Using licensed products
The National Institute for Health and Care Excellence has issued draft public health guidance relating to the growing problem of vitamin D deficiency and insufficiency in the UK. The draft guidance fails to make clear the importance of using licensed vitamin D products to fill prescriptions and, eventually, for over-the-counter sales, whenever possible.
At present I believe that over half of all NHS prescriptions in England for Vitamin D products (excluding those containing calcium) are supplied using unlicensed food supplements. The manufacture of these is almost completely unregulated. Excipients, colours and other ingredients can be changed at will. Actual amounts of active ingredient in vitamin D products have been shown by the Medicines and Healthcare products Regulatory Agency to be variable indeed. This is not the case with licensed medicines.
There are also legal and ethical issues for prescribers and for supplying pharmacies in providing food supplements against prescriptions. The prescriber will be liable for any adverse reactions, not the manufacturer. The supplying pharmacist is advised by the National Pharmacy Association to contact the prescriber if he or she intends to supply an unlicensed product against a prescription. One might be able to suggest a change in dose or form so that a licensed medicine can be supplied. Failure to contact the prescriber may have legal repercussions for the pharmacist. How feasible is all this in a busy dispensary?
I hope that when the Royal Pharmaceutical Society responds to the NICE consultation on the draft guidance it will include the above points, as well as pointing out the benefits for patients in receiving a licensed, quality-assured medicine. Prescribing data also suggest that this will save the NHS money.
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.20065545
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