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Thread: Mianserin or Tolvon

  1. #21
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    Re: Mianserin or Tolvon

    Quote Originally Posted by MyNameIsTerry View Post
    April 2019 statistics - cost per year:

    Mianserin (30mg) - £400.66
    Lofepramine(140mg) - £223.73
    Nortiptyline (75mg) - £95.77

    Any thoughts on this situation now Ian given cost seems not to be the issue with this psychiatrist if they have discounted the others you guys on this thread have mentioned?
    I'm not surprised mianserin is so expensive, Terry. The market for it must be tiny now so the cost of making it would be high, plus I suspect there may be wastage from meds reaching the use-by date unsold. Unless there is some huge market for it in an obscure part of the world that I don't know about, I really can't see why they bother. There can't be much profit in it even at 400 quid for a year's supply. Just announce production will cease in say 6 months and all patients should be switched to mirtazapine and be done with it.

    I'll also point out Mirtazipine (30mg) is £13.91 per year and considering you say its the same drug this psychiatrist is possibly wasting money?
    Yeah, prescribing a drug that costs 29 times as much as its claimed superior analogue isn't going to win her the Nobel prize for economics - though it might put her in the running for exchequer! The mental machinations of psychiatrists have long baffled and confounded me. I've concluded most have far more screws loose than any of their patients.

    BTW-do you have costings for dosulepin/dothiepin and tranylcypromine?

  2. #22
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    Re: Mianserin or Tolvon

    I'm out at the moment and have the report open on my laptop so will post it for later. The other you mentioned earlier wasn't listed, we probably don't use it anymore, but there was a good list. There are older public reports too, I have a link for one off those I can check. I should be able to find the total prescribing costs per med, I've linked them in the past, so we can see whether we even use the med this psychiatrist is offering. I'm thinking the OP's GP might have some success nudging them away from the most costly antidepressant to one they haven't considered that is cheaper because it is the GP who will take the repeat prescription costs later
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  3. #23
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    Re: Mianserin or Tolvon

    Hey I didn’t mean this to become a thing about the cost etc I was just saying they are cutting back on mental health and all other kinds of health problems and yes it seems silly to give a medication that costs so much if it doesn’t even work. I can’t get over trimipramine is £7,819 a year
    dosulepin 75mg is 63.44 a year
    tranylcypromine 10mg is between 243-336 for 28 tablets depending what company are making them.

    And I have rang my psychiatrist and she’s adamant to try me on these. Obviously came back with the answer just because it didn’t help others doesn’t mean it won’t help you. And if these don’t work then maybe she’ll look at something that I suggested....so now I’m stuck. Stay suicidal and depressed don’t take anything, take those she’s offered n basically waste my time n money... such a great choice!

  4. #24
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    Re: Mianserin or Tolvon

    Quote Originally Posted by beautifulfreak77 View Post
    .so now Iím stuck. Stay suicidal and depressed donít take anything, take those sheís offered n basically waste my time n money... such a great choice!
    Sigh! Medicine used to be the art of doctors amusing the patient until nature cured them...or not. Now it seems to be patients having to play along until their doctors exhaust their standard bag of tricks and start taking them seriously.

    Taking the mianserin seems to be your only option. It might surprise, but if it doesn't at least you're one step closer to getting something which is likely to.

  5. #25
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    Re: Mianserin or Tolvon

    Quote Originally Posted by panic_down_under View Post
    I'm not surprised mianserin is so expensive, Terry. The market for it must be tiny now so the cost of making it would be high, plus I suspect there may be wastage from meds reaching the use-by date unsold. Unless there is some huge market for it in an obscure part of the world that I don't know about, I really can't see why they bother. There can't be much profit in it even at 400 quid for a year's supply. Just announce production will cease in say 6 months and all patients should be switched to mirtazapine and be done with it.



    Yeah, prescribing a drug that costs 29 times as much as its claimed superior analogue isn't going to win her the Nobel prize for economics - though it might put her in the running for exchequer! The mental machinations of psychiatrists have long baffled and confounded me. I've concluded most have far more screws loose than any of their patients.

    BTW-do you have costings for dosulepin/dothiepin and tranylcypromine?
    It's as Kerry says. Prices at 02/2018:

    Dosulepin (25mg) = £0.96
    Dosulepin (75mg) = £1.21
    Tranylcypromine (10mg) = £239.94

    Prices at 04/2019:

    Dosulepin (25mg/5ml solution) = £1.61
    Dosulepin (75mg/5ml solution) = £4.88
    Tranylcypromine (10mg) = £287.07

    When prices are this high it says only one thing to me, these are artificial prices hiked up by manufacturers to discourage anyone buying them. The same has happened with others meds, as I'm sure you know all to well, and the response from bodies such as the NHS is circulars with do not prescribe written all over them.

    Sources:

    https://www.nhsbsa.nhs.uk/sites/defa...ary%202018.pdf
    https://www.nhsbsa.nhs.uk/sites/defa...ril%202019.pdf
    https://www.chemist-4-u.com/guides/pharmaceutical-advice/antidepressant-statistics-uk

    Yeah, I you are right some doctors are great at science but need management to tell them they can't do it all unless they have more funding. That and how doctors are well known to waste huge amounts of money on pointless stuff or simple waste issues that any business would be sacking people over.

    In recent years the NHS has been more proactive in changing this but it's always staggering that an organisation of this size, one of the problems actually as it hides problems all too easily, has been on his knees for decades yet it wasted so much money.
    Last edited by MyNameIsTerry; 11-08-19 at 03:21. Reason: Adjusted to correct prices
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    For free Mindfulness resources, please see this thread I have created to compile many sources together http://www.nomorepanic.co.uk/showthread.php?t=168689

  6. #26
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    Re: Mianserin or Tolvon

    Quote Originally Posted by beautifulfreak77 View Post
    Hey I didn’t mean this to become a thing about the cost etc I was just saying they are cutting back on mental health and all other kinds of health problems and yes it seems silly to give a medication that costs so much if it doesn’t even work. I can’t get over trimipramine is £7,819 a year
    dosulepin 75mg is 63.44 a year
    tranylcypromine 10mg is between 243-336 for 28 tablets depending what company are making them.

    And I have rang my psychiatrist and she’s adamant to try me on these. Obviously came back with the answer just because it didn’t help others doesn’t mean it won’t help you. And if these don’t work then maybe she’ll look at something that I suggested....so now I’m stuck. Stay suicidal and depressed don’t take anything, take those she’s offered n basically waste my time n money... such a great choice!
    Kerry, that's ok, for my part I was wondering whether your GP could use this angle in persuading the psychiatrist to look for another solution given there are meds you haven't tried yet that are far cheaper than this and it will be your GP who will be paying these huge costs at a time they are being told to cut back on them. But if you need it, you need it and I fully support that too.

    I think your GP should be working harder in this because they are still your primary care point. If there are better meds you could try then they could pick up the phone and have a discussion with psychiatrist, something many GP's reluctant to do which has always been to me!
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    For free Mindfulness resources, please see this thread I have created to compile many sources together http://www.nomorepanic.co.uk/showthread.php?t=168689

  7. #27
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    105

    Re: Mianserin or Tolvon

    Thank you both for your replies. I shall try and talk to my gp again but he doesn’t like to go against what the psychiatrist says as he says they know what they’re doing more than he does. Which I suppose is true or else I wouldn’t of been referred after trying the few that they suggest. I don’t know if he will be bothered about the Money if he thinks it’s going to help? I really don’t know. It’s not really a fair thing is it to make someone feel worse for having a tablet that costs more I’m already severely depressed I don’t really need the costs of it hanging over me and if it doesn’t work then it’s been a waste of money. Due to my anxiety and my EUPD I’m starting to overthink it all and get stressed and worrying I’m going to waste money that could be better spent...I don’t know what to do. Thanks for your help about this mysterious drug that I couldn’t find any reviews on. Maybe they don’t even make them here anymore and she’ll have to try something else.

  8. #28
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    Re: Mianserin or Tolvon

    Ian,

    You might also find this interesting. Number dispensed:

    Report to the House of Commons for 2017 = 3,834.

    https://www.parliament.uk/business/p...-07-11/163180/

    This one for NHS Scotland only financial year 2017-2018 shows 402 but at a cost of £34.68.

    https://www.google.com/url?sa=t&rct=...wEijATyOpq9eTL

    (note that an Excel spreadsheet)
    Last edited by MyNameIsTerry; 11-08-19 at 03:27. Reason: Removed incorrect comments about high pricing
    __________________
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    For free Mindfulness resources, please see this thread I have created to compile many sources together http://www.nomorepanic.co.uk/showthread.php?t=168689

  9. #29
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    Re: Mianserin or Tolvon

    Quote Originally Posted by MyNameIsTerry View Post
    April 2019 statistics - cost per year:

    Mianserin (30mg) - £400.66
    Lofepramine(140mg) - £223.73
    Nortiptyline (75mg) - £95.77

    Any thoughts on this situation now Ian given cost seems not to be the issue with this psychiatrist if they have discounted the others you guys on this thread have mentioned? I'll also point out Mirtazipine (30mg) is £13.91 per year and considering you say its the same drug this psychiatrist is possibly wasting money?
    Ian,

    Note that these were likely pre 2019 financial year prices as Mianserin is now £13.58 (10mg 28 tabs) and £30.82 (30mg 28 tabs). Mirtazipine (30mg 28 tabs) is now only £10.70.

    Something that irks me about the NHS is how it complains of expensive drugs yet doesn't tell us about the mass use of very cheap ones. Our prescription charge is now £9 per item yet look how cheap generics are. They make a profit from that charge which was always sold to the masses as a subsidised cost.

    EDIT: Apologies all, the tariff prices were in pence but it wasn't made clear in any of the tables or definitions. I've adjusted all the posts to reflect this. So, this drug isn't quite as expensive as I thought and my earlier comments about cost are incorrect however it's still more expensive than Mirtazapine which (at 30mg 29 tabs) is only £1.07.
    Last edited by MyNameIsTerry; 11-08-19 at 03:29. Reason: Adjusted to correct prices
    __________________
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    For free Mindfulness resources, please see this thread I have created to compile many sources together http://www.nomorepanic.co.uk/showthread.php?t=168689

  10. #30
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    Re: Mianserin or Tolvon

    Quote Originally Posted by beautifulfreak77 View Post
    Started on 60mg but couldnít handle it,so put me on 30mg it just made me sick still and very numb. After a few weeks I was upped to 60mg again and I just couldnít handle it,so she took me off that and has offered the mianserin...
    Kerry,

    That's a shame. Considering you have GAD the advice is to start at 30mg which is presumably because of the effect it can have on us whereas for depression only it can be started on 60mg. I think the prescriber made a mistake there but it's a shame even the 30mg wasn't easy. There could have been an element of that higher dose just rocking you badly and needing a load of time to get your anxiety levels down too but only you will know whether that is likely or whether the 30mg was inappropriate.

    I have GAD and to be honest I had a terrible time getting on this med. Knowing what I know now I would have insisted on coming off it but my GP kept insisting it was just my anxiety. I had never felt anxiety like that and ended up with a year and more far worse than before starting it.

    I hope you find something which helps. It seems you have others that could be tried, although that must make you despair at going through the rollercoaster of it all, so I hope you get some support in more than this med as it sounds like it shouldn't be the end of this. Something which annoys me about the NHS is how there seems to be such a dead end with one person like a specialist and doctors don't seem to have, or at least don't utilise, a second opinion.
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    For free Mindfulness resources, please see this thread I have created to compile many sources together http://www.nomorepanic.co.uk/showthread.php?t=168689

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