Wednesday, March 08, 2006

Why I Have £270 Worth of Drugs On My Desk

Last year I was treated for Hepatitis C at St Mary's Hospital in Paddington. One of the top places, an NHS flagship. Theoretically the treatment is very well organised, I would go in once a month, have tests, get the results of the previous month's tests, have a twenty minute chat with a specially trained nurse, collect my medication for the next month, etc. In theory. In fact my specialised nurse didn't much like taking blood, so would write out a chit and send me off to another hospital to have my sample extracted, and give me a prsecription to collect drugs from the pharmacy at St Mary's. What, precisely, my nurse did with the remaining 17 minutes allocated to the consultation I never asked.
Now the treatment regime for Hep C is constant, daily oral Ribavirin capsules, and weekly injections of Interferon, though some cases require a higher dose. It would have been possible for the liver unit to inform the pharmacy to expect, say, 14 standard dose prescriptions per week and 6 high doses, so that these could be prepared at a quiet moment and ready to hand out immediatley. No, each prescription was made up ad hoc and to save time they didn't count out the exact number of capsules, but gave us a whole box. 168 capsules, when 112 were needed. I expected there to be a smaller makeweight prescription near the end. No, I had to argue that I had more than enough at home before I was allowed not to take Ribavirin home on my fifth visit.
I have no objection to giving someone 100 aspirin rather than 84 because it's more cost effective than wasting time, but Ribavirin isn't cheap. If someone took the extra box the wasted drugs would cost roughly £1,000 per patient. I paid attention, refused surplus drus and still finished the course with 84 unused capsules, cost £270, as headline. I wonder how much of the NHS financial crisis comes from this kind of waste.


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