Knight & Sons. Waste removal. Recommendation.
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Noted. I wasn't quite sure from their material whether the 'ad lib' supply by pharmacists had to be mandated; hence the suggestion to check. There are plenty of individual manufacturers of generic methylphenidate, probably quite a bit cheaper too. I'm afraid I didn't see radnrach's "can't really take an alternative", so apologies for presuming otherwise. For myself I'm generally willing to trust that any manufacturer's offering of, say, 27 mg methylphenidate hydrochloride tabs, will contain that, and I'm not too worried about the minor quirks of things like their slow-release technology. I think it's likely that the medicines Serious Shortage Protocol does definitely give pharmacists some degrees of freedom anyway. But it's apparently not in operation here. See the Minister's recent reply to a written question: https://questions-statements.parliament.uk/written-questions/detail/2023-11-13/1660#. , which seems to approximate to: we can't apply the shortage protocol here because the drugs are in short supply. -
I'm not sure pharmacists have any discretion to alter specific medication prescriptions, although they can choose supplier where a generic is prescribed which may be offered by more than one company. This will only be for older medicines which are effectively 'out of copyright' . They can't issue alternatives on their own authority as they don't know what counter-indications there may be for specific patients. GPs may prescribe a specific supplier of a generic medicine where, for instance, they know patients have an adverse reaction to e.g. the medicine casings, so the Nottinghamshire directive to specify only generics where available may not always be helpful. -
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I see that in Nottinghamshire the local NHS Area Prescribing Committee is recommending that prescriptions should be for generic methylphenidate, giving their pharmacists the option of supplying any brand (or presumably a generic product). https://www.nottsapc.nhs.uk/media/bw5df5pu/methylphenidate-pil.pdf It might be worth checking with your local pharmacist(s) to see whether this will help them if, as I suppose would be necessary, your GP issues a replacement prescription. I'll have a look around our local NHS websites now, to see if I can find anything there. Nottingham, btw, provide more information, nominally for clinicians, at https://www.nottsapc.nhs.uk/media/vwxjkaxa/adhd-medicines-supply-advice.pdf. And at https://www.nottsapc.nhs.uk/adhd-shortages/.
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