Yorkshire PCTs have told pharmacists it is acceptable to dispense generically prescribed clopidogrel for all prescriptions after Lloydspharmacy instructed pharmacists to query prescriptions potentially using the drug off licence.Lloydspharmacy had told pharmacists to question all prescriptions for clopidogrel in combination with low-dose aspirin and return for amendment unless brand Plavix or the generic hydrogen sulphate salt was specified. Although generic clopidogrel is licensed for all applications in the EU, in the UK a patent prevents generic clopidogrel hydrochloride or besilate being used for the prevention of atherothrombotic events in patients with acute coronary syndrome.However, medicines management teams from NHS Hull and NHS East Riding of Yorkshire wrote to all pharmacists in East Yorkshire, advising them to end the policy. The generics’ balance of efficacy and safety made it “reasonable” to use the products off label, the PCTs countered.“It is likely that the cost of generic clopidogrel will become significantly lower than the branded product over the next few months and the potential savings on the drugs bill for both pharmacy and secondary care will be significant,” the PCT letter added.Lloydspharmacy superintendent Steve Howard said the multiple had acted in line with RPSGB guidance to ensure prescribers were aware the medicine was being used off-licence.“Many primary care organisations have stated that it is acceptable to supply [clopidogrel] against all prescriptions and where we have been informed this is the case the information has been passed to pharmacies,” Mr Howard said.
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