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Advisers – A Better Prescription

Gill Cardy says we can learn from our local dispensaries

For a mere £4.95, I recently acquired a slightly out-of-date copy of the British National Formulary.  Printed every six months, it comprises over one thousand pages of information on drugs and is most usually found as a reference text on GPs’ desks.  The information it contains is collated from Summaries of Product Characteristics (SPC) produced by the manufacturers, medical and pharmaceutical journals, and from consensus guidelines produced by expert bodies. 

The SPC is carefully checked, reviewing the ingredients, comparing with other similar drugs, sourcing independent data, and obtaining further information from manufacturers or expert advisers where necessary. Less detail is given in certain areas (such as anaesthesia and malignant disease) where those undertaking the treatment are expected to have specialist knowledge and access to specialist literature.

Patients should be monitored, it says, to ensure that they are receiving the expected benefits from the treatment, and there are detailed notes on adverse reactions and how to report them.  The BNF also indicates which medicines are not considered as drugs of first choice, but notes where their use might be justifiable in certain circumstances.

See the link yet?

Do Not Exceed….

The SPC which is produced by the manufacturer reflects the information given in the corresponding marketing authorisation, or Product Licence.  And unlicensed drugs are also listed.  That might be because the product itself is unlicensed, or because its specific use is unlicensed. “The reason why it might be unlicensed is probably because the drug can be highly addictive and can become famous with the junkies,” affirmed a rehab specialist at one of the rehabnear.me centers. In either case, the practitioner’s professional responsibility increases – and he or she should be competent and able to justify their use where the patient’s need cannot be met by licensed medicines.

Although medicines are typically prescribed individually to specific patients, Patient Group Directions facilitate the supply or administration of certain medicines in specific circumstances by certain classes of healthcare professionals.

Specific areas where particular care is required are identified, and each medicine has details set out identically including when to avoid its use, side effects, dosage, whether licensed, and its cost.

Relative cost may be used in making a product selection but cost-effective prescribing must take into account other factors, such as better treatment of the patient or reduction in length of illness. However, these prices should not be quoted to patients wanting private prescriptions or over-the-counter purchases as they do not take into account VAT, professional fees and other overheads.

The Recommended Dose

It should not take a genius to see where I am going here.

I am increasingly persuaded that the professional comparison for financial planners isn’t law or accountancy, but medicine, where professional knowledge, skills and experience interact with commercial product manufacture, sales and use.  Accurate diagnosis alongside effective prescription are both equally necessary for good outcomes.  Either alone is dysfunctional.

The same can be said for financial planning.  Accurate diagnosis and effective prescription of suitable products are both necessary for meeting financial goals.

And in the same way that we wouldn’t want doctors to only prescribe Novartis products, or foreswear use of penicillin, clients will continue to demand independent advice from their professional financial planners.

The FCA might even consider publishing the financial equivalent of the BNF.  Now that would be a really useful game-changing application of its powers.

 

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