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c/glp1uk·posted 3 months ago by u/tomas_broberg

[Discussion] we are measuring pharmacy at the wrong time and calling it noise

Discussion Slow Clap ×1 Receipts ×3

we are measuring pharmacy at the wrong time and calling it noise. It is the sort of thing everyone half-believes and nobody writes down.

Two years and four months on a tier 3 list. Referral date and every letter kept, which turned out to matter when the service reorganised.

Four pharmacies, four prices, same product, same month. The spread was larger than I expected and none of them were the headline offer.

GP said no in the spring, specialist said yes eighteen months later. Same person, same numbers.

That is everything I have. The rest is opinion and I have tried to keep it out.

2,165 up / 142 down94% upvoted49 commentsid 1938ts12 Apr 2026

49 comments

28 in this archive, depth 5

best — the order this archive was captured in

u/nordic_pricing0 points·3 months ago

Why the monthly pricing tracker works, and the rule that makes it work.

Members post the pharmacy, the product, the month and the price they actually paid — not an advertised offer, not a first-month discount. No links of any kind are permitted, which removes the entire incentive to post anything other than what happened.

The result is that the spread between pharmacies in a given month is visible, and it is consistently larger than people expect. That single table has saved members here more money than every other thread on the board combined, and it survives only because the no-links rule is enforced without exception.

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u/ms_fragmenter314 points·3 months ago

Discharged at goal back to the GP, who would not continue it. Nobody had mentioned that this was how it ends.

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u/sten_palacios151 points·3 months ago

Discharge from a specialist service at goal is a normal end point of that pathway. Whether prescribing continues in primary care afterwards is a local decision and is worth asking about at the start rather than at the end.

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u/mei_cardoso0 points·3 months ago

Disagree. That is the pathway in one ICB and it does not generalise even to the next one over.

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u/helga_vermeulen0 points·3 months ago

A private prescription is an independent route: it does not affect NHS list position, and it is not a step in the same pathway.

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u/priya_guerrero1 point·3 months ago

A private prescription is an independent route: it does not affect NHS list position, and it is not a step in the same pathway.

Agreed — and keeping the letters with dates is what makes any later challenge possible.

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u/helga_vermeulen1 point·3 months ago

Push back: a private prescription is a separate route, not a shortcut through the NHS queue.

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[removed]1 point·3 months ago

[removed by moderator]

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u/ilias_nakamura1 point·3 months ago·edited

Right, and reading the actual supply notice rather than the coverage of it saves a fortnight of speculation.

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u/crp_curious1 point·3 months ago

GP said no and specialist said yes is a very common sequence

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u/hassan_chowdhury107 points·3 months ago

Yes — the consultation that asks nothing tells you what kind of service it is.

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u/ahmed_okafor-28 points·3 months ago

In England, specialist weight management services are commissioned locally, so eligibility criteria and waiting times differ by ICB. There is no single national threshold to quote.

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u/tomas_brobergOP66 points·3 months ago

Small fix — that is the Scottish pathway. The post is asking about England and the answer is different.

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u/ines_lindqvist42 points·3 months ago·edited

Small fix — that is the Scottish pathway.

This is why national advice does not work here. It is commissioned locally and it varies.

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u/lane_watchermod · logistics89 points·3 months ago

Discharge at goal, which nobody warns people about.

Specialist services in England are commissioned to deliver a defined intervention. Reaching goal is a successful outcome and it typically ends with discharge back to primary care. Whether prescribing continues after that is a local decision that varies, and plenty of members here have discovered it at the point of discharge rather than at the start.

The useful thing to do is ask early: what happens when I finish, and does prescribing continue in primary care in this area. Ask it in writing, keep the answer, and you will at least know which conversation you are heading for.

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u/tomas_brobergOP51 points·3 months ago

Correcting myself: the referral was 8 months ago, not the figure I gave. I keep rounding it down.

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u/rina_nascimento22 points·3 months ago

Correcting myself: the referral was 8 months ago, not the figure I gave.

Disagreeing with this line: that is the arrangement in one nation and the question is about another.

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u/not_my_main_nm49 points·3 months ago

the price difference between pharmacies this month is genuinely large

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u/rt_shift_reggie33 points·3 months ago

Pharmacy pricing on a private prescription is set by the pharmacy. The spread between them in a given month is routinely substantial, which is why a tracker built from member reports is more useful than any headline.

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u/blunt_coldbox2914 points·3 months ago

Cosigning on discharge at goal. It catches people who have done everything right and did not know it was coming.

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u/crosspost_bot_no13 points·3 months ago

Agreed on keeping letters. Dates are what make an appeal or a re-referral possible.

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u/tomas_broberg25 points·3 months ago

ask the pharmacy for the price list, not the headline offer

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u/enzo_fonseca14 points·3 months ago

Scotland, Wales and Northern Ireland have their own arrangements. An answer that begins with "in England" should say so, and most of the confusion here comes from answers that do not.

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u/bence_ibarra21 points·3 months ago

The scheme cap in Ireland was the single most useful thing I learned in a year of reading this board.

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u/sock_puppet_spotter17 points·3 months ago

Concentrations can differ between products and between pharmacies. Switching mid-titration means redoing the arithmetic rather than carrying the old unit count across.

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u/bence_ibarra0 points·3 months ago

This. The monthly pricing tracker is the most useful thing on this board and it works because nobody is allowed to link anything.

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u/gradient_goblin5 points·3 months ago

specialist service, not GP, for tier 3 in most of England

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u/tomas_brobergOP2 points·3 months ago

Is this a discharge back to the GP, or a discontinuation?

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UK-specific access: NHS tier-3 and specialist weight-management pathways, the two-year waiting-list reality, private prescription routes and their monthly cost, pharmacy stock, MHRA supply notices, and how the UK rules differ from the US conversation that dominates most of the internet.

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