Again you make many good points, including quoting published references to evidence-based management of neuropathic pain, all of which I consider worthy.
I too want to restore the UK to the previous position, as in the world beyond the European Court, where doctors could happilyu prescribe amitryptiline and many other cheap safe and effective drugs for neuropathic pain, even though many are not licensed for that indication (see your box2 reference):-
Amitriptyline (not licensed for neuropathic pain)
Nortriptyline (not licensed for neuropathic pain)
Venlafaxine (not licensed for neuropathic pain)
Milnacipran (not licensed for neuropathic pain)
Oxcarbazepine (not licensed for neuropathic pain)
Lamotrigine (not licensed for neuropathic pain)
The GMC (http://www.bmj.com/content/350/bmj.h2043) stated "Doctors cannot prescribe an unlicensed drug on grounds of cost if a licensed product is available. This was confirmed by a ruling in the case of European Commission v Republic of Poland (C-185/10) in 2012."
So our great problem in the UK is that we must comply with the European Court, rather than mount a challenge based on national interest, patient benefits and social utility.
I have a cunning plan to free Margaret and Rapunzel .. which rather depends on NICE unravelling the licensing locks (pun intended) !
Rapid Response:
Rapunzel's tower or Castle Dungeons ?
Dear Shyan,
Again you make many good points, including quoting published references to evidence-based management of neuropathic pain, all of which I consider worthy.
I too want to restore the UK to the previous position, as in the world beyond the European Court, where doctors could happilyu prescribe amitryptiline and many other cheap safe and effective drugs for neuropathic pain, even though many are not licensed for that indication (see your box2 reference):-
Amitriptyline (not licensed for neuropathic pain)
Nortriptyline (not licensed for neuropathic pain)
Venlafaxine (not licensed for neuropathic pain)
Milnacipran (not licensed for neuropathic pain)
Oxcarbazepine (not licensed for neuropathic pain)
Lamotrigine (not licensed for neuropathic pain)
The GMC (http://www.bmj.com/content/350/bmj.h2043) stated "Doctors cannot prescribe an unlicensed drug on grounds of cost if a licensed product is available. This was confirmed by a ruling in the case of European Commission v Republic of Poland (C-185/10) in 2012."
So our great problem in the UK is that we must comply with the European Court, rather than mount a challenge based on national interest, patient benefits and social utility.
I have a cunning plan to free Margaret and Rapunzel .. which rather depends on NICE unravelling the licensing locks (pun intended) !
Competing interests: costs benefits and law