Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Dandelion on September 30, 2014, 07:37:20 PM
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I didn't know that hrt patches, like evorel cost more than the prescription charge.
The GP I saw on Friday told me.
This was before she decided to consult with a colleague for a second opinion as she is a trainee.
Dunno how much the cos it, as we never got that far, because after consulting with a colleague, patches were refused due to migraine.
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Hi Dandelion
Sorry to hear this
So what if the cost is more - our prescription charge is a nominal charge and this is the NHS which is subsidised. The product is licensed and should be freely available.
As for migraines - patches are usually recommended over tablets for migraine sufferers: this is what it says on this forum:
Migraine
Migraine is often triggered by hormonal fluctuations and therefore may occur around the time of a period. Such migraine may improve at the time of the menopause. Some women find that migraine may be triggered by the daily hormone fluctuations which can occur with oral (tablet) HRT so the transdermal (patch or gel) route is usually preferred with a history of migraine.
http://www.menopausematters.co.uk/atoz.php#GlossM
However if you have Evorel sequi the norethisterone can give rise to migraines if you are susceptible. You could have Evorel patches only, along with the micronised progesterone - Utrogestan - which should be the best option if you suffer from migraine.
You should not have to consider the cost at all but you are entitled to be prescribed any of the licensed products which are suitable treatment for your condition!
Hurdity x
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Hi Dandelion
Sorry to hear this
So what if the cost is more - our prescription charge is a nominal charge and this is the NHS which is subsidised. The product is licensed and should be freely available.
As for migraines - patches are usually recommended over tablets for migraine sufferers: this is what it says on this forum:
Migraine
Migraine is often triggered by hormonal fluctuations and therefore may occur around the time of a period. Such migraine may improve at the time of the menopause. Some women find that migraine may be triggered by the daily hormone fluctuations which can occur with oral (tablet) HRT so the transdermal (patch or gel) route is usually preferred with a history of migraine.
http://www.menopausematters.co.uk/atoz.php#GlossM
However if you have Evorel sequi the norethisterone can give rise to migraines if you are susceptible. You could have Evorel patches only, along with the micronised progesterone - Utrogestan - which should be the best option if you suffer from migraine.
You should not have to consider the cost at all but you are entitled to be prescribed any of the licensed products which are suitable treatment for your condition!
Hurdity x
Hi Hurdity
I asked the GP I saw on Friday about micronised progesterone, and she looked in her doctory book they have and could not find it.
I would like to get hold of this micronised progesterone stuff, but there seems to be a barrier at our surgery, because my own GP could not find it neither.
I know other women get it on the NHS but I wonder how I can get a doctor at my surgery to recognise and possibly prescribe it.
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Just curious - what point was your GP trying to make by telling you that a particular Prescription Only Medication costs more than the prescription charge of £8.05? Did you ask or was this information offered by the GP? How is this relevant? Some POMs cost less than the prescription charge, many cost more, some a lot more.
I actually qualify for free prescriptions and out of curiosity have Goggled the cost of the various POMs I take (several £100s per month I reckon). Whether I qualified for free prescriptions or not, I don't think I'd take kindly to a GP telling me how much things cost. Would he/she be implying that I'm not worth spending the money on?
Good luck with trying to secure any appropriate meds which you need. As Hurdity has said you should not have to consider the cost.
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Dandelion - if you know other women on this med can you ask them what the manufacturer is? Then it's worth looking at their website and seeing if the prescribing (PIP) code is there. If not contact the manufacturer and ask for the PIP code. Armed with this information your GP should be able to 'find' it on their system.
Good luck.
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Just curious - what point was your GP trying to make by telling you that a particular Prescription Only Medication costs more than the prescription charge of £8.05? Did you ask or was this information offered by the GP? How is this relevant? Some POMs cost less than the prescription charge, many cost more, some a lot more.
I actually qualify for free prescriptions and out of curiosity have Goggled the cost of the various POMs I take (several £100s per month I reckon). Whether I qualified for free prescriptions or not, I don't think I'd take kindly to a GP telling me how much things cost. Would he/she be implying that I'm not worth spending the money on?
Good luck with trying to secure any appropriate meds which you need. As Hurdity has said you should not have to consider the cost.
Hi
She sort of said it in a warning type of way, I'm glad she did.
She asked if I paid and I said I was at the moment as my HC form had ran out.
Maybe it said somewhere on the notes she was reading that I am on benefits.
I dunno why she asked. I took her to mean it in a helpful, heads up context.
I never thought of the 'not worth spending money on' angle. :)
She never did tell me the cost - we never got that far. I'm curious though, as I could be getting patches.
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Dandelion - if you know other women on this med can you ask them what the manufacturer is? Then it's worth looking at their website and seeing if the prescribing (PIP) code is there. If not contact the manufacturer and ask for the PIP code. Armed with this information your GP should be able to 'find' it on their system.
Good luck.
Hi Tiger, thanks.
The 'other women' that I speak off are women on these forum?
I must admit, I am a bit nervous about trying evorel sequi due to the norethisterone and possible lower moods, but, I don't get pmt, and I heard that it hits those hardest who already get pmt.
PS - Can any utrogestan users let me know who the manufacturer is, so I can contact them for this PIP code is. Cheers.
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Ooops, sorry Dandelion, didn't mean to put bad ideas in you head about your GP's intentions.
Still don't really see the relevance of the cost (beyond curiosity). I'm not aware of any imposed maximum for any individual patient.
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Ooops, sorry Dandelion, didn't mean to put bad ideas in you head about your GP's intentions.
Still don't really see the relevance of the cost (beyond curiosity). I'm not aware of any imposed maximum for any individual patient.
Hi Tiger,
No worries. I am a paranoid sort of person, yet, at the same time, sometimes I can fail to see unhealthy intentions in others and this makes me feel vulnerable, menopause, or rather, perimenopause just makes this a whole lot worse.
I'm so desperate to feel better I am even wearing a ladycare magnet that I abandoned not long after buying.
Opinions are divided on these, mine's up in the air, I'll give it enough time to make a judgement, then I will judge.
My hrt pills cost the normal prescription charge, and I was shocked the patches cost more. I am curious how much.
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Hi Dandelion. I'm currently on Estradot 50 patches and Utrogestan tablets for day 15-26. My patches were charged at one prescription charge and the Utrogestan at another prescription charge, being two items.
When I tried the Femseven Sequi patches, these were charged at double prescription charge as they count the oestrogen and the progesterone in the patches as two items. Think this only applies for Sequi/combined patches though.
Either way, if you're going to need both oestrogen and progesterone, however they are delivered they will be charged at 2 prescription charges.
My Utrogestan is made by Ferring Pharmaceuticals, if that helps you find the info.
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Packets of medicine, where there are two different preparations, cost twice the prescription charge.
So everol sequi, where there are oestrogen and oestrogen/progestogen patches cost £16.10.
everol conti, where there are only oestrogen/progestogen patches are £8.05.
Same with tablets, so shouldn't make any difference if you are on tablets or patches ???
I have heard of other people having problems with their doctor finding uterogeston. Mine took ages to find femeston (which is what I wanted - she looked at one with the wrong oestrogen and a continuous one before she found it). I think they would be better with a Doctory book that was laid out like the info on this site.
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Hi Dandelion. I'm currently on Estradot 50 patches and Utrogestan tablets for day 15-26. My patches were charged at one prescription charge and the Utrogestan at another prescription charge, being two items.
When I tried the Femseven Sequi patches, these were charged at double prescription charge as they count the oestrogen and the progesterone in the patches as two items. Think this only applies for Sequi/combined patches though.
Either way, if you're going to need both oestrogen and progesterone, however they are delivered they will be charged at 2 prescription charges.
My Utrogestan is made by Ferring Pharmaceuticals, if that helps you find the info.
Hi thanks.
I wonder if utrogestan has more than On manufacturer though.
This hrt malarkey y seems, for me, to have been a pointless series of needless obstacles just to make life difficult.
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Hi - I think Utrogestan is a "brand name" used by Ferring Pharmaceuticals. I think the general name for it is "micronized progesterone". Hopefully that's correct, but I'm sure someone will correct me if wrong.
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If a patient is in the UK a prescription is that - a prescription - each item on the sheet will be charged separately so i.e. 4 items, 4 amounts. I paid 'up front' for years which saved me money, now I'm 60 ::) ......
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a patient's required medication should not be about cost however I feel guilty accepting an item that I know to be very costly to the NHS and will always source a cheaper option if I can as I don't pay any prescription charges and don't like to abuse it.
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I agree with Stellajane
What sort of GP can't find a licensed product that is available? I mean even if they don't know how to look it up they should know about this site where the info is there - it has to be under either micronised progesterone, progesterone, or Utrogestan - there is nothing else it could be listed as!
You should never feel guilty babyjane! We are all entitled to whatever medication or prescription is advised for our condition and if there is a choice (eg with ADs or HRT) - that choice should be ours, having taken into account our medical history. I realise there is a limited budget but making patients feel guilty about medication should not have a place in our welfare state.
Hurdity x
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Feel guilty about accepting what our GPs prescribe! never. What we forget is the amount of time and energy, plus funding, that the various Drug Companies put into making these medications - that's where the guilt should be! All those years of manufacture and getting the meds accepted by NICE costs money ….. but once the funding has been clawwed back often those particular meds are withdrawn by the Companies >:( ……… or those meds are sold to mainland Europe at a cost to patients in the UK :-X
If we need medication don't forget: we are lucky to have the option of going to a GP/Consultant for advice. In the Middle East and parts of far off Asia people have no choice - not even pain relief. What we need is for the medical profession to stop treating patients as though we don't know anything …… to being listening, offering advice and for GPs to be allowed by the Government to allow patients longer than 10 mins.. :-X
MIMS was the Bible we used when I was a secretary. If it wasn't in there it wasn't available ……
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Yes, I feel some entitlement to having the correct prescriptions, specially as I have been a tax payer since aged 15! The HRT patches may cost more to the GP than the HRT tablets, but I don't care, and to be fair, the GP's have never quibbled on cost. I still have to pay for the prescriptions anyway.
I feel fortunate that I generally do not need many prescriptions, and hope this lasts. The main issue is that the cheap prescriptions are as effective as the expensive ones.
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I agree with Stellajane
What sort of GP can't find a licensed product that is available? I mean even if they don't know how to look it up they should know about this site where the info is there - it has to be under either micronised progesterone, progesterone, or Utrogestan - there is nothing else it could be listed as!
You should never feel guilty babyjane! We are all entitled to whatever medication or prescription is advised for our condition and if there is a choice (eg with ADs or HRT) - that choice should be ours, having taken into account our medical history. I realise there is a limited budget but making patients feel guilty about medication should not have a place in our welfare state.
Hurdity x
Hi Hurdity
Two GP's could not find it in their book, I got them to look under micronised as well. Hopefully, the manufacturer ferring will be able to supply me with a pip code.
Ironically, today, I am not flushing, very odd, some days totally dry other days soaking wet and burning up.