24th March 2023 - Source: Amanda Chell

Hi Amanda

Happy New year, I hope you are well.

We have a patient on Creon 25000 g/r caps. He has 1100 capsules a month at a cost of £28.25 a box.  I have worked out because he has 11 boxes this is a loss of approximately £32 a month. He doesn’t have any other regular meds with us. I have looked at discounts as brand is Viatis and cannot see any discounts on that product. I have asked dispensers to look for PI but have not found anything in that strength.

Can you confirm there are no discounts and should we be sending the script away. His dose seems to constantly be increasing!

Hello lovely,

Happy New Year to you too.

You are correct, this will be a significant loss maker as there is no discount.

I think on occasions, a PI has been available but not always and you need to ensure the price is less than 11.18% below list price.

It’s also a Part 2 item in the Drug Tariff- so my suggestion would be to ask the patient to take the prescription to a local pharmacy as they won’t suffer the clawback and loss that you are suffering.

Hope that all makes sense?

Hi Amanda

Please could you provide any guidance regarding:

1)    Stalevo – From a commercial perspective, would you suggest prescribing generically rather than by brand, and if so, would you dispense generically (if available?) or a certain branding (and if so, via which wholesaler)?


With regard to the Stalevo, I would suggest prescribing generically and dispensing Sastravi.

I think it is available through all 3 wholesalers, I don’t think there is a MDS on it but the list price is approx. 50% less than Stalevo.

Hi Amanda

Please can I check something?

Are we better off dispensing zapain tablets off a co-codamol tablet prescription?

Drug tariff co-codamol: £3.77

To buy (if it wasn’t out of stock): £3.70

Zapain to buy: £3.03

My gut is telling me its obvious and yes we should be giving zapain off a co-codamol script but I wanted to check as it doesn’t usually work this way


You are absolutely correct.

Doesn’t generally happen where the brand is cheaper than the generic, but in this instance – it is.

So, prescribe generically and dispense Zapain.