medicine packaging

[Carol Anne]

Picked up mum's monthly prescription order the other day, two big bags full poor old soul!!
What strikes me the most though is the trouble and expense the drug manufacturers put in to the packaging design, some of it quite elaborate and inventive. I can understand this for goods that I have to choose for myself in the supermarket, where it is well known that package design can influence choice. But prescription drugs?? What is the point of going to this expense when the consumer doesn't get to handle the merchandise so to speak.

[Buenchico]

The consumer might not get to 'handle the merchandise' but doctors do!

Drug companies spend a great deal of money on employing reps to call on GPs and extol the virtues of their particular product. They will happily provide the doctors with free samples to give to their patients. So, when a doctor wants to prescribe a particular type of drug he thinks, "Actually, I don't need to write this prescription. I've got something suitable in my own drugs cabinet".

When he goes to the cabinet he finds that he's got several similar products but his eye is drawn, by the packaging, to Product X. The drug company representative will have ensured that he's got a large enough supply to get him into the habit of giving his patients Product X, so that by the time he needs to write a prescription, he automatically prescribes Product X for this particular condition.

Chris

[Carol Anne]

I thought all doctors had to prescribe by generic name of the drug ie: fluoexitine instead of Prozac etc. so you would end up getting whatever the chemist happened to have on his shelf from whatever manufacturer?

[Buenchico]

Thanks for your reply.

The NHS puts pressure on doctors to use generic names where possible but studies show that many continue to prescribe by brand name.

Even if the doctor uses a generic name, there might be several manufacturers producing the same drug. In this case, it's in the interests of the manufacturer to ensure that his product is the one which catches they eye of the dispensing pharmacist.

Chris

[Carol Anne]

Most informative. Thank-you Chris.

But.... if GP prescribes generic and pharmacist dispenses brand name from top manufacturer how does that work in as far as the chemist has paid for the branded stock but can only charge NHS for the generic..? Or is it the case that if GP prescribes generic and pharmacy only has branded in stock the NHS has to pay the full price? Sorry to keep going on but this has puzzled me for some time now!

[Buenchico]

Even generic products can have different packaging. For example, something as simple as aspirin can be manufactured by many different firms, none of whom seek to call it anything other than 'aspirin'. Even so, people might be more likely to pick up the version which comes in smart packaging. (Of course, some firms seek to add their own brand name, such as 'Anadin', and vastly inflate their prices but that doesn't mean that firms who simply use the name 'aspirin' won't consider spending money on packaging)..

Some non-generic products do have genuine advantages over generic versions. For example, even though they might contain exactly the same amount of exactly the same drug as the generic version, the tablets might be easier to swallow. (For some patients, with certain conditions, that might be an important consideration).

Similarly, some tablets are designed to dissolve quickly (so that the drug 'gets to work' as soon as possible) whereas other tablets or capsules are designed to dissolve slowly (so that the drug is released slowly and works over a longer period). It's for reasons like this that the BMA supports the right of doctors to prescribe non-generic versions of drugs.

Pharmacists are normally obliged to dispense exactly what it says on the prescription but I understand that they are allowed a certain amount of discretion if the specified version is out of stock. (Some of this discretion seems to come from formal agreements but much of it seems to be simply that a doctor will say to a pharmacist ,'You really don't need to keep phoning me up to check that it's OK to swap these two versions of the drug over. Just go ahead and do it'). It should be remembered that, as far as drugs are concerned, a pharmacist is vastly more knowledgeable and better qualified than any GP, so it's perfectly reasonable that they should be allowed a certain amount of discretion.

Chris

[Carol Anne]

Excellent answer. Thanks for taking the time.

Carol Anne

[alijangra]

I have never heard of a GP handing out drugs from a cabinet in their office. I was of the understanding that all prescriptions had to be filled at a pharmacy. And I have been a nurse for years and now in my first year of Mpharm degree training to be a pharmacist. Shows what I know, eh? I live in Scotland, it's maybe different here?

[Buenchico]

Well I've certainly had drugs handed directly to me by a doctor, both at home and in the surgery. Admittedly, though, that was a long time ago. (I've not seen a doctor in over 20 years). However, I do know a drugs company rep and he certainly provides doctors with free samples. They must have some use for them!

Chris

[Carol Anne]

Im in west Glasgow Alijangra, and a nurse of over 25 years experience, likewise never seen the doc handing out pills. But we even get reps for all sorts coming into the hospital and leaving samples so I guess it makes sense