I'm not at your stage yet only at the about to start chemo stage but I have regularly got my meds (high blood pressure, and befre this HRT) from GP for 6 months. Ok not at first but that was because he wanted to see that I was ok with them and that they were working for me.
Almost every time I come on this site and read about these kind of problems I feel so sad for people having these probablems and eternally gratefull that I have such a great GP and a good group practice.
I was originally prescribed Tamoxifen on a prescription for 28 days worth at a time. I went to see my GP and told him that firstly as they come in packs of 30 could he save the pharmacist a job of cutting two off each time and prescribe 30! He checked his system and said 'yes you are right - they do come in 30s!'. I then asked that as I am on these for the next 5 years could I have more than one month at a time. He said yes and how many did I want. We settled on three months at a time.
I believe there are guidelines on regular prescribing but they are only that - guidelines. In a situation such as ours Tamoxifen is not a problem and they can prescribe higher.
If you still have a problem ask your oncologist for help (S)he may be able to drop a line to your GP. After all it is the hospital who specify what you take, not your GP.
OK...what I should tell you that it is NOT the doctor that does your repeat prescriptions but the reception/admin staff (and you all know what old bags we are!!!!).
If you ask for your prescription on a 3 or even 6 monthly basis and you are refused make an appt to see your GP...explain you have enough to cope with, what with onc/surgeon appts etc., and an extended supply would greatly help you. You will probably get a different response (even your Practice Nurse can adjust your repeat scripts whilst you are going for your Zolodex).
Make sure you all ask your GP for your medical exemption certificate too. As Custard rightly says, it entitles you too all free meds if you are on cancer therapy.
I have been on Arimidex for 3 and a half months now , and was originally only offered monthly prescriptions .
So I went to see my GP , and she said there was no problem with a 3 month prescription and promptly changed it...I also get my blood pressure pills on a 3 month prescription...so it sounds like individual GP's discretion on the matter.
Pheebster is right I get my tamoxifen in 6 monthly supplies. My other meds, chlonidine and dusolepin for the hot flushes are monthly but I go to see them every month for my zoladex jabs anyway.
You should have a card (apply online) giving you an exemption from prescription fees - and not just for the cancer drugs either!
When I started on it 3 years ago I think my first precription was 1 month from my Onc then 2 monthly thereafter from my GP. I've not had much need to see my GP since finishing chemo and rads and always had very regular Onc appts,I was told to only come and see them if I wanted to. Last Christmas I was on a big downer and had started to hate and despise the tamoxifen and had big heart to heart with my GP and he suggested changing brand and wrote a 1 month prescription then review, when I told him I worked and had to pay he immediatley put me to 3 monthly and I've stayed on this ever since.
This issue came up with me a few days ago re Tamoxifen. I asked for a 3 month supply last time I needed it and got 2 months so when I asked for a repeat prescription this time I asked politely if I could have a 3 month prescription as I had asked for previously. I got an e mail back saying, and I quote, I was " extremely lucky" to get 2 months as the PCT says 1 month at a time. It quite upset me as I feel anything but lucky at the moment. I wondered if it was down to cost but if it is only £4 why on earth can I not have 3 months. I find it quite insulting if they think I am incapable of looking after some tablets and when I next see my GP I will be saying so.
Ahhhh - feel better for that.
Best Wishes everyone. LooLoo x x
Does anyone know what you do if you want to go abroad for 5 months which I am planning to do once my Herceptin finishes. I am on Arimidex and getting one month at a time. Does it mean I will have to come back each month!
I work for a doctor and can tell you that your doctor is able to prescribe up to 6 months at a time, at his discretion.
Giving you one month is purely for costing reasons but now cancer patients don't pay for their scripts, I don't see the reasoning...it causes more work for the practice too.
I have patients who have up to 6 months at a time, but on the whole they are given 3 months.
Arimidex costs your GP about £70 per pack...whereas tamoxifen is only about £4!
I too am only allowed 2 months at a time. I was told this is because of the budget allocation by my PCT. I just fill in a form and then collect it at the chemist. I never go in to see my GP, am too embarrassed after an incident last year when I was on chemo when I passed out in his waiting room and then vomited all over his consult room, but then that's a whole different story!!!!
Just to add my experience. I am allowed 2 months prescription at a time but only have to hand the repeat form in with a stamped addressed envelope and they send it to me. I have to actually see the GP every 6 months although that may change this autumn with the pressure from the Swine Flu situation. I am on Femara and all sorts of other things for conditions prior to BC. I do actually think I rattle!
Ooh i must have slipped through the net as my surgery are letting me have 3 months of tamoxifen at a time... The "you might lose it" arguement seems daft as i am sure a fair few of us used to be on the pill prediagnosis... and they seem willing to trust us with six months worth of that at a time....
Thanks for this, Topsymo. As I'm only on tamoxifen, the "convenience" idea doesn't hold - and whenever did patient convenience become a deciding factor in anything! Also, my mother takes a large array of drugs which get started and changed at various times so she does run out of things at different times because they are added to the list at different times.
Yes, Phillidel, they do treat us like irresponsible children. Although your GP can't be expected to be an expert on breast cancer, Topsymo, it is a bit worrying that he feels able to make comments about alternatives when he doesn't have the knowledge. It makes you wonder how much of what he says is accurate, doesn't it? Just as well that we all do our own research!
If the only reason I see my GP at the next review is because she wants to see me and I don't have any issues to raise, I am thinking of invoicing her for my time...
Hi Eliza and Philidel - I have just found this on the web; it's about Wales but I assume it applies everywhere else - so we are doomed!
Q. Why has my GP limited my prescriptions to a 28 day supply?
A. Anglesey Local Health Board recommends as best practice to prescribe in quantities of one month, as this was the recommendation in a report produced by the Audit Commission ‘A prescription for
improvement. Towards more rational prescribing in general practice’. In this report the Audit Commission highlighted the issue of waste generated by repeat prescribing systems, and that the waste cost the NHS millions of pounds each year.
This is a recommendation for best practice and whilst the Local Health Board advises and encourages practices to adopt this policy, it is up to individual practices to produce their own repeat prescribing policies.
This is not a new LHB initiative and the vast majority of practices on the island have adopted this policy and it has been operating successfully for many years.
There are also national guidelines that doctors must adhere to regarding the frequency of medication reviews. The doctor’s own contract requires that a medication review is performed at least every
15 months, but it is recommended best practice that for vulnerable groups and patients taking multiple medicines that the frequency is reduced to 6 months.
Before this new policy was introduced, patients received supplies of medicines for varying quantities of treatment, for example, two months worth of aspirin, three months worth of blood pressure tablets and two weeks worth of pain killers on the same prescription. This meant that patients had to order repeats on different occasions, which increased the workload for the practice, and was inconvenient for the patient. Now, patients’ medicines have been aligned so that only one repeat
request a month needs to be completed for all the medication.
My hospital originally prescribed 3 month's worth of Tamoxifen, which (given the 5 year timescale) seemed quite reasonable. The first repeat prescription from my GP was for one month, which seems bizarre. I questioned it the second time around to be told that they are "not allowed" to prescribe more than one month's supply of any medication. Surely the administrative overhead on this must exceed any wastage by lost medication. Or do they think we're going to pop the whole lot at once?
I feel as if we're being treated like irresponsible children.
Eliza- you have summed up just what I feel.
The whole exercise seems just a waste of 3 people's time- mine, the GP and the dispenser- how can this be justified - and why does the patient have no say in the matter?
I agree with you re the drug review too: my GP made comments to me re possible alternative drugs and on other BC matters that indicate that he actually knows less about BC than I now do! This isn't a criticism of him- who would expect him to be an expert on every condition - especially now when so much info is available to the patient thro the internet, forums like this. etc
Topsymo, I feel very similarly.
I'm okay with taking something every day but having to take in a script and then go back to collect it esch month is a constant reminder of how life has changed. I hadn't actually met my GP until I went for the first repeat prescription (dx through screening)! And I had a "review" a while ago, only a few weeks after I had seen the onc and discussed the tamoxifen with him, so the GP's review was a pure waste of my time and hers. The same will be true at the next "review".
I think the limitations on how much they can give is because the NHS thinks that we silly patients will keep losing our supplies and then need more, which would be expensive and a control proble.
Hi,I get all of my meds on a 2 monthly script except Arimidex which is monthly,to be honest I have never thought of this so next time I put my request in I will ask for a 2 mthly script and see what they say.
I will let you know the result!!!
I am a year on from dx and started Arimidex in Jan 09. I have twice asked if I can have more than one month's supply at a time but have been told that that only one month's is allowed - with a review every 6 months.
I know this is really not a major issue but having been someone who seldom saw the inside of the surgery for months on end, I find this a tad dispiriting. I am well aware that my BC could return at any time but in the meanwhile I wish I didn't have to be treated as chronically sick by my local practice.
Does anyone else see this as an issue? My GP is OK but a bit strong and silent & I haven't been able to ascertain whether this is just his rule or whether it's a NICE guideline