Dymista hayfever treatment on the NHS

[dowie]

(note this isn't intended to be a medical thread or a discussion of hayfever or its treatments rather a thread about NHS policy re: funding treatments)

I'd read recently that a new drug (Dymista) could be prescribed for use on the NHS for treating hayfever and that trials had apparently shown it to be more effective than the typical over the counter remedies. I normally get bad hayfever in June and have some exams coming up so thought I'd approach my GP and ask about the possibility of being prescribed it. My GP hadn't heard of it and I had to spell the name for her... she typed it into her computer, paused for a bit then said "hmm this is £18, its too expensive we wouldn't prescribe this" then wrote down the names of some over the counter treatments I could go and buy from the chemist (the medication I use each year anyway essentially).

My question is that the drug in question is supposedly available on the NHS so presumably someone in some other post code is able to get a prescription for it - do different NHS trusts have specific policies on costs or drugs they can prescribe for different conditions or is this partly down to the opinion of the GP you happen to see at the time (who seemingly wasn't even aware of the drug's existence in the first place).

(just to make it clear - please don't turn this into a discussion about the pros and cons of different hayfever treatments but just NHS funding/policy)

 

[skippy2421]

I think they'd only prescribe it on the most serious cases where over the counter have little to no effect and the symptoms are particularly bad. I got prescribed some strong nasal spray stuff (ie a slightly stronger version of beconase i believe) along with some steroids when I was suffering quite badly with it and the constant stream of snot etc. was preventing a cough clearing up (coughs aren't meant to last nearly 2 months apparently). Not been prescribed it since despite its success at the time.

*This post is entirely speculation based on my experiences before the know it alls wade in

 

[holymonk]

£18 is too expensive its hayfever not cancer and there are other drugs available.

 

[arknor]

You could have offered to pay the £18

 

[Mr Jack]

Get grumpy. GPs will give in under pressure.

 

[Worthy]

Have you seen the list of side effects on their official website?

 

[dowie]

£18 is too expensive its hayfever not cancer and there are other drugs available.

Yes I'm aware there are other treatments and that people deem £18 to be too expensive - I'm asking about policy.

 

[atpbx]

I have suffered for years with chronic hay fever, it brings on asthma attacks, I get glued up eyes, my nose swells shut and all that guff.

I just buy cetrizine by the boat load off the internet and a couple of nose sprays over the counter.

 

[tom_e]

Have you seen the list of side effects on their official website?

Jesus wept, I'd keep the hayfever.

 

[Em3bbs]

Doctors generally hate people who read the internet and self medicate.

 

[dowie]

Have you seen the list of side effects on their official website?

Yes I have - most drugs that have effects will also have side effects... though I'd rather keep the thread on topic.

I have suffered for years with chronic hay fever, it brings on asthma attacks, I get glued up eyes, my nose swells shut and all that guff.

I just buy cetrizine by the boat load off the internet and a couple of nose sprays over the counter.

I do too but I'm not asking for medical advice here - just asking about NHS policy re: spending on drugs else this thread will probably be closed.

 

[*Moangroan*]

Have you seen the list of side effects on their official website?

I like the way drug companies label them as ''side effects''.....surely its ''effects'' of the drugs.

Its like saying the side effects of drinking arsenic is death....rofl

 

[holymonk]

Yes I'm aware there are other treatments and that people deem £18 to be too expensive - I'm asking about policy.

Ask about common sense, its hardly effective use of taxpayers money.

 

[dowie]

Ask about common sense, its hardly effective use of taxpayers money.

Its approved for use on the NHS already - do you actually have anything factual to contribute or are you just offering irrelevant opinion.

I'm already aware that some people might have an opinion that it is expensive.

 

[holymonk]

Its approved for use on the NHS already - do you actually have anything factual to contribute or are you just offering irrelevant opinion.

I'm already aware that some people might have an opinion that it is expensive.

There are many drugs that are approved by NICE, doesn't mean that they represent value for money in comparison to other drugs.

Just because you have a sniffle doesn't mean that you are going to get a prescription for an £18 drug that you happen to have looked up on the internet.

The NHS is not a bottomless pit.

 

[Crowort]

Since you can buy a lot of the ones they prescribe we know they are cheap as chips to make and buy. If a cheap one works why would they give you a more expensive one?

Cheap fairly well tolerated drugs that you doctor knows well will always be first line treatments imo I'm sure one of your medical types that knows the NHS well will drop by and expalin it better than anyone else can.

 

[dowie]

I'm sure one of your medical types that knows the NHS well will drop by and expalin it better than anyone else can.

I hope so... so far the thread is full of people offering pointless opinions

 

[Crowort]

I hope so... so far the thread is full of people offering pointless opinions

Not totally baseless opinions. I only know of NICE guidelines for other drugs I use (or are used for the same illness) and it goes like a flow chart. You start on drug xyz (cheap, works well and safest) then onto xyz2 (more side effects) then xyz3 (more difficult to use) then lastly xyz4/5 (costs over 100 times more than others)

The guidelines take cost / benefit into account. I still think the opinions of the doctors / NHS staff will be good in this thread but it doesn't mean the others are pointless.

Edit: I meant to say £18 doesn't sound that much really but of course better to use cheaper drugs if they have the same benefits.

 

[Xordium]

What you need to do with everything in life as on here is to provide a rationale of why you need it to get it and any decent GP would see that even if it was not a drug they were used to or had heard of (or do people seriously expect them to know all the 100s of drugs that come out or usage for old drugs).

Do you seriously think my GP never gives me exactly what I want? I get it not because I bully them into it (well I do sometimes) but because I can provide a reason. And £18 is really cheap for a drug. Maybe not for a hayfever drug but for something that is having consequences elsewhere and potentially significant ones then it is. Spell those consequences out eg

"The over the counter medications I have tried eg piriton, cetrizine, drops, sprays so far have all proved ineffective. I have important exams coming up and I know from past experience that during this time my performance will be reduced. Therefore, I wish to try this new medication that I have heard of. I know the cost is significantly higher however the cost to me if I fail my exams will be considerable both in my academic attainment but also self esteem and mental health etc etc"

Chuck in feeling a bit down from the hayfever and loss of libido and they will kick you out with whatever script you want

 

[Destination]

Basically if a cheaper generic alternative which is effective is available then that is the drug that should be prescribed.
In you case, you might not fulfil the full criteria for the use of the drug. One of the criteria might be that your doctor thinks it is a waste of money to give it to you.
Not being flippant, it is hard to write specific criteria that cover all bases, but when something can be provided for ten pence per day, having a cost of eighteen pounds is prohibitive.

One of the things impressed upon GPs now is to save money on the prescribing bill where possible.