Don't feel pressurised into prescribing unfamiliar drugs


For immediate release: Monday, 29 April 2013

Doctors should not feel pressurised into prescribing unfamiliar drugs when dealing with the aftercare of patients who have received treatment abroad, says UK-wide medical defence organisation MDDUS.

MDDUS has dealt with a growing number of calls from members seeking advice on responding to requests by patients to prescribe medication recommended by overseas doctors.

Some of these medications are not even licensed in this country and, according to MDDUS medical adviser Dr Mary Peddie, doctors should treat such requests in the same way as if the recommendation came from a UK specialist. “Each prescriber takes responsibility for the prescriptions they issue,” says Dr Peddie.

“Doctors must be prepared to explain and justify their decisions and actions when prescribing, administering and managing medicines. This advice also applies to patients who purchase medicines on the internet and wish the GP or practice nurse to administer injections.

“Many of the cases we see involve patients going overseas for fertility treatment. They may find lower costs for IVF treatment or greater availability of donors in a foreign country.

“On their return, some patients want their GP to provide medication which, in the UK, is usually provided by the specialist unit. The medication recommended may not be in use in this country, or may even be unlicensed here.”

The GMC guidance requires that if a doctor prescribes on the recommendation of another doctor or health professional, he or she must satisfy themselves that the prescription is needed, is appropriate for the patient and is within the limits of the prescriber’s competence. This guidance is equally applicable whether or not the treatment is being recommended by someone outside of the UK.

One of the difficulties which can arise with recommendation from abroad is in the differing treatments and drugs used.

“We have handled cases where doctors have received patient requests for medication recommended to them in another country but the drug is either not licensed in the UK or the recommended preparation or dosage differs,” adds Dr Peddie.

Doctors must provide effective treatments based on the best available evidence. GMC guidance Good Medical Practice states: “Prescribe drugs or treatment only when you have adequate knowledge of the patient’s health and are satisfied that the drugs or treatment serve the patient’s needs.”

The guidance says that if you prescribe an unlicensed medicine, you must be satisfied that there is sufficient evidence of the medicine’s safety and efficacy and also that you take responsibility for overseeing the patient’s care, monitoring and follow-up or ensure that arrangements are made for another doctor to do so.

Doctors should not feel pressurised into working outside of their competence level. “If you do not consider that you have the appropriate knowledge and experience to prescribe a particular medicine, you do not have to do so. But you should explain your reasons for declining and explain other available options, including the option to seek a second opinion.” says Dr Peddie.


For further information contact Richard Hendry on 0845 270 2034 or 07976 272266, or email

Note to editors

MDDUS (The Medical and Dental Defence Union of Scotland) is a medical and dental defence organisation providing access to professional indemnity and expert medico- and dento-legal advice for doctors, dentists and other healthcare professionals throughout the UK. For further information on MDDUS go to

This page was correct at the time of publication. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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