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General => The Shed => Topic started by: manicscousers on January 31, 2011, 17:47:18

Title: PCT costcutting excercise?
Post by: manicscousers on January 31, 2011, 17:47:18
genuine question
My doctor put me on omeprazole, 40mg per day as the medication I am taking, including ibroprufen, causes bad stomach pains.
Today, I received a letter stating that, from the next prescription, I would be put on 10mg per day. When I queried it, I was told the PCT sends someone in each month and they do this sort of thing, don't look at medical records or know the medical history.
It was suggested that I take more excercise, stop smoking,stop drinking, lose weight, don't eat spicy foods and lots of other things I don't do.
We have been with the same surgery for 38 years and never had this happen before, so, what do you think, are they just trying to save money?
Title: Re: PCT costcutting excercise?
Post by: Tulipa on January 31, 2011, 17:57:25
I had a similar thing with my inhalers, the doctors had obviously been told I should have a cheaper one, I tried it for a couple of weeks but was so breathless I was allowed to go back to my normal one, sounds a similar exercise  :(
Title: Re: PCT costcutting excercise?
Post by: saddad on January 31, 2011, 18:11:56
Trying to be seen to be doing something to defend their position?  :-X
Title: Re: PCT costcutting excercise?
Post by: Stedic on January 31, 2011, 18:29:57
I have a medical background (but I'm not a GP, nor do I work for a PCT).

I've heard of this before, partly because some GPs will prescribe quantity X of a drug because they always have, when in fact a smaller quantity of the drug will work.  My advice would be to go to your doctor with the letter and ask to remain on 40mg, or at least reduce it more slowly (so say 30mg, see if that works, then 20mg....).  It might be that the lower dose works for you, which reduces the drugs you're taking and is surely a good thing. If not, you should be able to get back to 40mg more quickly.

Oh and yes, it is a cost cutting exercise!
Title: Re: PCT costcutting excercise?
Post by: ACE on January 31, 2011, 19:13:54
Quote from: manicscousers on January 31, 2011, 17:47:18

It was suggested that I take more excercise, stop smoking,stop drinking, lose weight,

Surely it's worth a try, anything is better than cramming pills down your throat, I had tons of stuff to take when I came out of hospital, but in the end I only took them as a last resort. I will have to use pain killers tonight, because I overdid it a bit today. My own fault, it says take two on the bottle, but  one tablet will do the job, along with the  placebo effect..
Title: Re: PCT costcutting excercise?
Post by: manicscousers on January 31, 2011, 19:22:02
Quote from: ACE on January 31, 2011, 19:13:54
Quote from: manicscousers on January 31, 2011, 17:47:18

It was suggested that I take more excercise, stop smoking,stop drinking, lose weight,

but I excercise as I can, don't smoke, drink or eat spicy foods and lose weight as I can, obviously, the person doesn't know anything about me. I've rang the doctor to be told they are mental, he has changed the prescription back, I will try to take a lower dose if I feel I'm not going to need the ibroprufen as he said it is a very high dose :-\
wish there was an alternative to the ibro
Title: Re: PCT costcutting excercise?
Post by: grannyjanny on January 31, 2011, 19:39:29
Mal I've PM you.
Title: Re: PCT costcutting excercise?
Post by: manicscousers on January 31, 2011, 19:41:52
Thanks for that, Janet  :)
Title: Re: PCT costcutting excercise?
Post by: BarriedaleNick on January 31, 2011, 19:53:05
There isn't much alternative to the Ibro.
Im not allowed any of that type of drug - no asprin etc as I have a bad history of stomach ulcers so if I need painkillers the only alternative is paracetamol and/or the opiates or the man made opiates.  Not a great choice!

Often 10 mg is a suitable dose if it is just taken as a prophalactic againt damage caused by ibro - the higher does are more ofter given to people with severe stomach issues.  It also can have side effects - inhibiting acid production in the stomach can cause digestive issues - so a lower dose would be preferable..

I maybe wrong but i guess its probably just part of a review to see if prescriptions are in line with the guidelines..
Sending out daft letters would also seem to be part of the process as well..
Title: Re: PCT costcutting excercise?
Post by: small on January 31, 2011, 22:51:38
Not really relevant to the cost cutting aspect, but I take 20mg daily and it does the trick for me.....but I'd be spitting feathers if I got a letter suggesting lifestyle changes without finding out what my lifestyle was to start with....
Title: Re: PCT costcutting excercise?
Post by: Digeroo on January 31, 2011, 23:35:11
I agree that the work of GPs should be reviewed.  But I think that any change should come through the GP who knows the individual circumstances.









Title: Re: PCT costcutting excercise?
Post by: manicscousers on February 01, 2011, 09:30:18
I wouldn't have minded if it came from the doc. The person wrote
We are reviewing how we look after patients with long term indigestion and heartburn symptoms.
BTW, I don't suffer from indigestion and never have  ???
Title: Re: PCT costcutting excercise?
Post by: shirlton on February 01, 2011, 09:50:28
I am on a maintenance dose of Lansoprazole 15mg for acid reflux but if I ever have to have painkillers it is put up to 30 whilst I  am on them.
Last year they tried to give me a cheaper blood pressure pill that had a different carrier in it. I was quite ill. Now I have to state that I want besilate and not masalate. The chemist told me that they cost quite a bit more.
Title: Re: PCT costcutting excercise?
Post by: pumkinlover on February 01, 2011, 10:10:42
Having received a letter like that it looks very much like a standard letter it would be natural to feel that it is part of scheme to reduce costs. It is obviously written with no knowledge of the circumstance of each patient and in that sense could lead to patients reducing a medication that they need.
I think that it wold be appropriate to write to the PCT to complain how this has been done.

On the other hand (I'm not qualified in prescribing) but the dose seems high for prophylaxis (prevention rather than cure).  At our surgery you can ask a GP or nurse prescriber to telephone you back to answer any queries such as this or speak to the pharmacist where you pick up your meds. Like all medication the dose should be appropriate to your needs and anything higher increases the risk of side effects, with out therapeutic benefit.

On the other hand I have seen the enormous waste, bags and bags of prescriptions which are issued to patients on  repeat prescription and have to be thrown away after a few months as the patient never came to collect them. The waste of money involved is huge-and that is just one small surgery, so I can appreciate the need to cut costs.

However I do not think what has happened to you is the right way to do it.


Anne x
Title: Re: PCT costcutting excercise?
Post by: dtw on February 01, 2011, 14:41:54
I thought the government were getting rid of PCTs.

I take it this is one last ditch attempt to justify their existance and save themselves.