The price of nitrofurantoin 100mg tablets has reduced from £12.29 for 28 tablets in June, to £3.53 for 28 tablets in July. Therefore, when appropriate, 100mg tablets are currently the most cost-effective nitrofurantoin preparation.
The North of Tyne formulary includes nitrofurantoin:
- 50mg & 100mg tablets
- 50mg capsules ( in macrocrystalline form)
- 100mg m/r capsules (Macrodantin® & Macrobid®)
- 25mg in 5ml sugar-free suspension
In September 2013 the prices were £3.66 for 30 x 50 mg capsules vs £31.33 for 28 tablets, hence the drive in many areas at that point to prioritise 50mg caps over tablets. The work done then generated significant savings for CCGs and was therefore a worthwhile exercise, although now that the drug tariff has changed, ongoing benefits are limited.
There was not a significant price differential in the 100mg formulations at that point in time therefore that strength was not a focus of the work.
It is frustrating when national pricing mechanisms change with little/no notice and previous good work is undermined but finances do dictate that we have to make the savings where we can.
In the case of nitrofurantoin many of the patients involved will hopefully not be on repeat prescriptions and therefore an awareness of the lowest cost agent now should not be a complete rework for practices, just a change in priority now when prescribing.