The link works OK-signed.

I can't provide a link to the specific regulations, there was however apparently an article in The Telegraph or Sunday Telegraph in the last few days (sorry I can't be more specific but this is how I originally became aware of the issue as my elderly father told me about it out of concern for hsi grandson, I am trying to track it down but could not find it on the website yesterday).  This has been an issue for some years, I had a dispute with our surgery about 12 years ago as they gave my son a mix of generic & branded medication at one dispensing, I had to be very firm and draw reference to statistics provided by Epilepsy Action, then the British Epilepsy Association.  The petition, if you look at it on the No 10 website, was started by someone on behalf of the Joint Epilepsy Council.  The dispenser at our surgery was unaware of the new proposals and quite shocked by the idea.

It should also be remembered, as we discovered four years ago, that a GP can overrule a consultant in terms of medication (ie your consultant -expert - can say that one needs X dosage of a particular medication but a GP - generalist with perhaps very limited knowledge of your condition - can disregard this and neither you as the patient nor your consultant can override the GP) and this too is most unsatisfactory.

I would certainly not think the pharmaceutical industry is involved in this particular petition, the argument is not that branded should always be used rather than generic but that the patient should be guaranteed continuity of what they have ie if they already use generic, always use generic as a switch to branded can be equally damaging, it is thechange which is significant.   There are already a number of issues regarding foreign manufacture and parallel importation of medication which in itself has led to medical problems.   As I said, this is not just about epilepsy although that it how I became aware of it.  Of course the proposals would save very little when one considers the additional costs of treating those made ill by a switch of medication and perhaps becoming unemployed/homeless.

Am having problems with the window, text is disappearing out of the box so will end here.   Does anyone know why this happens after about 1000+ characters???

SilentCallsVictim wrote on Aug 4^th, 2009 at 12:41pm:

I now have some information, helpfully picked out for me by a helpful agent on the DH helpline.

I quote below from what I am assured is the only relevant document covering these proposals that is published at this time. More detailed proposals may well be published in due course. The following quote is from 7.6 (ii) on page 20 of The Pharmaceutical Price Regulation Scheme 2009. (This covers a period of five years.)

Quote:

The earliest date for the implementation of generic substitution it set to be January 2010.


The petition is simply a means of canvassing support for the exclusion of particular categories. Provision is already made for this, and it would seem unlikely that the view of NICE would not be considered in determining which categories are to be treated in this way. It is far too soon to allege that the particular drugs in question are not to be subject to this exemption. There is however no reason why well-organised interest groups could not canvass support for their particular case.

One hopes that the exemptions will be properly drawn so that the benefits of generic substitution may be gained where this is appropriate. The leading members of the pharmaceutical industry will doubtless be campaigning for as many exemptions as possible.


Most important perhaps is the provision for the prescriber to opt out of substitution. This is where the responsibility should lie. If the prescriber is perhaps unaware that a suitable generic substitute is available then it is fair for them to prescribe by name, but leave it open to the dispensing pharmacist to make a substitution if one is available. If they are unwilling for a substitution to be made then they must carry the responsibility to indicate this.

For the scheme to work, it is vital for prescribers to be aware of when substitution is not appropriate, so that whole categories of drugs do not have to be covered by exemptions simply to prevent inappropriate substitution in a few necessary cases.


I hope that the needs of sufferers from epilepsy and their carers will be properly met, and do not believe that they have yet been overlooked. The petition will help to ensure that this does not happen. I also hope that the same care will be taken in respect of sufferers from all other conditions, especially those without powerful lobby groups to argue their case.

As always, all manner of problems will emerge with the implementation, but I will leave speculation about this to those who are better aware of the relevant procedures.


Barbara is to be thanked for generously stating that epilepsy is but one of perhaps many conditions where there is a case for exemption.

It could be seen as odd that neither the petition, nor the information on the JEC website, makes any reference to the highly relevant provisions in the proposal. This would have perhaps enabled an explanation as to how they may be unsatisfactory in nature and why the drugs in question are unlikely to be covered by an exemption to be provided. If the petition had said “there are to be exemptions, please ensure that the following groups of drugs are on that list and that this provision is not dropped” it would have attracted far fewer signatures and generated far less possibly unnecessary concern.