by Jeanne Hambleton © 2008
NFA Leader Against Pain-Advocate
The coproxamol debate is continuing to gather pace in spite of the Government.
I am pleased to tell you that MPs Anne Begg and Dr Howard Stoate, who have been fighting since July 2005 to save this 50-year-old ‘safe’ painkiller from extinction, are seeking a Government U turn in the House of Commons.
It is claimed that 70 per cent of GPs and 90 per cent of rheumatologist were against the withdrawal and there have been calls for a special debate for the withdrawal to be reversed. The news comes from Pulse Today website, owned by GPs and available to GPs (http://www.pulsetoday.co.uk/).
It is understood a Pulse survey will be used during the proposed debate expected to be held this week. The debate will bring pressure on the Government to change the decision to re-classify the licence of the drug. From January 1st coproxamol became an illegal drug prescribed at the responsibility of the doctor for named patients only. This meant GPs and rheumatologists could face litigation from patients in the event of any problems. It is suggested this may discourage some GPs from prescribing coproxamol.
It is hoped that Alan Johnson MP, Minister of Health, will see how the withdrawal has been bungled and coproxamol withdrawn against the wishes of so many GPs and their patients, that he will initiate a full review.
Pulse Today writer Nigel Praities reported when the painkiller was listed as a Category M medicine in December, coproxamol had a “reimbursement price payable to pharmacists of £2.79 for 100 tablets. From January 2008 it has been changed to Category C with a reimbursement price payable by PCTs of £20.36 for 100 tablets.”
As a result doctors are coming under greater pressure from PCTs to switch patients from this painkiller due to the big price increase from January 1st.
Pulse Today reports the seven-fold price hike has prompted swift action from PCTs. Dr Iain Gilchrist, a GP in Hertfordshire, and treasurer of the Primary Care Rheumatology Society, said he had already received a letter from his PCT detailing the price increase for co-proxamol and urging GPs to switch patients to alternative analgesics. However, nearly 40 % of GPs told Pulse last month, in December, they planned to continue prescribing it on a named-patient basis.
Dr Martin Kittel of Windsor who launched a coproxamol website in March 2005, pointed out, in my original article in November 2007, that, “Coproxamol by experience is just a lot more effective than other equal drugs and for many patients causes less side effects. Coproxamol is highly cost effective and its withdrawal will not only harm patients, but also harm the health service. The NHS will pay a lot more for equally effective pain relief, strapping it of cash badly needed in fighting other diseases.”
Before the withdrawal on December 31 it was estimated that 1.7 million GP patients each year receive 7.5 million prescriptions for coproxamol.
TV DOCTOR ADDED HIS SUPPORT
Dr. Hilary Jones, the GMTV medical professional, also came out in support of the battle to save coproxamol.
In an interview with Jim Pollard of Arthritis News, Dr. Hilary said many of his patients were asking what alternative painkillers they can use but he did not have the answer. His patients said other painkillers make them sick and were not as effective. Dr. Hilary, who had taken co-proxamol, claimed the painkiller was a safe drug.
Like others Dr. Hilary urged those in need of coproxamol to write to their MPs to have the decision reversed. The article outlining Dr. Hilary’ views on coproxamol appeared in the August/September 2006 issue of Arthritis News.
LOSS BY DEFAULT
The ‘illegal’ classification of the painkiller and a huge price rise for 100 tablets could result in the total loss of coproxamol.
With just one manufacturer continuing to provide the coproxamol needed for named patients, pressure on surgeries to meet the tremendous price increase, could result in the production of the painkiller becoming uneconomical if only a handful of GPs continue prescribing. The supplier could decide it is no longer viable to produce the painkiller for small numbers.
Dr Stoate from Dartford has claimed GPs should be allowed to prescribe coproxamol without ‘walking a legal tightrope’ and the classification should be reversed.
Although notices have already gone out to wholesalers and stockists to return their unsold supplies of coproxamol Anne Begg and Dr. Stoate are hopeful of delaying the withdrawal to allow them more time to solve the problem.
The Aberdeen South MP Anne Begg who has secured the debate is quoted in the Pulse Today article as saying those who take coproxamol need the Department of Health to remove the ban for the patients who can fine no alternative to coproxamol
Pulse Today also reports Dr Peter Fellows, who is the chairman of the GPC prescribing committee, as claiming those who wanted to withdraw coproxamol ‘have no idea of reality’ and no ‘clinical experience’ on prescribing.
“In my view, the Medicines and Healthcare Products Regulatory Agency has got it wrong. The alternatives are dangerous, ineffective, and expensive and have side effects such as constipation and headaches. We opposed the withdrawal then, and we continue to oppose it now,” Dr. Fellows told the writer (email@example.com – http://www.cmp.com/).
Dr. Stoate is also asking why is the Government is anxious to offer patient choice and empowerment when coproxamol, used by thousands of patients, is being withdrawn. Empowerment and patient choice were words used by the former Health Secretary Patricia Hewitt. It is also reported that the NHS has been ‘moving away from the old monolithic, monopoly NHS to a self-improving system with more choice for people about the services they use and more freedom and responsibility for GPs to get the best services for people with long-term conditions’. Pulse Today claims the Government promised to put patients in control of their treatment options but this has been undermined and GPs and their patients feel badly let down.
Pulse Today writer Nigel Praities reported a Pulse survey had revealed some GPs had been prescribing for over 100 patients and 60 per cent of surgeries still have a ‘hard core’ of patients who are using coproxamol.
A GP from Burnley in Lancashire has written into the website saying, “I have been a GP for more than 40 years. I have not seen anybody complaining of the side effects of coproxamol. Only one patient has developed an addiction out of many hundred of prescriptions I must have issued. My patients who have been on coproxamol for several years have sworn of its efficacy and not overused it. They have found it difficult to control pain with other drugs. I totally agree with Dr Howard Stoate and offer my full support for coproxamol to be available on prescription.”
Another GP from Southampton writing to Pulse Today in support, said, “ I am a single handed inner-city GP and look after an increasingly elderly population. Some 170 of my patients are in nursing homes and regularly need analgesic medication. NSAIDs have unwanted side effects – codeine and other opiate-type medication constipate and paracetamol is often not efficacious enough. I need a medication that provides more analgesic benefit than paracetamol but has few side effects. Coproxamol fits this gap perfectly. I have prescribed it for more than 25 years with positive feedback from patients.
“I have never personally known a case of suicide from this drug. My nursing home patients have their medication dispensed by nursing staff, so an overdose would be impossible. I think the proposed ban on this drug is wrong and will cause much suffering for my patients. I would like to add my support for the cancelling of the withdrawal of co-proxamol.”
The debate continues.
May I ask you please to support the reversal of the withdrawal of coproxamol. Log on to theyworkforyou.com, click ‘your MP’ and add the post code.
You will be presented with details of your Member of Parliament and click the line to send a message. Ask your MP to support a review of the decision to withdraw coproxamol to be raised by Anne Begg MP. This is a cross party issue. Whatever your colour – be it red, blue, yellow or green, or just red, white and blue all at the same time, if you have pain and need coproxamol, we need your support.
If you already know the name of your MP, most use the same email address – surname followed by initial without a break @parliament.uk –for example firstname.lastname@example.org
If you have a good response please send me your news. Jeanne