Raza Ali, director and superintendent at Riverside Pharmacy in Nottingham, has claimed his local clinical commissioning group's (CCG) decision to switch certain generic prescriptions to branded versions has left the pharmacy "overrun" with the more expensive option.

Mr Ali told C+D: “Based on a 10% clawback on four products over one year, I estimate I am losing over £10,000 on top of the [funding] cuts I am already facing. This does not take into account expenses that may be incurred on obtaining some branded generics.”

Mr Ali listed "quetiapine, metformin, co-codamol, insulin needles and even paracetamol", as examples of medicines that have been switched to a branded generic by the CCG.

“If we dispensed and were paid as per the drug tariff for metformin MR, the pharmacy would make roughly £4,632 a year. Instead we incur a loss of about 35 pence per pack, so a net loss of over £5,000,” Mr Ali explained.

A spokesperson for Nottingham Clinical Commissioning Partnership told C+D its medicines management team "continually evaluates and updates its guidance regarding individual medicines". See below for the CCG's full response.

Mr Ali continued: "Overall, this is short-sighted and leads to price hikes and market shortages, undoing the hard work pharmacists have done over the years reducing the cost of medicines."

“Branded generics will [continue to] be pushed [by CCGs], prescribing changes will be made, and the effect on community pharmacy will be ignored.”

Patient distrust

The switch to branded generics has resulted in “a real distrust” towards pharmacies from patients, said Mr Ali, who added that “GP practices are poorly communicating [prescribing] changes”.

“[Patients] feel we are behind the changes and are doing it to make a profit,” he said.

“The community pharmacy either makes a loss if they dispense the prescription, or refers the business on and loses the patient,” Mr Ali added.

CCG benefits from pharmacists' feedback

Nottingham Clinical Commissioning Partnership told C+D: "We benefit from excellent feedback from our community pharmacists to develop [our prescribing] advice and guidance."

"We would invite any pharmacist with concerns about the prescription of particular medicines to contact our medicines management team or to raise [the issue] with the local pharmaceutical committee," it added.