Eyedrops at nearer UK NHS negotiated price

[littlemermaid]

Anyone managing to get formulated cyclosporine or autologous serum in UK?

UK NHS Formulary drug prices are negotiated nationally with international pharmaceutical companies. If Drugs Committees of local Clinical Commissioning Groups do not 'list' the meds (as recommended/requested by local Ophthalmic Committee, usually headed up by local Consultant Ophthalmologists), then NHS hospital prescriptions may be rejected locally (our GP, 'if they prescribe it, they should pay for it'). Usually the GP would support a hospital specialist prescription. Or the patient/GP would apply to CCG Drugs Committee for 'Specialised Meds'. It is possible to ask the local Ophthalmic Committee for help accessing meds. Also regional Health Trust Medicines Management and Pharmacy will consider direct purchase for unfunded meds (negotiable). NHS England Specialised Services drugs budget is under review.

This is why, with chronic or difficult eye problems, we can be better off in tertiary hospital specialist Eye Clinic Outpatients with easy access to meds and lenses (like Azyter, cyclosporine, sclerals) ('if you have any problems getting this, let me know', Moorfields pharmacist) (although, 'we can only let you have 1m supply, after that your GP has to pay', cash-strapped children's hospital).

Here is a useful suggestion from [head office, national pharmacy chain] -

'Thank you for your enquiry relating to eye drops for your daughter. I have checked the current prices of these items and they are;
Hylo-forte £19.44 for 10ml
Hylo-tears £17.63 for 10ml
Saline Minims £12.54 for 20

Any bulk discount would need to be applied locally and is discretionary. In the past I have given 5-10% discounts on large over the counter purchases.

It is very disappointing that the CCG have withdrawn funding for these important medicines and there is a different route to consider. I would recommend that you ask your daughter’s GP to prescribe the items on a private prescription. This would still meet the “no cost to the NHS” criteria, but you would not have to pay the VAT on the medicines. This would equate to an immediate 20% saving. Our dispensary computer system does have an algorithm that applies a discount to expensive prescriptions so a private prescription, for say six months, may attract an additional saving on top of the 20% VAT saving.

A further consideration is that a pharmacy can charge any price they choose for a private prescription so there is some benefit in shopping around different pharmacy companies for the best deal.'

[lizlou29]

Useful info LM. As you know I've been 'lucky' that my eye clinic's pharmacy put my specially formulated Cyclosporine from Moorfield's on a repeat order and I have a prepaid NHS prescription card, also when I see SH he usually gives me drops they have in the office (supplied by drug reps?). Luck of the draw sometimes - my GP surgery made it clear they wouldn't prescribe the Cyclosporine "wasn't on formulary" "would have to jump through hoops and would take months". I thought it may be different for paediatric but clearly not.

[littlemermaid]

UK Vision Strategy and Fight for Sight give us great hope that eye problems will be better recognised, funded and treated in future. There will be less variation once everyone is IT linked and tracked. We are very lucky with our NHS.

Yes, Lizlou, our Paediatric Ophthalmologist sent the GPs his research paper to explain what LM has but they clearly haven't read it. We've done better by avoiding the GP partners and seeing a locum trained in Sierra Leone who puts basic meds through with respect to the Consultant Specialists. He is well over-qualified and seems to have wider hospital experience.

Genetic Alliance UK tell me people get progress by asking GPs to put their 'budget difficulties' in writing when they reject Consultant-prescribed meds. Same when we are allergic or become sensitive to generic or branded meds listed on the Formulary, which may/may not be cheaper. Then we can take it from there.

[littlemermaid]

Royal College of Ophthalmologists news Newly Published Ophthalmic Specials Guidance 25/04/2014, updated 7 May 2014

'Analysis of primary care prescription data for the first nine months of 2013 has revealed that over 30,000 prescriptions for unlicensed eye preparations were dispensed in England and Wales at a cost of almost £3 million. The UK Ophthalmic Pharmacy Group (UK OPG) believes that this is not an effective or cost efficient use of NHS resources.

The Royal College of Ophthalmologists and the UK Ophthalmic Pharmacy Group are concerned about the suitability and the cost of certain unlicensed ophthalmic preparations prescribed and dispensed in primary care.

The General Medical Council’s advises that unlicensed medicines may be prescribed ‘on the basis of an assessment of the individual patient, you conclude, for medical reasons, that it is necessary to do so to meet the specific needs of the patient.’

Following on from the advice by the GMC, the College and the UK OPG have produced the Ophthalmic Specials Guidance (document updated 7 May 2014).

Press release

[cathy8889]

Hi, sorry if this question has already been asked but I was just wondering if cyclosporine could be prescribed on the NHS, I get really confused about how it works in the UK. I wanted my doctor to prescribe me Vismed Gel vials but she told me she couldnt yet on their website it says they could be obtained via NHS, confusing :s

Thanks

Cath

[Splat]

Littlemermaid you have a private message!

I get my Cyclopsporine on the NHS, Cathy. My consultant at Moorfields prescribed it in the first place, and my GP and chemist order me repeats direct from moorfields who send it to them. I have a pre paid prescription card, and am able to use this to get them. The cyclo formulation I use IS a vet drug tho, so maybe it has to be done by moorfields in the first place?