NHS Cuts…. &#39No&#39 to recommended medication.

[dori2o]

The Dr at the pain clinic recommended that I try lidocaine patches in tandem with capsaicin cream to try and give me some relief at night so I can get a few more hours slepp.

Went to the GP last week and they have refused to prescribe the lidocane patches as the local PCT won’t pay for them.

Has anyone else had this and is there any advice on how to obtain them?

[Di]

My GP was only too happy to let me try them last year. I just mentioned them in passing and he prescribed them. If your pain consultant has said you should have them there’s no reason for the PCT to refuse. Get your consultant to write to your GP.

[Anonymous]

Are you thinking of using the cream underneath the patch or on the area where the patch goes?? The skin underneath the patch can get very sensitive and the capsaicin cream is quite strong. I’m not sure I would do that, but if that’s what the doctor recommended…

I hope you get the patches as they are helpful. As Di says, ring the clinic and ask the Pain Clinic doctor to write a note to your GP.

Jan at PainSupport

[Rob]

I think they may have meant “in tandem” as used together but in seperate places as lidocaine would not stick to a cream easily if at all. If the GP refuses refer back to the Consultant as they can prescribe direct. There shouldnt be a PCT funding issue and the cost issues are probably only GP practice policy. Ask them for details in writing.

[YARDMAN]

Hi,The pain clinic put me on these parches just before Christmas and I have had no problems getting repeats from my gp although she did mention they would cost £2000 per year to the NHS to which I replied,”remarkably good value don’t you think “She never said anything else after that.

[picton]

YARDMAN that’s one of those killer replies that I usually tend to only WISH I had said! 🙂

It won’t stop them thinking hard about it come April when it’s coming out of their own budget though 🙁

[dori2o]

Thanks for the advice.

I’m going to make an appointment to see the GP again next week as the Pain Dr has sent a letter advising I should be referred to the Orthopedics for my other knee as it has been very painful now for about 6 months, but my GP has previously refused to refer me as the pain ‘might just go away on it’s own’. Thats what I was told 19 years ago with the other one. ‘It’s only Osgood Schlatters it’ll clear up with a bit of rest’, yeah…right.

As for the ‘in tandem’ aspect of the patches, he has advised that I use the cream under the patch, securing it with surgical tape or by use of a tubigrip bandage if necessary.

The Pain Dr said the cram will help the lidocaine penetrate the skin and get to the nerves quicker.

I use capsaicin a lot at the moment, especially at night, but you are right, it causes the skin to be very sensitive in the area it is applied.

We’ll have to see what happens next week.

[dori2o]

Just to update on this.

I saw a different GP and got the lidocaine patches, but he said not to use them in tandem with capsaicin just yet. Use them on their own first to see if there is any relief.

Used first one yesterday and there was no change. Just about to put todays on.

Also with regards the referral, I have to have an x-ray before he will refer me so it looks as though he has at least done something (his words not mine). So it’s off to the Integrated Care Centre in Oldham later. They’re open 8am-8pm with no need for an appointment, just take the form GP gave me and ‘drop in’. It also houses the ‘Drop in’ centre.

I think thats all for now.

[sarahwithstars]

they are way too expensive to justify for most patients (over £70 per box of 5 patches).

My old hospital only allows patients to use their own lidocaine patches in hospital, we dont supply them because they are too costly and we certainly wouldnt start them for a patient.

The reality is, while it is all very well for individuals to say that they a good, there is very little evidence that they make a significant difference when use on the back. Their use is only documented as helpful in diabetic neuropathy of extremeties, toes and heels in particular.

[Lupin]

Hi all,
I don’t want to cause a debate but I get very angry that there have been previous posts about people being refused these patches by their GP. The NICE Guidance 96 specifically refers to topical lidocaine as a Pharmacological treatment for neuropathic pain.

Also my pain consultant (specialising in spinal cord injuries – SCI) told me there have been a number of studies on the neuropathic central pain and lithocaine. They concluded lidocaine can bring about a significant reduction of some of the different pain sensations which make up central pain caused by CNS injuries. I and a number of my SCI friends use a one or more of IV infusions, patches and tablet form (in my case to help reduce severe night time allodyia).

I get sick of hearing that it is a postcode lottery as to whether folk get to try out pain medications. If you have neuropathic pain NICE states you can have these patches. I get then without any question from my GP, prescribed by my pain management consultant.

Rant over
Lu

[sarahwithstars]

lidocaine does work for neuropathy but as I said, the evidence is with use of patches on the extremeties affected by diabetic vasculitis etc.

and the drug is useful for neuropathies centrally, but not when given through the patches- Australia’s health care systems for treating chronic pain use a lot of lidocaine infusions and ensure the anaesthetic of choice in caudal epidurals is lidocaine mixed with steroids.

yes the patches are a postcode lottery, but only because there is no evidence they worked! if they were a miracle tool, then the evidence would say so, and it would be worth the money to roll it out for patients in significant pain.

[sheevee]

Sorry Sarah but the pain patches make a significant difference to my nerve pain and I feel strongly that anyone who feels they may help should at least be able to try them. It is very much a case of who prepares the figures and what basis they started from – lies, lies and statistics!! The more people who use them will hopefully bring down the unit cost. Won’t it also come down soonish when the licence expires as it did with Zovirax cream?

[sheevee]

Would be very wary of putting the capiscain cream under the lidocaine patches. Perhaps try with a small patch first as the patches can be cut to whatever size needed.

[jean]

I have been using lidocaine pain patches (Versatis) now for 6 years and could not manage without them. I am glad to hear you have managed to get a prescription for them as they have been a godsend to me along with Fetanyl patches etc. I hope you manage to find some relief with them. I use two to three per day and have never had problems getting them. I have never heard of using Capsacin with them before and cannot imagine how they would work together but i wish you good luck and hope your pain improves

[Di]

I’ve used capsacain and lidocaine patches and wouldn’t dare put the capsaciain under the patch. It burns like crazy even on its own until your skin gets used to it.

[Author]

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