Read 318 times)

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Offline Dr DeEath

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Slightly Sinister Development, Or?
« on: 30 January 2018, 01:30:40 PM »
I had a call from  someone who was in the same support group as me twenty years ago. He is coming up to 50 years on insulin. You may recall that I have had some fun and games with repeats and now have to do smaller requests (approx. 4 weekly) as I get 56 days of one drug, 84 of another, etc. The new administration team leader doesn't seem to like you getting a prescription every 56 days and the 84 day one two times out of three. Add the anti-anginal every 28 days and I think they are more confused than I am. Anyway my friend has had a similar bit of messing about which seems linked to micro-management of spending. However, last Friday he received a letter saying the practice was reviewing all patients that get repeats of blood glucose strips. The review is being done by an outsider (!) when I would have thought is should be one's GP, consultant or DSN. Each patient has to attend and will be reviewed prior to getting an upgrade to this company’s preferred product. My friend has delved in LinkedIn and found they are a pharmacist turned sales executive. To me it smells – what do you think?
T1 for over 50 years.  MDI on Porcine insulin.  Lisinopril and Atorvastatin.

Offline himtoo

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Re: Slightly Sinister Development, Or?
« Reply #1 on: 30 January 2018, 01:51:55 PM »
definitely has an odour about it.......................fortunately I still get my prescription every 4 weeks -- that sounds a nightmare with your repeats
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 06/2013 6.1 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
Dafne grad. necrobiosis lipoidica on legs
laser treatment on both eyes 2002 and 2012, injections left eye 3 , wearing Noctura mask since oct 2014

Offline Pattidevans

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Re: Slightly Sinister Development, Or?
« Reply #2 on: 30 January 2018, 03:31:04 PM »
I had a call from  someone who was in the same support group as me twenty years ago. He is coming up to 50 years on insulin. You may recall that I have had some fun and games with repeats and now have to do smaller requests (approx. 4 weekly) as I get 56 days of one drug, 84 of another, etc. The new administration team leader doesn't seem to like you getting a prescription every 56 days and the 84 day one two times out of three. Add the anti-anginal every 28 days and I think they are more confused than I am. Anyway my friend has had a similar bit of messing about which seems linked to micro-management of spending.

I can only tell you what my opinion is based on at least some inside knowledge gained as a member of the Patients Panel Group of how surgeries work regarding drug prescriptions.

All surgeries are bound to stick to their budgets for prescribing.  Good surgeries will do their best to minimise their spend if possible by several means e.g. finding the same drug cheaper from a different supplier/drug company and specifying that make on the script (hence you may see your out of patent drugs such as Levothyroxine, from a different supplier from time to time). 

The wastage on prescription drugs is horrendous and costs the NHS many millions of pounds.  Mostly this occurs because either the patient puts the repeat prescription management in the hands of their pharmacy, who then continue to request the drugs whether they are needed or not.  For example, for a very short time I let the pharmacy manage my repeats.  Like yourself I get drugs prescribed in different amounts e.g. I get 55 Liothyronine tablets at a time and I only take a half tablet daily.  Others come in 28 day repeats.  The pharmacy were ordering ALL my drugs every 28 days, so after 2 months I had 220 days worth of Liothyronine.  Meantime,  if for whatever reason (unlikely but not impossible) I may be taken off that drug, it could leave me with a huge supply of a very expensive drug that would be completely wasted.  The other problem is patients themselves just asking for repeats of drugs they have ceased to take.  It's something that was on discussion at our last meeting last week.  The Patient panel are now producing leaflets and posters to put up in the surgery asking people to think before requesting drugs.

Quote
However, last Friday he received a letter saying the practice was reviewing all patients that get repeats of blood glucose strips. The review is being done by an outsider (!) when I would have thought is should be one's GP, consultant or DSN. Each patient has to attend and will be reviewed prior to getting an upgrade to this company’s preferred product. My friend has delved in LinkedIn and found they are a pharmacist turned sales executive. To me it smells – what do you think?

Test strips are a large expense and indeed some people will be getting them prescribed who either don't use them, or do not use them appropriately.  I think it highly unlikely that they are looking at restricting access to test strips for T1 diabetics.  However, there will be a economy of scale if your particular surgery (or in fact the CCG that your surgery is under) has negotiated a deal with one supplier of strips and it sounds very much likely that this is what is happening at your surgery... or it might just be that the review is being done by a rep in order to ascertain how much of a discount based on usage he/his company can offer.  Or, it could be that a hardworking and hard pushed surgery doesn't have time to physically administer the exercise.  So I don't think it is necessarily a shady deal.  However, I know it has happened at other surgeries and that some of the meters/strips on offer have been disappointing or unreliable compared to those supplied by the more mainstream manufacturers.  My surgery did a deal some years ago for the Wavesense Jazz.  AFAIK it's a decent meter, but it's not for me because my meter is the handset of my pump and so I need Accu-Chek strips.  I have had no problems continuing to get the AccuChek strips prescribed.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.


© 2015 Patti Evans

Offline Paulines7

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Re: Slightly Sinister Development, Or?
« Reply #3 on: 30 January 2018, 05:32:31 PM »
About a year ago, our surgery stopped issuing strips.  The patients as far as I know, as I am one of them, knew nothing about it.  The first time I knew was when I didn't get the strips that I had put in for on my repeat prescription.  When they weren't there I rang the surgery up and was told they had stopped issuing them due to the cost. 

I then spoke to the Manager and said that I relied on them as I did not take medication for my diabetes but relied on diet alone and I needed to test my blood at various times especially when eating anything new.  She said she would speak to my GP.  In the end they decided that I could have strips so I could test, but I would need to have a different meter as the strips for those were cheaper.  I was then given two new meters, strips to go with them and have had no problems since. 

I suspect that your surgery could be doing a similar thing, Dr DeEath.

My meds were out of sync but I put a note on my repeat form asking if I could have 56 instead of 28 so I could order them all at the same time and not have to do one halfway through.  They duly obliged.

Diabetes Type2 diagnosed March 2014.  Treated by diet only.  HbA1c 60 on diagnosis, 52 in June 2014, 50 October 2014, 44 December 2014, 48 May 2015, 50 Sep 2015, 53 Jan 2016, 50 Oct 2016, 56 Feb 2017, 50 Jun 2017. 50 Aug 2017. 47 Feb 2018  Pacemaker fitted 2008 - replaced 2017.

When I get old I don't want people thinking
                      "What a sweet little old lady"........
                             I want 'em saying
                    "Oh Crap! Whats she up to now ?"

Offline Pattidevans

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Re: Slightly Sinister Development, Or?
« Reply #4 on: 30 January 2018, 06:51:17 PM »
Quote
About a year ago, our surgery stopped issuing strips.  The patients as far as I know, as I am one of them, knew nothing about it.  The first time I knew was when I didn't get the strips that I had put in for on my repeat prescription.  When they weren't there I rang the surgery up and was told they had stopped issuing them due to the cost. 

For T2s not on insulin I presume? 
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.


© 2015 Patti Evans

Offline sedge

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Re: Slightly Sinister Development, Or?
« Reply #5 on: 30 January 2018, 09:48:45 PM »
Insulin or Gliclazide etc it would have to be.

If you use a 'Smart' meter or for instance, use the same meter to test blood and/or ketones then I would have thought that you would be able to keep the one you use, providing you use the special features etc.
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline Paulines7

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Re: Slightly Sinister Development, Or?
« Reply #6 on: 30 January 2018, 11:38:34 PM »
Quote
About a year ago, our surgery stopped issuing strips.  The patients as far as I know, as I am one of them, knew nothing about it.  The first time I knew was when I didn't get the strips that I had put in for on my repeat prescription.  When they weren't there I rang the surgery up and was told they had stopped issuing them due to the cost. 

For T2s not on insulin I presume?

I assume so.  I didn't ask.
Diabetes Type2 diagnosed March 2014.  Treated by diet only.  HbA1c 60 on diagnosis, 52 in June 2014, 50 October 2014, 44 December 2014, 48 May 2015, 50 Sep 2015, 53 Jan 2016, 50 Oct 2016, 56 Feb 2017, 50 Jun 2017. 50 Aug 2017. 47 Feb 2018  Pacemaker fitted 2008 - replaced 2017.

When I get old I don't want people thinking
                      "What a sweet little old lady"........
                             I want 'em saying
                    "Oh Crap! Whats she up to now ?"

Offline Dr DeEath

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Re: Slightly Sinister Development, Or?
« Reply #7 on: 31 January 2018, 01:30:30 PM »
The background to my friend’s strips review is unclear.Whilst I accept there is wastage with some repeats I partially blame the practices for prescribing 28/56/84 days worth of medication. I use my pharmacist for repeats but was managing fine until the new practice administrator interfered. However,I do know of people who stockpile. Another friend’s wife is on a repeat - at times she runs out of thyroxine but has enough Naproxen to treat the village!

Over 30 years ago the GP I saw was a heavy smoker and whiskey drinker, and it was well known both got supplied by drug companies. This is why it smells slightly to me.
T1 for over 50 years.  MDI on Porcine insulin.  Lisinopril and Atorvastatin.

Offline Dr DeEath

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Re: Slightly Sinister Development, Or?
« Reply #8 on: 06 February 2018, 01:35:16 PM »
There was an item on the radio that I did not catch fully but it was about the amount of pressure drug companies put on doctors. Apparently some sales reps (executive/consultant/etc. is definitely the wrong term) get prescribing habits from local pharmacies and then try to apply pressure (even bribe). GPs.

My friend has had another development. He had a letter from a pharmacy  he has never used that new what practice he was with saying they could handle his repeats for him - so where did they get his information from? TBH after having had a nightmare with Boots he is very happy with his current one.
T1 for over 50 years.  MDI on Porcine insulin.  Lisinopril and Atorvastatin.

Offline BBarb

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Re: Slightly Sinister Development, Or?
« Reply #9 on: 07 February 2018, 12:34:23 PM »
I have a friend who was a dental nurse and she used to tell me about the bribes dished out by the drug firms to them re mouth rinses, tooth past and brushes as well as other items used in the surgery. 
It also struck me yesterday when I went for my 4 weekly eye injection that the NHS must be the largest user of plastic in the whole UK.  I should thnk they would find it very difficult to cut down on it as they throw most stuff away after one use because of hygiene.

Offline Pattidevans

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Re: Slightly Sinister Development, Or?
« Reply #10 on: 07 February 2018, 12:44:39 PM »
We always come away from the hygienist with handfuls of little Teepee brushes and small samples of toothpaste.  We save the toothpaste for when we go away for a weekend or take a couple on a longer holiday.  Now you have difficulty getting through security with your toilet bag and have to put it in your hold baggage every little helps weight wise.  I note nearly all toothpaste tubes these days are plastic!
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.


© 2015 Patti Evans